Swimming is an excellent sport for people of all ages, abilities and fitness levels. As a gentle, low impact exercise it is ideal for people with injuries, or those who find other types of exercise too hard on their joints. But don’t be fooled, while low impact, it can definitely be a high intensity workout benefiting the whole body and can improve flexibility, endurance and overall body strength.
Like any activity that involves repetition, swimmers are prone to overuse injuries, particularly in the shoulders. Swimming can also put strain on the neck, elbow and knee, however the majority of complaints that physiotherapists see in swimmers are related to the shoulder.
What Exactly is Swimmers Shoulder?
Swimmer’s shoulder is a general term used for injury in swimmers, consisting of pain in the front and/or side of the shoulder. The injury is usually the result of some irritation of the tendons and other structures within the space between your shoulder blade and the head of your upper arm. If left untreated it can cause considerable pain and can lead to issues outside of swimming such as carrying things, reaching above your head and sleeping on your side.
What Causes Shoulder Pain in Swimmers?
The main causes of pain in the shoulder to be aware of are:
● Poor Stroke Mechanics
A poor swimming technique can put excessive load on the shoulder, especially in the catch position, which is where your hand enters the water to begin the underwater part of the stroke. This can be due to a weakness in the stabilising muscles, lack of flexibility or endurance, poor movement patterns or a combination of these.
● Sudden Overload or Overuse
If you suddenly increase your training load, it can put too much stress on your shoulder all at once. Like other exercises such as running, the body needs a gradual and progressive overload to build up slowly. If you are new to swimming, or haven’t swum in a long period of time, begin with one or two swims per week for a month and then add in extra swimming session or slowly increase the duration of your swim. If unsure, a swim coach or sports physiotherapist can help guide you so you build up your swimming safely.
The shoulder complex is designed to achieve the greatest range of motion of any other joint system in the body and is vulnerable to increased laxity or too much movement. This can result in the upwards and forwards movement of the humeral head (upper arm bone) against the socket of your shoulder blade.
● A Muscular Imbalance
Regular swimmers can develop an imbalance in the muscles, where the adductors and internal rotators of the arm become stronger due to the resistance in swimming. This leaves a relative weakness of the external rotators and scapular stabilisers rotators (they control the position of the humeral head in the shoulder socket) as they are not getting used as much. If this occurs, it can alter the way the humeral head moves, possibly irritating tendons and structures in the shoulder joint.
How to Prevent Swimmers Shoulder
There are definitely some preventative measures you can take to minimise the risk of shoulder pain caused by swimming.
● Build Up Your Load Gradually
As mentioned above, always increase your load gradually to prevent excessive strain on the joints and other structures. Initially, allow at least one rest day between swimming sessions and don’t rush trying to improve straight away! Spend some time focusing on your technique and endurance, and the results you want to achieve will follow.
● Improve Strength and Conditioning
As is the case with other cardiovascular exercises such as cycling or running, doing some strength work to help your muscles become stronger will stablise your joints, will help prevent injury and likely also improve your technique. For the shoulder, training that focuses on the back and rotator cuff strength will be the most beneficial. As mentioned above, the muscles at the front of our body are used a lot in swimming, leaving the muscles that oppose them weaker. So, counteract that by strengthening the back and rotator cuff. Consulting with a sports physio who has expert knowledge in shoulder physiotherapy is the best way to obtain a personalised exercise program.
● Increase Your Flexibility
Your spine must be moving optimally to prevent overload at your shoulder. Therefore, increasing your flexibility, especially of the thoracic spine or mid back and the pec muscles will ensure you have a better range of movement for your shoulder and better stroke mechanics.
Every swimmer is different so if you are experiencing pain or would like some advice before returning to the pool, book a consultation with Melbourne Sports Physiotherapy for a thorough assessment and exercise plan to suit you. They offer a variety of services depending on what your needs and concerns are – deep tissue massage, physiotherapy for back pain, soft tissue therapy and much more. They will get you swimming pain free in no time and will work with you on achieving your desired results.