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What Cause’s Swimmer’s Shoulder?

Swimmer’s shoulder is complex. And like many things in life, it can’t always be explained by one specific cause. It is likely a combination of the following risk factors.

Inadequate Dryland Training

Inadequate dryland can mean two different things. Either you aren’t doing enough dryland training or the dryland training you are doing is not well rounded. If you don’t do enough dryland training, your body is less likely to handle the demands on swimming.

If your dryland program is not well rounded, you run the risk of overtraining certain muscle groups or leavingyour muscles too fatigued for your pool workouts. Both extremes can increase your risk of Swimmer’s Shoulder.

Training Error

You probably have heard the phrase “too much, too soon.” Doing too much, without the proper recovery and build up can increase your risk of developing Swimmer’s Shoulder. A common example is coming back to swimming after an extended break. Many swimmers are guilty of resuming their normal routine too quickly. Some swimmer’s come away unscathed, but for others their shoulders start to feel painful and begin to ache after a short while.

Hand Paddles

Using hand paddles, by itself, is not a risk factor. However, using hand paddles for a large portion of your workout can bring on Swimmer’s Shoulder. While using paddles can make your workouts more enjoyable, limiting how much you use them can go a long in way in preventing any shoulder injuries.

Technique Errors

If you think about how many strokes you take in the pool each swim, you quickly realize that any technique flaw can add up over time. Some of the most common technical errors I see swimmers make are lack of body rotation, crossing your midline during hand entry, and a thumb-first hand entry.

As a physical therapist who specializes in the treatment of swimmer’s issues, technique errors comprise some of the biggest risks I see for developing Swimmer’s Shoulder. Any small improvement in technique can take the stress off your shoulder while improving your performance.

What Can You Do About Swimmer’s Shoulder?

1. Fix Any Technical Errors

One of the first things I like to do with any of the swimmers I worked with is review a recent video of them swimming. Reviewing your technique allows you to look for any technical errors that may be leading to your shoulder issues. Even if you do the right stretches or exercises out of the pool, if you don’t address your technique errors in the pool, it will be much harder for your shoulder pain to go away. This makes fixing your technique a top priority.

2. Regain Full Mobility

In order to get your shoulder back to normal, addressing any tightness in the shoulders and the neck is another important step. Tightness in the back of the shoulder, muscles around the neck, and the midback are all common impacted areas in swimmer’s with Swimmer’s Shoulder. Addressing these tights spots can help you regain full mobility and help decrease pain around your shoulder.

3. Strengthen the Muscles Around The Shoulder

One of the muscles that is often weak in swimmers with shoulder pain is the serratus anterior. The serratus anterior muscle commonly becomes inhibited as a result of pain around the shoulder. In simpler terms, muscle inhibition occurs when the communication between your brain and the muscles becomes disrupted as a result of the pain in your shoulder. When a muscle is inhibited, it can’t work as well as it normally would, making it weaker.

Without addressing the serratus anterior, the rotator cuff and other muscles around the shoulder have to work twice as hard when you are swimming. This can further irritate any muscles or tendons around your shoulder. Because of this, strengthening the serratus anterior is another important focal point if you have Swimmer’s Shoulder.

The Final Touch

Once Jamie had a better understanding of the causes and treatment for Swimmer’s Shoulder we were able to create a plan for her to get back to swimming. Jamie went through exactly the steps outlined above and within a few months, she was back to swimming full workouts without any pain.

While Swimmer’s Shoulder is incredibly frustrating and can be quite intimidating, knowing what it is, what causes it, and what you need to do about it, makes it a little bit easier to deal with. Working with a healthcare professional who understands swimming, can help give you the tools you need to overcome Swimmer’s Shoulder and get back to swimming pain free.

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Alex Ewart, DPT, CSCS, is a physical therapist with extensive experience treating swimming and triathlon injuries. As a former competitive swimmer and current multiport athlete, Alex brings a unique understanding of the demands and challenges faced by these athletes. His specialized knowledge and personalized approach have helped countless swimmers and triathletes overcome injuries and regain their confidence in the water.

You can follow Alex @theswimmingpt or learn more about him at theswimmingpt.com.

References:

Nichols, Andrew W. MD, FACSM. Medical Care of the Aquatics Athlete. Current Sports Medicine Reports 14(5):p 389-396, September/October 2015. | DOI: 10.1249/JSR.0000000000000194

Bak K. The practical management of swimmer’s painful shoulder: etiology, diagnosis, and treatment. Clin. J. Sport Med. 2010; 20: 386–90.