Comprehensive injury prevention training significantly enhances upper limb dynamic stability and front crawl performance in adolescent swimmers: A randomized controlled trial.

INTRODUCTION

Adolescent swimmers are at high risk of shoulder overuse injuries due to repetitive upper limb movements and limited neuromuscular control during growth spurts. Comprehensive injury prevention strategies targeting the entire kinetic chain may yield superior functional outcomes compared to shoulder-focused training. This study compared the effects of localized versus comprehensive programs on upper limb dynamic stability and front crawl performance.

METHODS

Twenty-six male adolescent swimmers were randomly assigned to control (Ctrl, n = 8), local exercise (LEG, n = 9), or comprehensive exercise (CEG, n = 9) groups in an 8-week trial. The local program included shoulder-focused stretching and strengthening, while the comprehensive program added scapular stabilization, core strengthening, and integrated neuromuscular training. Upper limb stability was assessed via the Upper Quarter Y-Balance Test (YBT-UQ), and swimming performance via 50-m front crawl time and efficiency. ANCOVA adjusted for baseline scores analyzed between-group differences.

RESULTS

The CEG showed significant improvements in YBT-UQ scores in all directions for both arms (Δ = 7.6-15.3 cm; p < 0.05, η2 = 0.25-0.54), faster front crawl times (Δ = -9.6 s; 95 % CI -16.4 to -2.8), and enhanced overall performance (Δ = 15.1; 95 % CI 2.7-27.5) versus LEG and Ctrl groups. The LEG showed moderate, non-significant gains; no meaningful changes occurred in Ctrl.

CONCLUSION

Comprehensive, multi-component injury prevention training improves upper limb stability and swimming performance in adolescent swimmers. Localized shoulder exercises alone are insufficient, underscoring the need for integrative programs targeting shoulder, scapula, core, and neuromuscular coordination.