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. 2025 Jul 10;17(1):193.
doi: 10.1186/s13102-025-01200-8.

Does corrective exercises influence the performance, posture, range of motion and shoulder pain of swimmers with upper crossed syndrome? randomized clinical trial

Hossein Rezaei  1 , Mahdi Gheitasi  2 , Seyed Mohammad Hosseini  1
Affiliations

Does corrective exercises influence the performance, posture, range of motion and shoulder pain of swimmers with upper crossed syndrome? randomized clinical trial

Hossein Rezaei et al. BMC Sports Sci Med Rehabil. .

Abstract

Background: This study sought to evaluate the effect of corrective exercises on forward head angle, forward shoulder angle, thoracic kyphosis degree, range of motion, and shoulder pain in elite front crawl swimmers presenting with upper crossed syndrome.

Methodology: In this quasi-experimental study, 30 professional male swimmers aged 20 to 40 years (mean ± SD age: intervention group = 28.85 ± 6.49, control group = 27.66 ± 6.19) were randomly assigned to experimental (n = 15) and control (n = 15) groups. The experimental group underwent an eight-week corrective exercise program alongside their regular training. Assessment measures included photogrammetric analysis for forward head and shoulder posture angles, flexible ruler for thoracic kyphosis quantification, visual analog scale for pain evaluation, handheld chronometry for record assessment, and goniometer goniometric measurement for range of motion evaluation. After confirming normal data distribution using the Shapiro-Wilk test, Mixed ANOVA was used to assess the effects of the intervention at a significance level of 0.05.

Results: The analysis revealed significant improvements in forward head posture (P <.001), rounded shoulders (P <.001), thoracic kyphosis (P <.001), shoulder range of motion (P <.001), and pain levels (P <.001) in the intervention group. However, no significant differences were found in performance measures such as swim record (P >.386) and stroke rate (P >.630).

Conclusion: Corrective exercises were effective in improving postural alignment, range of motion, and shoulder pain symptomatology, but did not significantly affect swimming performance. These findings suggest such exercises are more effective for addressing postural and clinical concerns. Further research using longer or varied protocols is recommended to explore potential performance outcomes.

Trial registration: Clinical trial code: IRCT20240306061185N1, registered at the Iranian Registry of Clinical Trials on 08/03/2024.

Keywords: Elite swimmer; Shoulder pain; Upper crossed syndrome.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Research Institute of Physical Education and Sports Sciences of Iran (Code: IR.SSRC.REC.1402.294). All participants provided written informed consent to participate in the study. We certify that the study was performed in accordance with the 1964 Declaration of Helsinki and later amendments. The research’s informed consent document clearly communicates the study’s purpose, procedures, risks, benefits, and rights to participants. Participants are informed that data will remain confidential, and their participation is voluntary. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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