Swimming-related shoulder accidents: A Bibliometric Analysis of International Research Developments

INTRODUCTION

Competitive swimming is among the hottest sports activities practiced worldwide, with thousands and thousands of athletes collaborating at leisure, collegiate, and elite ranges.¹ Swimming is understood to supply a number of well being advantages, together with elevated cardiovascular endurance, muscle energy, flexibility, and health.² Because swimming includes intensive repetitive actions, particularly these carried out overhead, swimmers are at important danger of overuse accidents.^3,4 One of probably the most prevalent musculoskeletal accidents related to swimming is swimmer’s shoulder,² which refers to numerous types of shoulder accidents comparable to rotator cuff tendinopathy, shoulder impingement, labral damage, and scapular dyskinesis.⁴ All of those accidents happen from the repetitive overhead movement required throughout coaching and competitors.^3,5,6 In a single coaching session, aggressive swimmers could make a number of thousand shoulder rotations, inflicting mechanical stress to the shoulder joint.⁵ The better the coaching load is, the upper the danger of ache improvement and useful dysfunction.

The prevalence of shoulder ache amongst aggressive swimmers has been considerably greater than that noticed in different athletic populations. The early research within the discipline have demonstrated that shoulder ache affected coaching and competitors in a considerable variety of swimmers, declaring the necessity for creating measures geared toward stopping accidents and treating them.^4,7 Furthermore, research have established an affiliation between shoulder ache and elements comparable to modified shoulder energy, range-of-motion impairments, and elevated joint laxity, suggesting that each biomechanical and physiological elements contribute to the event of damage.^6–8

Besides the bodily issues, swimmer’s shoulder usually results in decreased athletic efficiency and coaching days, prolonged durations of rehabilitation, in addition to attainable incapacity in the long term.³ Chronic shoulder ache in athletes can pose some psychological issues attributable to lowered participation and future efficiency considerations. Therefore, swimmer’s shoulder could be thought-about not solely as a scientific downside, but in addition as a serious one for coaches and sporting establishments.⁵ As consciousness of swimming-related shoulder accidents has elevated, so has the quantity of scientific literature devoted to understanding these situations. Recent analyses point out that analysis on swimmer’s shoulder and shoulder ache in aggressive swimmers has expanded considerably, with growing contributions from sports activities medication, rehabilitation, biomechanics, and orthopedic disciplines.^2,3,8 Despite this development, a number of vital analysis facets comparable to publication developments, influential contributors, collaborative networks, and geographic distribution haven’t been comprehensively evaluated.

Therefore, the present examine goals to conduct a bibliometric evaluation of the worldwide scientific literature regarding swimmer’s shoulder. Through an intensive examination of developments in publications, citations, authorship networks, and journals, a complete perception into the event of literature associated to swimmer’s shoulder could be achieved.

METHODS

Bibliometric evaluation is a quantitative analysis technique that examines scholarly publications to determine developments in analysis output, influential research, main authors, and contributions of nations and establishments inside a given discipline. Bibliometric strategies have been used to make sure a scientific and dependable analytical method.⁹

Search Strategy

The dataset for this bibliometric examine was obtained from the Web of Science (WoS) Core Collection, chosen for its intensive protection of high-quality literature and integration with bibliographic mapping instruments. The information discovered have been exported and examined utilizing VOSviewer, a software program software for producing and visualizing bibliometric networks. The search was carried out on April 1, 2026.

The search technique used was:

TS= ((“swimmer’s shoulder” OR “swimmers shoulder”) OR (swim* AND (shoulder damage* OR rotator cuff OR impingement”))

Literature was collected from the years 1965 to 2026. The search was carried out with out restrictions on doc sort or publication yr.

Standard bibliometric procedures have been used for information extraction.¹⁰ Search outcomes have been exported in teams of 500 as tab-delimited recordsdata of full information and cited references from WoS. This format was used to make sure compatibility with our bibliometric evaluation software program, VOSviewer.Records exported in a number of batches have been merged right into a single dataset. Author names and institutional affiliations have been standardized earlier than bibliometric evaluation. This allowed for the visualization of a number of key parameters comparable to co-authorship, co-citation, and key phrase co-occurrence.

RESULTS

The remaining Web of Science dataset included 542 publications associated to swimmer’s shoulder and shoulder situations in aggressive swimmers, revealed between 1965 and 2026.

The geographic evaluation revealed the main contributors in analysis on shoulder problems in swimmers. The United States was the main contributor with 204 publications, adopted by England (48), Australia (43), Canada (30), and Brazil (27). Other notable contributors included Spain, Belgium, Japan, Italy, China, Portugal, and Germany. Collaboration between international locations on analysis on this discipline was additionally revealed. Specifically, the United States occupied probably the most central place, with collaborative hyperlinks to England, Australia, Canada, Brazil, and a number of European international locations. Furthermore, smaller however important collaboration networks have been additionally noticed amongst international locations such because the Netherlands, Belgium, Portugal, Spain, Germany, Italy, Japan, and Poland, indicating worldwide participation however uneven world illustration.

The affiliation density visualization confirmed a number of concentrated institutional hubs somewhat than a single dominant world analysis middle. A big cluster was noticed across the University of North Carolina, Hospital for Special Surgery, University of Colorado, Drexel University, and Arcadia University. Other establishments such because the University of British Columbia, Ghent University, and Stanford University have been discovered to be important contributors, though they weren’t a part of any clusters.

The writer co-authorship community equally demonstrated a number of distinct analysis clusters. In specific, the VOSviewer visualization revealed collaborative networks round authors comparable to Tate, Hibberd, Kaneoka, Cools, Accardo, Silva, Verhagen, Barbosa, and others. In phrases of publication output, Angela Tate was probably the most frequent writer within the dataset with 11 information. Several authors, together with Ann M. Cools, Kevin Kuppens, Filip Struyf, Elizabeth E. Hibberd, Mika Kaneoka, Yuko Matsuura, and Saori Feijen, every appeared among the many best contributors with 7 information.

Publication output in analysis on swimmer’s shoulder turned extra constant after 2000, following intermittent output in earlier years. Publication quantity then elevated sharply within the mid-2010s and has continued to extend ever since. This is supported by the best annual publication rely, which occurred in 2024 with 48 information. Furthermore, the 5 most up-to-date full years (2021-2025) accounted for 179 publications, which is roughly 34% of the whole publication rely.

Figure 5 illustrates that quotation exercise adopted an analogous upward sample, rising most quickly after the mid-2010s and reaching its highest stage close to the top of the examine interval. The obvious decline in 2026 ought to be interpreted cautiously as a result of the yr was incomplete on the time of study.

Figure 6 presents a chart of the highest 20 journals and publication sources in analysis on shoulder problems in swimmers. The most distinguished journal was Physical Therapy in Sport with 24 information, adopted by Journal of Sport Rehabilitation (23), Journal of Athletic Training (22), American Journal of Sports Medicine (20), and British Journal of Sports Medicine (16). Other notable journals embody the International Journal of Sports Physical Therapy and Scandinavian Journal of Medicine & Science in Sports.

The language distribution of analysis on shoulder problems in swimmers was extremely concentrated, with 514 publications written in English. This represents 97.5% of the whole dataset. German accounted for six publications, Spanish for 3, Portuguese for two, and Italian and Korean for 1 publication every.

Table 1 signifies the highest 10 cited articles discovered throughout the swimmer’s shoulder assessment. The high cited examine was “The training-injury prevention paradox: Should athletes be training smarter and harder,” which was cited 1,189 instances. The second highest cited article was “Mechanisms of Tendon Injury and Repair,” with 442 citations, adopted by “The Relationship Between Training Load and Injury, Illness and Soreness: A Systematic and Literature Review,” with 400 citations. Most of those extremely cited articles featured points with coaching load, tendon damage, shoulder rehabilitation, impingement signs, muscle activation of the scapula, and shoulder ache amongst swimmers.

DISCUSSION

This bibliometric examine exhibits that analysis on swimmer’s shoulders amongst aggressive swimmers has elevated drastically lately. This could be seen in Figures 4 and 5, which present that there have been few publications within the late 1900s however that publications step by step elevated after the 2000s, with the most important improve occurring within the latest decade. From this commentary, swimmer’s shoulders have gotten a rising concern in sports activities medication, particularly because of swimming’s repetitive nature.^5,11,12 The rise in publications and citations additionally factors to a rising consciousness of overuse accidents and their impression on athlete efficiency, rehabilitation, and long-term shoulder well being.

Figure 4 exhibits that quotation exercise has elevated sharply lately. This signifies that analysis on swimmer’s shoulder has gained extra tutorial consideration. Improvements in sports activities medication, diagnostic imaging, rehabilitation science, and biomechanics seemingly contributed to this development by enhancing understanding of rotator cuff tendinopathy, impingement, labral damage, and scapular dyskinesis in swimmers. This improve in analysis is vital, as a result of a swimmer’s shoulder not solely constitutes an damage that causes ache, but in addition impacts coaching quantity, aggressive potential, and long-term continuation within the sport. Increased consideration within the literature additionally alerts the need of conducting analysis that will likely be dedicated to the prevention and making return-to-sport selections. This development is additional supported by Table 1, which exhibits that probably the most cited papers within the assessment include intensive literature on coaching load, tendon damage, shoulder rehabilitation, impingement signs, and scapular muscular features. Table 1 signifies that probably the most related literature on swimmers’ shoulder accidents isn’t solely about damage description, but in addition about understanding the reason for repetitive stress damage and bettering prevention and remedy approaches. This is particularly true since latest research recognized an affiliation between shoulder ache and coaching quantity, supraspinatus tendinopathy, energy imbalances, and scapular kinematic abnormalities.^5,13,14 It is obvious that the problem is the results of a number of elements, somewhat than one damage. Future analysis should comply with up with scientific, biomechanical, and rehabilitation approaches.

Analysis of geographic developments revealed a big focus of scientific manufacturing in developed international locations. Figure 1 reveals that the United States contributed probably the most within the nation collaboration community. Other international locations that additionally contributed included England, Australia, Canada, Brazil, and varied European international locations. This is most definitely the results of higher funding for analysis, extra developed sports activities medication applications, and the provision of a aggressive swimming inhabitants. Consequently, as a result of restricted participation of creating international locations, swimmer’s shoulder analysis can not absolutely cowl your complete swimming inhabitants. Research productiveness depends upon the provision of monetary assist, tutorial sources, and publication prospects, which fluctuate considerably throughout international locations and communities. As a outcome, athletes from much less prosperous areas usually are not sufficiently represented within the proof base.^15,16 Further analysis should embody wider geographical distribution, which can improve the applicability of present suggestions in numerous coaching and healthcare settings.

The figures associated to authors and establishments present that the sphere is supported by a number of lively collaborative teams somewhat than a single analysis middle. For occasion, Figure 2 highlights institutional clusters, together with universities and medical facilities which can be extra intently related throughout the analysis community. Figure 3 exhibits a number of writer collaboration clusters, indicating that swimmer’s shoulder analysis is performed by a number of teams throughout sports activities medication, rehabilitation, orthopedics, and biomechanics. However, the separation between some clusters means that stronger worldwide and interdisciplinary collaboration should still be essential. VOSviewer is predicated on collaboration patterns between authors, establishments, and publications. That is why separate clusters would possibly point out that scientific information is creating in small scientific communities somewhat than a unified world one.¹⁷ More collaboration between these teams might assist in bettering examine designs, creating various samples, and making certain relevance of the long run findings to aggressive swimmers everywhere in the world.

The findings from journal developments counsel that the swimmer’s shoulder literature is concentrated within the fields of sports activities medication, sports activities rehabilitation, bodily remedy, and orthopedics. As seen in Figure 6, probably the most frequent publication sources are Physical Therapy in Sport, Journal of Sport Rehabilitation, Journal of Athletic Training, American Journal of Sports Medicine, and British Journal of Sports Medicine. The undeniable fact that the literature on this matter is revealed primarily in these sources could be attributed to the sensible and evidence-based facet of the world. This is vital because the above fields have direct involvement within the identification of the danger elements, remedy of shoulder ache, in addition to improvement of rehabilitation and prevention applications for swimmers.^11,18 Based on this recognized journal sample, it’s seemingly that this discipline will develop additional in the direction of clinically relevant analysis that will profit clinicians, athletic trainers, bodily therapists, coaches, and athletes.

Language developments additionally reveal a big limitation within the literature. As proven in Figure 7, 97.5% of publications have been in English, suggesting that analysis in different languages could also be underrepresented or much less seen within the database. This creates potential language bias and will restrict understanding of swimmer’s shoulder analysis from non-English-speaking areas.

Additional limitations embody the usage of Web of Science as the primary database and the reliance on the search phrases “swimmer’s shoulder” and “swimmers’ shoulder,” which can have not noted associated research. Future analysis ought to broaden database protection, use wider search phrases, and promote better worldwide collaboration to reinforce world illustration and apply findings to sensible prevention and rehabilitation applications. This is particularly related because the bibliometric evaluation outcomes could differ relying on the database chosen for the aim. Language limitations are additionally important since they’ll lower the provision of the knowledge that’s related to the topic of curiosity, however solely accessible in different languages.^16,17

The predominance of orthopedic and sports activities medication journals demonstrates that swimmer’s shoulder is more and more acknowledged as a clinically vital musculoskeletal dysfunction requiring multidisciplinary administration. Future investigations ought to prioritize potential damage surveillance, standardized diagnostic standards, imaging correlations, and high-quality rehabilitation trials to enhance prevention and return-to-sport choice making.

CONCLUSION

This bibliometric evaluation reveals a big improve in scientific papers on swimming-related shoulder accidents over time, supported by substantial will increase in publication and quotation counts since 1977. Additionally, international locations such because the United States, England, Australia, and Canada emerged because the international locations contributing most to analysis on this discipline. In mixture with the invention that a lot of the analysis on this discipline considerations sports activities rehabilitation and orthopedics, these findings emphasize a brand new course in the direction of scientific functions regarding swimming-related shoulder accidents. While creating international locations are poorly represented on this discipline, future analysis ought to goal selling worldwide cooperation in addition to creating preventive and rehabilitative approaches.