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Swimmer’s Shoulder is Incredibly Common

Swimmer’s shoulder is a musculoskeletal injury that can result from repeated overhead movements of the arm. It is caused by inflammation and damage to the soft tissue and tendons. The injury is common in competitive swimmers but may develop in any athlete who participates in repetitive overhead motions.

Why does my shoulder hurt after swimming

The shoulder is a very complicated joint with many muscles and ligaments working together to pull and rotate the arm. Swimming is an excellent way to exercise and strengthen these muscles as the shoulder and arm are both used.

However, the shoulder is not the only area of the body that is affected by swimming. Muscle performance in the back, neck, arms, and legs also provides stability and movement during swimming.

There are many reasons swimming can cause shoulder injury, which usually attributes to a lack of range of motion or a loss of strength in specific muscles. Swimmers with poor flexibility in their shoulders will experience pain when they reach their arms overhead.

The shoulder is a ball and socket joint made up of the humerus’ head, the round ball, and the glenoid socket, which is the cup-shaped depression. This joint has a great structure that allows movement in several directions: up and down, forward and back, side to side, and from the front to the back.

Research shows that many elite swimmers have shoulder pain because of stiffness from shoulder impingement, unfortunately making it “normal” to experience pain when they reach their arms overhead.

Limited flexibility produces a lack of strength in specific muscles. For example, swimmers with tight chest muscles are likely unable to perform a streamline with ease, and this tightness can cause overcompensation with shoulder instability.

A competitive swimmer usually exceeds 4000 strokes for one shoulder in a single workout, making this sport a common source of shoulder pathology. Shoulder pain is the most common musculoskeletal complaint in swimming, with reports of incidence of disabling shoulder pain in competitive swimmers ranging from 27% to 87%.

Brian J. Tovin, DPT, MMSc, PT, SCS, ATC, FAAOMPT

It is imperative to maintain a healthy range of motion by stretching and doing exercises that increase neuromuscular control and muscle strength around the glenohumeral joint. A good rule of thumb is to stop swimming when you start feeling pain.

Symptoms of swimmer’s shoulder

Swimmer’s shoulder is an injury that can affect people who do many repetitive shoulder movements, such as swimmers or tennis players.

Under the supervision of a medical professional, inflammation of the tendons and bursa sacs in the shoulder is treated with physical therapy, anti-inflammatory medication, and cortisone shots. One treatment method is to wear a sling designed to keep the arm in a particular position to allow the inflammation to subside.

The incidence of swimmer’s shoulder has been reported to be as low as 3% and as high as 67%. When specifically defined as “significant shoulder pain that interferes with training or progress in training,” an incidence of 35% has been reported in elite and senior level swimmers.

Sherwin SW Ho, MD

The best way to avoid this injury is to use good technique when performing repetitive movements and listen to your body when it tells you that something is wrong.

How do you strengthen your shoulders for swimming

The rotator cuff is a group of muscles and tendons that hold the head of the humerus (upper arm bone) to the scapula (shoulder blade) and provide stability to the shoulder joint. 

Strength in these muscles is vital for maintaining good posture and activities such as throwing, lifting, and swimming.

More importantly, the rotator cuff muscles need to be strong to keep the humeral head in position during sudden movements or heavy lifting, which can cause the ligaments around the shoulder to stretch or tear.

Body roll in the freestyle stroke

Proper technique is essential for freestyle swimming because it’s a long-axis stroke, which means that when one shoulder is underwater–the opposite shoulder is likely above the water during a stroke cycle. This occlusion makes it a lot more challenging to see mistakes and correct them underwater.

The backstroke is also tricky because it is a long axis stroke and requires many different muscles, joints, and movements to coordinate together.

Poor stroke mechanics are a big problem with swimmer’s shoulder and can be caused by a few different things. 

One of the most common causes is improper body roll. A lack of flexibility and strength in the lower back, hips, and legs creates a technique where the swimmer doesn’t have enough rotation and momentum. 

Or a swimmer’s breath is not timed correctly during the stroke cycle. And they compensate by forcing their head to rise and arch their back.

Overuse is a classic training error that occurs in swimming as athletes typically train 10-12 hours per week in the water in addition to dry-land training. Swimmers can average 10,000 yards per day of training. The high level of repetitions, estimated at 4,000 strokes per side, that occur during training sessions, can cause fatigue, leading to the conditions discussed earlier. Modification of swim yardage may need to be emphasized if the swimmer wants to prevent progression of an injury.

Brian J. Tovin, DPT, MMSc, PT, SCS, ATC, FAAOMPT

There are a few different reasons why people don’t use proper body roll, but it’s important to remember that it’s something that needs to be worked on to avoid swimmer’s shoulder.

Making it back to full shoulder strength

Coaches and athletes monitoring their training might find it useful to know about the different scapular stabilizers and what they do.

  1. The serratus anterior helps to protract the scapula and rotate it upward
  2. the middle trapezius help to protract the scapula and hold the head of the humerus in place.
  3. The rhomboids help to retract the scapula as well as aid with stability during rotation of the arm.
  4. The lats help to adduct and medially rotate the arm and help stabilize the shoulder joint.
  5. The posterior deltoid helps with abduction and extension of the arm.

The serratus anterior is often the first to go when something is wrong with the shoulder. It is also often the most forgotten scapular stabilizer for swimmers. The serratus anterior is activated by protracting the scapula and rotating it upward.

When the shoulder is in a down position, the serratus anterior activates to help protract and rotate the scapula upward. Good movement patterns are essential for healthy shoulders.

Any overhead motion can cause problems because they create a lot of stress on the collection of muscles that help with adduction and medial rotation of the arm. Neuromuscular control is essential for a healthy shoulder.

Sports medicine for the coach

External and internal rotation exercises can help rotator cuff strength. If you are a coach, these are exercises that you should be doing as well. Training errors can cause shoulder problems as well.

If you are a coach, it is crucial to be aware of these training errors that can lead to shoulder problems and avoid them.

If you are a swimmer, strengthening your rotator cuff muscles can help protect your shoulders from injury.

Physical therapy is also beneficial for swimmer’s shoulders, especially if the pain worsens or does not subside after an extended period of time off.

Swimmer’s shoulder can be prevented by taking time to dynamically warm up before being active, paying attention to the pain level in their shoulders, proper rest, and light passive stretching after intense workouts.

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