How to Finally Fix and Prevent Swimmer’s Shoulder

Michael Butler
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Fixing and Preventing Swimmer’s Shoulder – It Starts with Posture

Have you ever been swimming and began to feel some pain on the top of your shoulder as you hit your stride? It’s possible that you or someone you know has a pain disorder caused by prolonged swimming called swimmer’s shoulder.

Swimmer’s shoulder – also known as swimmer’s syndrome – is most common in competitive swimmers and triathletes who swim regularly, but it can occur in any athlete with high overhead motions, such as baseball pitchers and tennis players.

There are a few different reasons why you or someone you know may be experiencing swimmer’s shoulder. The pain is not only a result of the joint being misaligned or out of the socket, but can be caused by the muscle imbalances around the joint.

Swimmer’s shoulder is a condition that results from too much time spent in shoulder impingement – a biomechanical situation in which the tendons of the rotator cuff muscles and the biceps tendon rub and irritate against the shoulder joint.

Sleep on your back.

The gentle arch of the lower curve of your neck helps eliminate the strain your head places on your shoulder. It balances the workload between the back and front of the shoulder.

Improve your t-spine mobility.

Your shoulder blades should be pulled back, so that your ribs don’t protrude forward. Without this posture, your shoulders will attempt to compensate by protruding forward. This may cause them to roll forward, which may allow your shoulder joint (glenohumeral joint) to be exposed and vulnerable. You may experience pain, especially when your arms are in the forward position (for example during the crawl stroke in swimming).

That’s because swimmers’ shoulder is usually caused by poor posture and weak muscles in the upper back. You can also experience shoulder pain if you have tight or stiff muscles, weak shoulder stabilizers, or poor coordination.

So how do you improve your posture? Here’s how I was taught to correct my posture.

Slouch (see below for the right way to slouch) Place your hand on your upper back so that it rests in between your shoulder blades. This will allow you to pull your shoulder blades back slightly. Adjust your posture so that your hand stays in between your shoulder blades, and pull back. You may need to work up to this level of back strength. Practice this several times a day. Once you are strong enough, you won’t need to touch your back to maintain your posture and your shoulders will be back in a good position.

Improve scapular stability.

Improving overall shoulder stability is the first step in fixing and preventing swimmer’s shoulder.

Shoulder stability refers to the joint position, muscle length, and muscle strength of the shoulder as a whole. The glenohumeral joint (shoulder) is a ball and socket joint. What most people don’t know is that it is also one of the most unstable joints in the body.

This makes it very susceptible to overuse injury of the rotator cuff muscles, biceps tendons, and labrum.

To improve shoulder stability, you have to first increase shoulder muscle length, and strengthen the muscles around the joint. You can also do proprioceptive exercises to improve joint position.

Some of the best shoulder stability exercises involve resisted external rotation (REX) movements. They include:

Abduction = Using resistance to pull your arms out to the side.

Adduction = Using resistance to pull your arms back down to your hips.

External Rotation = Using resistance to pull your arms back behind your torso.

And here’s a great rotator cuff exercise:

Internal Rotation = Using resistance to pull your arms in front of your torso.

Strengthen your rotator cuffs.

While the rotator cuffs are commonly injured, they are also simple to prevent. By strengthening your rotator cuffs through a daily routine, you can help to prevent them from becoming injured in the future.

Each shoulder is supported by four rotator cuff muscles. These muscles surround the shoulder area and provide support and stability while you’re moving your arms in various directions.

Keeping these muscles healthy and strong should be a key priority for anyone who is an avid swimmer. Unfortunately, swimmer’s shoulder is very common in this group.

One of the most common ways that people injure their rotator cuffs is from regular wear and tear associated with repetitive movements. Swimming makes it easier to develop rotator cuff issues because a large portion of swimming is done with the arms, and the swimming stroke puts a lot of repetitive pressure on the shoulder area.

The basic rotator cuff routine should include the following:

  • 90 Degree Internal Rotation
  • 90 Degree External Rotation

Swim with perfect technique.

Practice your strokes frequently. Include flip turns and underwater kicking into your drills.

Don’t swim too much.

Allow yourself a good warm up before you begin a session.

Wear a supportive swimsuit and swim in a suit that fits as close as possible without restriction.

Stretch your back and shoulders after each session.

Add in upper body strength training to build upper body and shoulder strength.

Rest as a response to injury or excessive training.

Address and fix breathing problems.

Make pre-hab routine.

Swimmer’s shoulder is the bane of all swimmers, especially those who do a lot of laps in the pool.

It can affect any swimmer of any age and is caused by several factors: poor technique in the water, awkward movement, repetitive motions of the arms, a poorly fitting suit, particularly a wetsuit that’s too tight or too loose (beware, some locker room attendants are notorious for wearing ill-fitting wetsuits because they often keep one leg zipped up and the other leg unzipped to maintain the proper temperature. Leave your wetsuit on for the entire length of time so you can check for fit while you’re in the water…don’t be a sucker for the quick change).

The good news is that swimmer’s shoulder is a relatively easy condition to fix and it’s possible to avoid it in the first place. There are several things you can do to prevent and to treat it.

Figure out what the cause is and take the appropriate measures to address it. For example, if you’re using an ill-fitting wetsuit, switch to a suit with better water resistance.

Ensure you perform proper stretching and strengthening exercises to keep your shoulder healthy.

In Summary

Swimmer’s shoulder is caused by repetitive overuse from common swimming motions including the freestyle crawl stroke and backstroke.

Frequent therapy and rest are the best ways to prevent and treat a case of swimmer’s shoulder.

An injured swimmer’s shoulder can be treated with physical therapy and rest.

An injured shoulder can be less painful when resting and taking a break from swimming.

A physical therapist can help harness the body’s natural healing power.

Swimmer’s shoulder can be painful and disabling. If you suffer from swimmer’s shoulder …

You’re probably not enjoying your swim workouts.

You’re probably not enjoying your swim workouts. You are probably in pain when lifting your arm outward.

You are probably in pain when lifting your arm outward. You think it is only going to get worse, never better.

So what’s the cure? Prevention and treatment. And a physical therapist can help. If you’ve been to a few athletic trainers or doctors and they’ve recommended cold therapy, rest, and anti-inflammatory medication for shoulder pain, take action.