Context Shoulder injuries comprise the largest proportion of swimming injuries, and a large percentage of swimmers participate with pain. Therefore, it is assumed that shoulder pain decreases performance, but researchers have not compared collegiate swimmers` performance with and without pain. Objectives (1) To determine if individual swimmers` shoulder pain and function are associated with a change in normalized swimming performance over a season, (2) to determine if differences in normalized swimming performance exist among 3 collegiate teams, and (3) to qualitatively describe and compare each team`s training regimes. Design Cross-sectional study. Setting Swimmers completed preseason (T1) and postseason (T2) surveys including pain ratings and shoulder function using the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire. Swimming times were obtained from published meet results. Coaches reported training programs through interviews and tracking logs. Patients or Other Participants Fifty-two National Collegiate Athletic Association Division III swimmers from 3 teams. Main Outcome Measure(s) Stepwise linear regression was used to determine if pain and function related to performance. Team demographics and normalized swimming performance (reduction in time per lap from season beginning to end) were compared with analyses of variance with post hoc tests. Results Initial KJOC scores, but not pain, related to individual swimming performance. Differences in team performance were found (P = .006), with Team 3 having the greatest reduction in time (1.01 s/lap), a lower percentage of females, a more experienced coach, and a periodization schedule with large increases and decreases in yardage. A main effect (P = .043) was found for baseline demographics, with Team 3`s swimmers being taller and having longer competitive experience. Conclusions The initial KJOC score predicting swimming performance improvement demonstrates the need for athletic trainers to prioritize enhancement of preseason function. Endurance training-induced hypoalgesia and motivation may explain the lack of effect of shoulder pain on performance. Further research is needed to elucidate optimal periodization and dry-land training.
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