Contributor: Hollie Heisler, PT
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It’s been estimated that up to 65 percent of competitive swimmers will experience a problem with their shoulders at some point in their careers. This is not surprising when you consider a competitive swimmer may swim six to eight miles a day and easily hit up to 1 million strokes per year.
Put this together with the fact that the joints that comprise the shoulder are very mobile, and it’s no wonder there are high incidents of overuse syndromes and other biomechanical abnormalities.
Avoiding swimmer’s shoulder
So how do you avoid such an injury, often generically referred to as swimmer’s shoulder? One of the most important things for every athlete to know is the difference between normal muscular soreness and fatigue vs. early symptoms of serious injury, such as decreased range of motion, weakness and pain.
If the symptoms seem abnormal, try to determine any contributing factors such as changes in intensity, distances, or stroke mechanics. The sooner a potential problem is identified and addressed, the better the chance for a quicker and healthier recovery.
Remember, you need to pay attention to your body. If you continue to swim in order to work through and ignore the pain, your inflammatory response will increase. This will make it harder to pinpoint a diagnosis and focus the treatment on the source of the problem.
The role of conditioning
Another important aspect of injury prevention and rehabilitation is strength and conditioning.
Due to the unstable nature of the shoulder, a strong and stable shoulder girdle (meaning the muscles within and surrounding your shoulder) is a necessity. Shoulder girdle weakness can contribute to a faulty stroke, and put increased stress on your rotator cuff and biceps.
Two areas to pay special attention to are the internal rotators of the shoulder and the scapular stabilizers. The internal rotators are more prone to fatigue in freestyle swimmers, as electromyogram studies that measure the electrical activity of muscles at rest and during contraction have shown.
One final thought to keep in mind to minimize risk of injury is to be cautious with stretching.
Most swimmers do not lack flexibility and actually have a tendency to be hypermobile. Try to avoid partner stretching, which has a tendency to be too aggressive. A gentile five to 10-minute upper extremity warm-up should be enough to increase blood flow and prepare the muscles for a workout.
Occasionally a swimmer may develop some tightness in the posterior shoulder capsule that can be a source of pain. A clinician, athletic trainer, or physical therapist should assess this area if pain persists.