Glenohumeral internal rotation deficit (GIRD) in young and asymptomatic elite swimmers

J Athl Train. 2023 Dec 9. doi: 10.4085/1062-6050-0263.23. Online ahead of print.

Abstract

Context: Glenohumeral internal rotation deficit (GIRD) may affect overhead athletes and contribute to shoulder injury. The aim of our study was to assess data on passive shoulder ROM in young elite swimmers and to determine the prevalence of anatomical and pure GIRD (aGIRD and pGIRD) in a large sample size of asymptomatic elite swimmers with a new classification method.

Objective: to assess data on passive shoulder ROM in young elite swimmers and investigate possible association with anthropometric data and competitive practice routine.

Design: Cross-sectional study.

Setting: Research laboratory.

Patients or other participants: A total of 752 asymptomatic elite swimmers were by voluntary participation (391 males, 361 females; mean age, 15.88 ± 2.31 years). Passive glenohumeral rotational ROM was measured bilaterally to investigate the prevalence of aGIRD and pGIRD. Evaluations were performed with athletes at rest before any training or competition.

Main outcome measure(s): GIRD and associated aGIRD and pGIRD in elite youth swimmers by identifying a standard classification procedure.

Results: GIRD was found in 136 participants (18.1%); aGIRD was present in 28 cases (3.7% of all) whereas pGIRD was observed in 108 cases (14.4% of all). No significant differences were found regarding GIRD between sex, age, age group, years of training, breathing side and distance. Swimmers classified as pGIRD showed significant less dominant Internal rotation, Total range of motion and External rotation gain (P < 0.01) than aGIRD; conversely, aGIRD swimmers shows significant less non-dominant IR, ER and TROM than pGIRD (P < 0.01).

Conclusions: GIRD is a relatively common condition in asymptomatic elite youth swimmers; In order to not overestimate this condition, anatomical and pure GIRD have to be distinguished. While they play a role, the respiratory side, dominant limb, and crawl did not have a significant impact when facing an elite swimmer with GIRD.

Keywords: gird; overhead; shoulder; swimming; upper limb.