How to Prevent Swimmer’s Shoulder

Swimmer’s Shoulder is a swimmer’s worst nightmare. Also known as shoulder impingement, Swimmer’s Shoulder is a common injury among swimmers where the shoulder ligaments and muscles become aggravated due to the constant joint rotation. Approximately 90 percent of all swimmer’s complaints and injuries are related to problems with their shoulders with one of the most notable being Swimmer’s Shoulder.

Swimmer’s Shoulder is an annoying injury that can last for months if left untreated. Repetitive use of the shoulder joint for long hours in the pool can lead to irritation, inflammation, tears, and scarring of the ligaments and muscles. It is a painful injury and results in a limited range of motion, affecting performance in the swimming pool.

Let’s take a look at what causes Swimmer’s Shoulder and how to prevent it.

What is Swimmer’s Shoulder?

Swimmer’s Shoulder is a musculoskeletal condition caused by the tendons in the shoulder becoming inflamed and swollen and pressing on nearby bones, muscles, or other tendons. It is also known as impingement syndrome, subacromial impingement, or painful arc, and is a common cause of shoulder in swimmers due to the constant joint rotation from swimming. It is also a common injury in athletes who use their shoulders a lot in their sport, such as baseball, cricket, softball, and tennis players.

Swimmer’s Shoulder is a common injury among swimmers.

What Causes Swimmer’s Shoulder?

Simply, overuse, misuse, or abuse of the shoulder joint. The shoulder is one of the most complex joints in the human body and is designed to permit a very wide range of motion. However, if the joint is overused, it can lead to impingement and inflammation of the muscles and tendons around the joint.

The shoulder is an extremely mobile joint and needs to be well supported by the ligaments and muscles surrounding the joint. One of these groups of muscles and tendons is called the rotator cuff, which sits under the top of the shoulder blade bone and attaches the upper arm bone to your shoulder. The rotator cuff helps lift and rotate the arm.

Shoulder impingement or Swimmer’s Shoulder occurs when the rotator cuff rubs against the top of the shoulder blade bone, known as the acromion. When the arm is lifted, the space between the rotator cuff and the acromion narrows and increases pressure. The increased pressure of the rotator cuff rubbing against the acromion irritates the rotator cuff, which leads to inflammation and impingement.

This friction or irritation causes inflammation of the tendons and muscles around the shoulder joint and can cause bone growths known as spurs to develop. These can be extremely painful if left untreated and may require surgery to remove if large enough. 

The ligaments and muscles around the shoulder joint can be overused and misused in several ways:

•         Poor technique
•         Over-training
•         Fatigue
•         Previous shoulder injury
•         Hypermobility (over-stretching)
•         Using hand paddles that are too large

If Swimmer’s Shoulder is left untreated, it can lead to labrum or rotator cuff tears, bursitis, ligament and capsule damage, and cartilage damage.

Watch this video from the Coastal Orthopedic Center in Texas on Shoulder Impingement Syndrome.

What are the Symptoms of Swimmer’s Shoulder?

The most common Swimmer’s Shoulder symptoms include:

•         Muscle weakness or fatigue
•         Reduced range of motion
•         Shoulder instability
•         Increased joint laxity than with the other shoulder.
•         Shoulder discomfort or pain

Swimmer’s shoulder is caused by overuse, misuse, or abuse of the shoulder joint. 

How is Swimmer’s Shoulder Treated?

Swimmer’s Shoulder can be treated in several ways, ranging from conservative treatments such as physical therapy and ergonomic adjustments to drastic measures such as surgery. Most people with Swimmer’s Shoulder thankfully don’t need surgery and can get by with conservative treatments, which include:

•         Rest, ice, heat, or pain medication as prescribed by a health professional
•         Ergonomic adjustments such as reducing the need for repetitive movements. This can be done by changing things like lowering shelves at home or changing the way you sit at work.
•         Steroid injections can reduce inflammation in the shoulder joint and provide temporary pain relief during the healing period.
•         Physical therapy, such as stretching, strength training, and joint stabilization exercises can help the shoulder heal. Seeing a physical therapist or sports therapist is another option for looking at strategies to prevent re-injury.

Physical therapy, such as stretching, strength training, and joint stabilization exercises can help the shoulder heal. 

How To Prevent Swimmer’s Shoulder 

Prevention is always better than cure and the risk of developing Swimmer’s Shoulder can be prevented in several ways. Here are some ways to prevent Swimmer’s Shoulder: 

•         Shoulder prehabilitation (Prehab)
•         Preseason and postseason assessment
•         Stretching and warming up before swimming or other sports
•         Avoiding repeated stress on the shoulder where possible
•         Maintaining a good posture and practicing correct body mechanics when exercising or working
•         Resting when your shoulder joint feels tired or overused

Prehabilitation

Shoulder prehabilitation (prehab) is a “pre-rehab” program of functional exercises that mobilize, stabilize, and strengthen the muscles around the shoulder joint to prevent strain on the rotator cuff and injury. Functional exercises are movement patterns that are designed to improve an athlete’s technique in a specific area of the body.

These exercises are the same as those done in rehab after an injury, but doing them before the shoulders become painful will hopefully prevent the injury from happening in the first place.  These include movements for mobility, stability, and strength that will prevent inflammation around the shoulder joint and reduce a swimmer’s risk of shoulder impingement or strain.

Shoulder prehab helps the ball and socket joint of the shoulder remain intact, which, in turn, allows swimmers to maintain a healthier posture and better swimming stroke under fatigue.

Shoulder prehabilitation reduces a swimmer’s risk of shoulder impingement or strain. 

Top Five Prehab Movements for Preventing Swimmer’s Shoulder

Here are the top five dryland exercises and movements that can be performed as part of a prehab program to prevent Swimmer’s Shoulder.

1. Unsticking the Scapula

The first prehab movement to perform would be to “unstick” the scapula bone in the shoulder. The athlete must use a band and concentrate on elevating and depressing the shoulder to allow for a greater range of motion in the swimmers’ pull strokes. This exercise also activates the stabilizing muscles around the shoulder joint.

Watch this video of this exercise performed.

2. Eldoa Stretches

Eldoa Stretches are a great exercise for loosening up the upper body and mobilizing the shoulders. There are a variety of ways to perform these stretches – watch this video to see how to execute Eldoa Stretches.

3. Supine Pulldown

The supine pulldown combines the benefits of shoulder retraction with a swim-specific pull and is an excellent exercise to do to prevent shoulder strain. In this exercise, the humorous is placed correctly into the shoulder joint. As the lats, triceps, and shoulders pull the hand to the hip, the shoulder stabilizers activate to keep the back pressed against the floor.

Watch this video to see supine pulldown exercises performed.

4. Shoulder Combo and Band

The shoulder combo and band exercise is for strengthening the shoulders to prevent injury. Once the shoulders are mobilized and able to move into an ideal position, this is the next exercise, which combines a band pull-apart with an upward and downward rotation motion. This movement offers swimmers resistance in multiple directions and builds strength in the shoulders. The thickness of the band and the distance from the band will determine the intensity of the exercise.

Watch this video to see the shoulder combo and band exercise performed.

5. Internal and External Rotation

The shoulder is designed to permit a very wide range of motion and needs to move in and out as well as up and down. This internal and external rotation exercise focuses on the rotator cuff muscles in the shoulder, which strengthens and stabilizes the shoulder joint across all planes.

Watch this video to see how to do internal and external rotation exercises.

Dryland Shoulder Stretches for Swimmer’s Shoulder

You can also loosen and strengthen the pectoral muscles, the posterior rotator cuff muscles, and the thoracic spine muscles with these simple dryland stretches. If you are already experiencing pain in your shoulder, consult a medical professional before doing these or any other shoulder-focused exercises.

1. Shoulder External Rotators Stretch / Lats Stretch

This exercise can be done lying on the floor on your back or standing next to the frame of a door. If you are standing, place your elbows by your side, bending them out at a 90-degree angle. Keeping your elbows at your side, rotate your body forwards until you feel the stretch in your shoulder in the front. If you are lying on the ground, wedge your hand under something and keep your shoulder flat on the floor.

2. Pectoralis Major Muscles Stretch / Stop Sign Stretch

Sit on the floor, extend your legs out to the side, bending your knees and keeping the soles of your feet together. Keeping your back straight, place your elbows on your knees or thighs and begin pushing towards the floor with your forearms.

Watch this video for a version of the stop sign stretch using a foam roller.

3. Thoracic Spine Mobility Stretch (with wedge/foam roller)

Lie flat on your back, bend your knees up, and place a wedge underneath your thoracic spine. Relax over the wedge – place a towel over the wedge if it is uncomfortable. If you are new to this exercise, cross your arms over your chest. If you have done this exercise before, you can place your arms behind your head. Lift your buttocks into the air while pushing upwards through your legs to stretch the upper thoracic area and keep the buttocks down to stretch the mid-lower thoracic area.

Watch this video for a variety of thoracic mobility exercises and stretches.  

Final Thoughts

Swimmer’s shoulder is an annoying and persistent injury that only gets worse if left untreated. It takes you out of the pool or off the tennis court and can take months to come right. Prevention is the best cure, so start doing those dryland exercises to strengthen and stabilize your shoulders to prevent any injuries from occurring in the future.

Happy swimming!