Swimmer’s Shoulder: Causes, Treatments, and Prevention

Swimming is an excellent full-body workout that offers so many health benefits, from improved cardiovascular fitness to enhanced muscle tone. However, frequent and intense swimming sessions can also lead to overuse injuries, one of which is commonly known as “swimmer’s shoulder.” If you’re a swimmer who has experienced shoulder pain or discomfort, you’re not alone. This condition affects countless swimmers worldwide, ranging from recreational fans to competitive athletes. But what is swimmer’s shoulder, and how can it be managed or prevented? Let’s explore the causes, treatments, and strategies to maintain strong, pain-free shoulders.

What Is Swimmer’s Shoulder?

Swimmer’s shoulder is a term used to describe a range of shoulder injuries commonly seen in swimmers. It is not a single diagnosis but rather an umbrella term for conditions like rotator cuff tendinitis, shoulder impingement, and bursitis, which are all related to repetitive overhead arm movements. These conditions can occur because of the repetitive stress that gets placed on the shoulder joints when swimming, especially with strokes like freestyle, backstroke, and butterfly. When swimmers repeatedly raise their arms over their heads, this can lead to inflammation and irritation of the tendons and muscles that surround the shoulder joint. This may cause pain, discomfort, and reduced range of motion, ultimately affecting your swimming performance.

Causes of Swimmer’s Shoulder

The primary cause of swimmer’s shoulder is overuse. However, there are additional factors that can increase your risk of developing this condition:

• Inadequate Warm-Up or Cool-Down: Skipping warm-up exercises and cool-down stretches can leave your shoulder muscles more vulnerable to strain and injury.
• Poor Technique: Using poor form when swimming can place unnecessary stress on the shoulder muscles and tendons.
• Lack of Flexibility: Tight shoulder muscles can limit your range of motion and even contribute to improper shoulder mechanics and poor technique.
• Overtraining: Some swimmers may push themselves to improve their times and endurance, but without getting enough rest, the shoulder muscles can become fatigued.
• Muscle Imbalances: Swimmers often develop strong chest and shoulder muscles, but the muscles in the back may not be as strong. This imbalance can cause the shoulder blade to move improperly, leading to pain and discomfort.

Symptoms of Swimmer’s Shoulder

Swimmer’s shoulder, also known as shoulder impingement or rotator cuff tendinitis, can cause a wide range of symptoms that may affect your performance in the pool and your overall comfort. Recognizing these symptoms early can help you prevent swimmer’s shoulder from getting worse. Here are some common symptoms of swimmer’s shoulder:

• Dull, Aching Pain: Pain from swimmer’s shoulder often starts as a mild, dull ache in the front or side of your shoulder. The pain is often more noticeable with movements like freestyle stroke, which can strain the shoulder joint.
• Worsening Pain: Swimmer’s shoulder pain typically worsens during or immediately after swimming. The repetitive motions involved in swimming can irritate the shoulder muscles and tendons, which can even lead to pain hours after their workout or the next day.
• Reduced Range of Motion: As inflammation and irritation build up in the shoulder, you may notice a decrease in your shoulder’s range of motion. This can make it difficult to lift your arm above your head, reach behind your back, or do other common actions like getting dressed or carrying objects.
• Weakness and Fatigue: Over time, the impacted shoulder may start to feel weak or easily tired, especially during strenuous swimming sessions or weightlifting exercises. Shoulder weakness can also cause muscle imbalances that put extra strain on other parts of your upper body.
• Clicking or Popping Sound: Some people with swimmer’s shoulder experience a clicking, popping, or grinding sound or sensation when moving their shoulder. While these sounds may not always be painful, they can be a sign that there’s an imbalance in the shoulder joint.
• Tenderness and Swelling: In some cases, the shoulder may feel tender to the touch, especially around the front of the joint. Swelling can also occur, making the shoulder appear slightly puffy or larger than usual. This tenderness can make it uncomfortable to sleep on the affected side.

Treatment Options for Swimmer’s Shoulder

• Rest and Activity Modification: Rest is often the first step in treating swimmer’s shoulder, especially if you’re dealing with severe pain. Continuing to swim or perform overhead activities can make your injury worse, which can ultimately delay your recovery. Instead, focus on low-impact activities like walking or cycling that don’t strain the shoulder before you gradually reintroduce swimming.
• Physical Therapy: Physical therapy is one of the most effective treatments for swimmer’s shoulder. A physical therapist can assess your shoulder mechanics and swimming technique to identify areas of dysfunction. This approach can involve soft tissue massage, joint mobilization, and targeted exercises to strengthen various muscles and shoulder stability.
• Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help reduce inflammation and relieve pain in the early stages of treatment.
• Ice & Heat Therapies: Applying ice to the affected shoulder can help reduce inflammation, numb pain, and decrease muscle spasms. After the initial pain has subsided and inflammation starts to go down, heat therapy can help with relaxing tight muscles and improving blood flow to the area.
• Corticosteroid Injections: For severe cases of swimmer’s shoulder where your pain is not relieved by other treatments, corticosteroid injections can be an option. These injections can reduce inflammation and provide significant pain relief.
• Kinesiology Taping: You can learn how to apply kinesio tape to the area to support muscles and joints without restricting your movement. This can help reduce pain, improve circulation, and provide stability to the shoulder during recovery. Taping is often used during the rehabilitation phase to allow swimmers to gradually return to training while still protecting their shoulders.
• Surgical Intervention: Surgery is typically reserved for severe cases, such as full-thickness rotator cuff tears or persistent shoulder impingement that does not respond to conservative treatments. Recovery from surgery involves a structured rehabilitation program to restore strength and range of motion.

Shoulder Exercises for Swimmers

Strengthening your shoulder muscles and improving stability can help you prevent swimmer’s shoulder. Try incorporating these exercises into your routine to help reduce your risk for swimmer’s shoulder:

• External Rotation with Resistance Bands

1. 1. Attach a resistance band to a stable surface.
   2. Hold the band with your elbow bent at a 90-degree angle and your upper arm close to your body.
   3. Rotate your forearm outward while keeping your elbow stable.
   4. Perform 2-3 sets of 12-15 reps on each side.

• Scapular Push-Ups

1. 1. Get into a plank position.
   2. Keep your arms straight and pull your shoulder blades together.
   3. Push your shoulder blades apart without bending your elbows.
   4. Repeat for 2-3 sets of 10-12 reps.

Shoulder Workouts for Swimmers

In addition to targeted shoulder exercises, incorporating these workouts can strengthen your upper body and improve your swimming performance:

Pull-Ups

• Pull-ups are a great option for strengthening your upper back and shoulder muscles, which are essential for swimming. Aim for 2-3 sets of 6-8 reps.

Lat Pull-Downs

• This exercise works like the pulling motion used in swimming strokes, which can be particularly effective for swimmers. Aim for 3 sets of 10-12 reps.

Dumbbell Shoulder Press

• Strengthens the deltoids to promote better shoulder stability. Use moderate weights for 3 sets of 8-10 reps.

Shoulder Stretches for Swimmers

Staying flexible in the shoulder muscles can help prevent injuries like swimmer’s shoulder. Try incorporating these stretches into your routine:

• Cross-Body Shoulder Stretch

1. 1. Bring one arm across your body and hold it with the opposite arm.
   2. Hold for 20-30 seconds, then switch sides.

• Sleeper Stretch

1. 1. Lie on your side with the affected shoulder down.
   2. Use your top hand to gently press your lower arm towards the floor.
   3. Hold for 20-30 seconds on each side.

• Doorway Stretch

1. 1. Stand in a doorway with your arms bent at 90 degrees, pressing against the door frame.
   2. Lean forward to stretch the chest and front of the shoulders.
   3. Hold for 20-30 seconds.

Prevention Tips for Swimmer’s Shoulder

Preventing Swimmer’s Shoulder involves a combination of proper technique, strength training, and working on your flexibility. Here are four tips:

• Focus on Your Technique: Ensure you have proper form to avoid unnecessary stress on the shoulder joint.
• Incorporate Cross-Training: Balance your swimming routine with exercises that strengthen the shoulder stabilizers, including yoga, Pilates, or weight training.
• Warm-Up and Cool-Down: Always include a warm-up and a cool-down with stretches to help you maintain your flexibility.
• Listen to Your Body: If you feel pain, stop and rest. Remember: pushing through pain can lead to more serious injuries.

Visit AICA Orthopedics for Swimmer’s Shoulder Solutions

Swimmer’s shoulder can be a frustrating condition, but with the right approach, it is manageable. Understanding what swimmer’s shoulder is recognizing the symptoms early, and implementing a combination of rest, therapy, and targeted exercises can help you stay on top of your swimming game. By incorporating shoulder exercises for swimmers, shoulder workouts for swimmers, and shoulder stretches for swimmers into your routine, you can boost your performance in the pool while reducing your risk for injury. Our team of chiropractors, orthopedic doctors, and physical therapists are here to help!