Shoulder Treatment - Swimmers Shoulder
Welcome to the first of three articles on looking after your shoulders. The articles will provide easy to absorb information to help you keep your shoulders healthy and avoid time out of the pool. The first article takes a look at common shoulder injuries that affect swimmers.
The highly repetitive action of swimming, which primarily uses the upper body for forward propulsion can predispose swimmers to overloading and overuse injuries of the shoulder. In fact, research indicates that 40-90% of swimmers will suffer from swimming related shoulder pain.[i]
There are a range of pathologies which commonly affect swimmers. Often referred to as ‘swimmers shoulder’, they include rotator cuff impingement injuries (very common); shoulder bursitis; and bicep tendinopathy. We will take a closer look at one of the most common injuries in masters swimmers – injury of the rotator cuff.
Triggers of Shoulder Pain in Masters Swimmers
Age-related wear and tear (degeneration): Rotator cuff injury in masters swimmers is commonly an age-related injury. Typically occurring after the age of 40 and becoming increasingly more prominent as people age. Degeneration is often due to overuse and repetitive actions of the shoulder over many years. This is common in people who have participated in overhead sports such as tennis or swimming.
Over time, small tears in the rotator cuff muscles can occur, leading to weakness and functional movement issues. If the condition is not treated these small tears can lead to bigger tears becoming more problematic as time goes on. It can also lead to shoulder impingement, a painful condition whereby the tendons of the rotator cuff become impinged as they pass through the shoulder joint, causing limited movement and pain when lifting your arm (such as swimming freestyle).
Poor technique and fatigue: A significant contributor to shoulder injury is poor swimming technique. This can lead to fatigue and overload of the muscles surrounding the shoulder joint. If you are experiencing shoulder pain, it is worthwhile having your stroke looked at, you may find making a small adjustment to your stroke reduces your risk of injury.
Muscle weakness: The shoulder is a versatile, yet unstable joint. It is important for the surrounding muscles to be strong, enabling stability and function in the joint. (Specific strength exercises will be covered in a later article).
Symptoms of Swimmers Shoulder
The initial onset of shoulder pain is normally felt during or immediately after swimming. This is the time you need to assess the cause of your problem and begin early management. Other symptoms may include:
- Certain movements outside of the pool including reaching behind you, washing your hair, putting on a jacket, or placing your wallet in your back pocket.
- Location of pain: Shoulder pain from a rotator cuff injury typically presents as pain over the lateral aspect of the shoulder (deltoid). The pain can radiate down to the elbow and will be felt as more of an ache. If it’s accompanied by tingling or pins and needles, your neck may also be involved.
- Night Pain: You may experience pain at night so it is important to avoid sleeping on the affected side.
- Shoulder weakness and loss of range of movement are a factor.
I have shoulder pain when swimming, what now?
Act as soon as possible; do not have a ‘wait and see’ attitude. Shoulder injuries can hang around for a long time if left too long, progressively worsening in function and pain.
- Have your stroke looked at and corrected if required
- Make sure you have an extended, slow warm up. Your warm up may include specific mobility stretches to get you ready for the session.
- Avoid aggravating strokes (normally freestyle and butterfly)
- Avoid using hand paddles.
- If you have pain, see your therapist. They will assess the issue and provide you with an appropriate treatment plan.
Next Month: Managing your shoulder injury - How bad is it? Can I swim still? A bit about self-treatment and when to get help.
Final article: Importance of strength training for Masters athletes - why it's so necessary, how it helps, what type of strength training you need. A few simple exercises to keep you out of trouble!
[i] The practical management of swimmer's painful shoulder: etiology, diagnosis, and treatment.Bak K Clin J Sport Med. 2010 Sep; 20(5):386-90.