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EL HOMBRO NADADOR

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Hola, soy un hombro nadador y voy a presentarme. Dicen que soy nadador de élite, nado 20-30 horas semanales, pudiendo dar 4000 brazadas por día1, y cerca del 90% de la capacidad propulsiva de un nadador proviene de las extremidades superiores43, donde yo colaboro mucho, y durante el recorrido de una brazada de crol me encuentro en posiciones de impingement durante el 24,8% del tiempo74,75. Viendo estos datos empiezo a comprender porqué tantos de los míos acaban lesionados o con molestias que se cronifican e impiden una vida deportiva competitiva; veo a muchos hombros nadadores quejarse, y es que el dolor musculoesquelético de hombro es el más común entre nadadores3,4,5,10,11,13,32,39,49,54,70. Entre jónenes nadadores de élite puede estar presente en el 91%54. Pero no queremos profundizar en las patologías asociadas, ya que eso podéis verlo en la entrada de blog  El hombro nadador dolorido

La natación, al igual que cualquier actividad que realizemos de forma repetida va a configurar un hombro con unas adaptaciones específicas a esta tarea, hablamos de adaptaiciones que aparecen tras muchos entrenamientos en el agua, y especialmente cuando se realiza de forma competitiva.

Adaptaciones a largo plazo:

«El resto de hombros que no nadan me ven raro, dicen que soy diferente, creo que la natación me ha cambiado…..»

Hipertrofia de la musculatura anterior del hombro4,33, debido a las excesivas revoluciones; y se ha relacionado con el dolor de hombro y la postura de hombros adelantados entre nadadoras de competición33,60. (Ver: Pectoral menor corto Imputado). La tensión sobre la apófisis coracoides en nadadores es frecuente y suele evidenciar un uso excesivo de esta musculatura y un desequilibrio habitual entre pectoral menor y serrato anterior.Recordemos que el pectoral menor se lleva la escápula a protracción realizando las tres rotaciones que disminuyen el espacio subacromial: rotación inferior, inclinación anterior y rotación interna; mientras que el serrato realiza la protracción llevando la escápula a las tres rotaciones que amplían el espacio subacomial: rotación superior, inclinación anterior y rotación externa.

Cifosis, cabeza adelantada, disminución de la lordosis cervical, escapulas en protracción y la cabeza del húmero anteriorizada y rotada internamente2,48.

Inestabilidad glenohumeral1,61,70. Algunos autores han observado un aumento en la laxitud capsular anterior e inferior21,29,73 que va a permitir más grados de movilidad en rotación externa, lo que aumenta las demandas al manguito rotador y tendón largo del bíceps para reducir la traslación superior y anterior.

La musculatura rotadora interna y aductora del hombro se hace más fuerte y más hipertrofiada que sus antagonistas19,69,71.

Aunque la natación se considera un deporte simétrico, se aprecian diferencias bilaterales al medir la fuerza rotacional en máquina isocinética8,22. (Ver: ITV Glenohumeral: Fuerza)

DRIG, aunque es estadísticamente significativo46, es muy pequeño, especialmente si lo comparamos con deportistas que realizan lanzamientos. Rienmann et al, achacan estas diferencias bilaterales a las actividades diarias y otras actividades recreacionales. Pérdida de aducción horizontal de 5,4º comparado con deportistas “Nonoverhead”25. (Ver: Historia anónima de un hombro lanzador: DRIG)

Es verdad que en determinados periodos de mi carrera deportiva como hombro nadador, tengo dolor, y debe tener algo que ver algunas de estas adaptaciones que se han explicado en esta entrada, pero os lo voy a detallar mucho más en la siguiente entrada: «El hombro nadador dolorido«.

El resto de hombros puede que me vean raro, pero me da igual…..no se dan cuenta que soy adicto al cloro, que a veces sueño que soy un delfín, y que cada vez que el agua y yo nos encontramos soy feliz.

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