Swimmers Shoulder

Jonathan Hersch, M.D. { Orthopaedic Associates USA }

Researchers estimate that up to two thirds of all competitive swimmers will experience shoulder pain at some point in their careers. Older, recreational swimmers also experience shoulder pain, but usually for different reasons. All these folks are usually labeled with experiencing "swimmer"shoulder. However, the way in which competitive or recreational swimmers find relief depends on the nature of their pain.

Competitive swimmers develop shoulder pain because they have extreme shoulder joint flexibility called laxity. This comes in training an average of 60 miles per day, which causes repetitive stretching to the shoulder joint. Freestyle, butterfly, and backstroke are particularly stressful. Although a key to successful swimming performance is to have greater than normal shoulder flexibility, there's a point at which point to the shoulder joint can become unstable. With instability, structures around the shoulder (most often the rotator cuff tendons) can become pinched or rubbed, leading to irritation with inflammation and pain experienced during and after activity. These conditions are known as tendonitis or bursitis.

Help with these athletes begins with temporarily modifying their training routines to remove some of the excessive stresses to their shoulders. This can mean decreasing mileage, alternating strokes or changing techniques. Icing injured shoulders after practices is crucial. In some cases of persistent soreness, a doctor may prescribe anti-inflammatory medications. Rehab focuses on improving the strength around the shoulder joint to provide better balance and stability. A physical therapist or athletic trainer can identify which muscles need selective strengthening. In general, most of the swimmers need improved control of the shoulder blade and increased rent or some portion of the rotator cuff. The solution for these athletes is usually not increasing shoulder flexibility. Any stretching that causes discomfort to the shoulder should be avoided. A gentle, five to 10 minute warm-up should be enough to increase circulation to the extremities and prepare the muscle to work out.

Older, recreational swimmers develop painful shoulders for very different reasons. Many take up the sport in their retirement years and have shoulders that are not flexible or stock off. As we get older, we lose range of motion in the most of our joints -- the shoulder and shoulder blade are no exceptions. Shoulder inflexibility can lead to faulty stroke habits with overhead portions of strokes. Trying to compensate for that in flexibility irritates the shoulder structures. The answer for these athletes is to improve the overall flexibility and strength of their shoulders. A sports medicine professional can quickly find areas around the shoulder that need improved flexibility and strengthening, and can teach simple exercises that can be done at home.

The bottom line is this: shoulder pain does not have to limit anyone who wants to participate in swimming at any level. Never ignore shoulder pain that develop swimming -- it will only get worse overtime. The sooner intervention is begun, the quicker the shoulder pain will leave and swimming can resume at your pace. Good luck and stay fit!