Many swimmers will experience this condition despite proper training. Swimmer’s shoulder is a condition that results in symptoms in the front and side area of the shoulder.
Often, the onset of symptoms may be associated with poor posture, shoulder stiffness (or too much movement), lack of strength control or overtraining. In some cases, patients with swimmer’s shoulder may have irritation or tearing of the rotator cuff, long head of the biceps, or labrum.
The Therapists at Sheddon Physiotherapy and Sports Clinic are familiar with these conditions and have designed a preventative strategy (along with treatment) for these conditions.
The structure of the shoulder is designed to be both very stable by virtue of the rotator cuff tendons, the ligaments of the joint and the surrounding joints as well as mobile due to it being a ball and socket joint attached to a shoulder blade. This creates an environment that allows it to accomplish complex movement patterns.
While most overhead sports such as throwing, racket sports, and volleyball require two or three overhead movement patterns, swimming requires several overhead movement patterns, involving continuous shoulder rotation in both clockwise and counterclockwise directions.
Most shoulder conditions can be divided into macrotrauma and microtrauma based on how it happened.
Macrotrauma is a single incidence that you remember happening and results from outside forces acting on the shoulder.
Swimmer’s shoulder, on the other hand, is a condition that comes on slowly due to repetitive activity and can be classified as microtrauma.
Things Within Us That Affect It
Swimmer’s shoulder usually presents as pinching of the rotator cuff tendon, bicipital tendon, or bursa. Most impingement involves compression of these structures under the top of the shoulder.
The cause is usually a tight back of the joint pushing the ball forward in the socket and tight front muscles (slouch position).
(before and after photos using “The Posture Perfector”)
The mechanism can also occur through a series of problems (this is more common) in swimmers with loose shoulders.
The loose joint, in these swimmers, start to move excessively during the over 4000 strokes done during workouts. They compensate and cause problems at the collarbone, the upper back, the neck…etc.
Failure of the rotator cuff and the shoulder blade muscles to maintain the shoulder properly in its joint, leads to tissue damage and breakdown.
Research has shown that swimmers with painful shoulders alter their stroke subconsciously to avoid painful positions.
For example, during early pull-through, the hand usually enters the water close to the midline with the elbow above the surface of the water. The upper extremity then continues to “reach” forward below the surface of the water towards the midline of the body. In swimmers with painful shoulders, the hand enters further away from the midline with the elbow dropped closer to the surface of the water. This change is usually made to avoid the pinch position. Another adjustment occurs at the end of the pull-through phase, when the hand should be close to the thigh with rotation inward of the shoulder. In swimmers with painful shoulders, the shoulder was rotated outward and the pull-through phase was shortened to avoid impingement.
In addition to identifying the internal problems contributing to swimmer’s shoulder, we must determine if the problem is due to overuse, misuse, or disuse.
Overuse is doing a task with a frequency that does not allow the tissues to recover. OVERTRAINING – This is where good coaches make the difference.
Misuse is using improper form or equipment, which may put abnormal stress on the tissue structures. (this can be poor dryland train