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What Causes Swimmer’s Shoulder Pain and What Should I Do to Treat It?

Swimming is undeniably an activity that many people enjoy, but it wouldn’t be surprising if these people, especially athletes, start to experience body pain and shoulder pain because of it. Swimmer’s shoulder, or shoulder impingement, is what happens when swimmers aggravate their shoulders during swimming due to constantly rotating their joints.

So what causes swimmer’s shoulder pain, and what should you do to treat it? Swimmer’s shoulder occurs when the repetitive movements using the same set of shoulder muscles cause wear and tear on your shoulder, leading to muscle imbalance and joint restriction. You can treat swimmer’s shoulder by getting professional care, modifying your training, and getting physical therapy, among others.

Why Do I Get Shoulder Pain From Swimming?

Swimming is a staple during summertime, which is one of the many reasons why you must understand swimmer’s shoulder and what causes it.

Swimming is a great workout with so many benefits, but swimmer’s shoulder is one common joint injury that can occur in both recreational and competitive swimmers. An important thing to note, though, is that swimmer’s shoulder doesn’t only occur in swimmers. It’s a common condition for athletes who do repetitive movements with their shoulders, such as volleyball, baseball, and softball players. Any kind of athlete who uses their shoulder muscles in repetitive overhead motions can suffer from swimmer’s shoulder.

Since the shoulder is the most mobile joint in the human body, it permits a wide range of motion. While this may sound like a good thing, it makes it unstable because of this mobility. Overhead activities with repetitive action, such as spiking a volleyball and doing swim strokes, can cause inflammation of one’s rotator cuff. The inflammation then reduces blood flow and compresses the tendons. If this condition remains untreated, swimmer’s shoulder will cause the rotator cuff to lead to even more serious conditions.

To put it simply, repetitive strain in our shoulder joint can irritate tendon and muscle tissue. Tiny tears could develop and end up in inflammation and scar tissue. This will prevent the joint from moving smoothly. Moreover, these repetitive movements involving the same set of muscles in our shoulders can lead to muscle imbalance and joint restriction, and with this constant exertion, we could end up with swimmer’s shoulder.

While overusing the shoulder could be the main cause of this condition, you can also get swimmer’s shoulder from other factors. A previous shoulder injury, poor posture, sub-optimal stroke technique, and inadequate rest can all end up in injury.

What Are the Symptoms of Swimmer’s Shoulder?

Swimmer’s shoulder symptoms are usually mistaken as soreness, but it’ll help to know the difference between ordinary muscle fatigue and the symptoms of swimmer’s shoulder.

One sign to look out for is pain that radiates along the back of your shoulder as if it’s set in your muscles so deeply. You may also feel some pain along the front of your shoulders. If you continue swimming during a certain period, your pain could get worse. This could also be referred to as shoulder tendonitis.

Other common symptoms of swimmer’s shoulder include:

  • Reduced strength in one shoulder compared to the other
  • Increased joint laxity in one shoulder compared to the other
  • Decreased range of motion in one shoulder compared to the other
  • Localized inflammation and pain in your shoulder
  • Difficulty reaching the area behind your back
  • Change in your stroke pattern or “lazy elbow”
  • Worsening pain when lying on your shoulder
  • Pain extending from your shoulder to the neck or down your arm
  • Pain when your arm is extended overhead

If you start feeling shoulder pain while swimming, consult with a doctor or shoulder expert immediately to avoid the problem from worsening. Stop swimming and simply rest your shoulder to reduce inflammation.

Other common characteristics of this injury include the following:

  • Errors in training, such as poor stroke technique
  • When the swimmer has naturally ligamentous laxity existing with multidirectional shoulder instability
  • Inflammation of bicep and supraspinatus tendon within the subacromial muscles in your back

How Do I Treat Swimmer’s Shoulder?

Treatment for swimmer’s shoulder or impingement syndrome is usually non-surgical and involves stretches and physical therapy. However, if your impingement is severe (there are serious tears in your rotator cuff or your doctor finds nerve damage), surgical options may be needed.

Some of the ways to get the most efficient treatment include identifying the muscles or tendons involved, understanding the severity of the situation, and receiving a proper diagnosis from a professional.

Some treatments include:

  1. Resting — When you are resting from swimmer’s shoulder, take note that this means total rest, and that includes no swimming for 24 to 48 hours. Wait until there’s no more pain before you go back to swim training.
  1. Getting physical therapy — Professional passive care may include ultrasound, trigger point work, cross friction tendon massage, adjustments to your shoulder and neck, post-isometric relaxation for your involved muscles, and interferential current.
  1. Applying ice — For this treatment, directly apply ice to the shoulder after your training for about 20 minutes.
  1. Using anti-inflammatory medications — Take these meds as prescribed for a few days after your injury to lessen inflammation.
  1. Modifying your training — Swim zoomers and other kinds of fins can keep your body elevated while swimming. These equipment can help if you start experiencing small shoulder problems as you work out. Ask your coach to check your body and arm position, and ask them to take a video of your movement so you can see and discuss the stroke mechanics with your coach.
  1. Doing rehab exercises — Rehabilitation exercises can strengthen your external shoulder rotators. It’s typically said that each day you swim on a painful shoulder equates to one day of rehab.
  1. Doing swimmer’s shoulder stretches — Your posterior rotator cuff muscles, thoracic spine, and pectoral muscles are the three most common areas that have tightness or stiffness, thus requiring correcting. The following stretches can help you address them:
  • Shoulder external rotators or lats stretch
  • Thoracic spine mobility
  • Pec major stretch

Be sure to consult your physiotherapist to diagnose your injury accurately before you do these stretches.

  1. Getting physical therapy — More often than not, physical therapy is needed to recover from swimmer's shoulder. Your physical therapist will work on your rotator cuff muscles, thus releasing tension and preventing further irritation. When you’ve healed enough, they could ask you to perform customized exercises that target your rotator cuff muscles.

How Can I Prevent Swimmer’s Shoulder?

To avoid this injury, first, be sure you know the difference between ordinary muscle soreness/fatigue and serious injury. If you notice that the symptoms aren’t as normal, determine contributing factors like changes in intensity, stroke mechanics, and distances. If you identify and address a potential problem sooner rather than later, you'll have better and quicker chances of recovery.

Further ways to prevent swimmer’s shoulder are:

  1. Proper technique — Do catch and pull. When your hand gets to the water, “catch” the water with the third or fourth finger of your leading arm. It’s important that the thumb doesn't enter first because this could cause the shoulder to internally rotate.

When doing body rotations, you should rotate your body slightly to the right as your right arm enters the water. Do this as well for the left arm.

  1. Strength and conditioning — Do strengthening exercises to protect your shoulder. Be sure to also rest when your shoulder joint is starting to feel overused and tired.
  1. Careful stretching — Don’t stretch with a partner as this can be too aggressive and intense. Simply do a 5 to 10-minute warmup of your upper extremities.

What Are Other Injuries I Could Get From Swimming? 

While swimmer’s shoulder is common, it’s not the only injury you can get. Below are other injuries you could get from swimming:

  1. Neck injuries

Swimming can also lead to neck strain because of the contortion that’s involved when you keep your head above the water during a breaststroke. Neck injuries could also occur from rotating the neck to breathe while doing a freestyle stroke.

Prevent neck injuries by keeping your head aligned with your spine and the rest of your body as you swim. Don’t just twist your neck to breathe — rotate your whole body.

One treatment for neck injuries could be creating variety in your exercise routine by performing various strokes. Ask your doctor how often you can exercise and the steps you should follow.

  1. Breaststroke swimmer’s knee

The breaststroke can be a physically demanding stroke in a competitive setting. When you face your feet out when you do the breaststroke, you might impact your knee ligaments, causing inflammation, swelling, and knee pain. 

To prevent this, avoid exercises that consist of only the breaststroke. Practice other strokes and improve your hip abduction angle. Treat this injury by applying ice at least two times a day and following all preventative measures in the exercise routine approved by your physician.

  1. Swimmer’s ear

Swimmer’s ear may not be related to orthopedics, but it can be extremely uncomfortable for swimmers. It’s contracted after you swim in water with high levels of bacteria.

Treat Swimmer’s Shoulder and Get Quality Physical Therapy With AmeriCare Physical Therapy

Swimmer’s shoulder can happen whether you’re a recreational swimmer or a professional athlete. Luckily, physical therapy can help you recover and prevent any re-injury from occurring. Here at AmeriCare Physical Therapy, our physical therapists can treat your sports injuries, concussion, jaw pain (TMJ), and vertigo, among others.

We guarantee quality treatment with our staff that’s dedicated to serving you as they aim to maximize your body’s potential. Call us now or head to our website to book an appointment.

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