Swimmer’s Shoulder

Overview

What is swimmer’s shoulder?

Swimmer’s shoulder involves tendons, tissues that connect muscles to bones. The tendons in the shoulder become inflamed and swollen, pressing on nearby bones, muscles or other tendons. Swimmer’s shoulder is sometimes called shoulder impingement, subacromial impingement or painful arc.

Inflammation usually affects the tendons of the rotator cuff (group of tendons and muscles around the shoulder joint). These tendons can pressure the acromion, the top part of the shoulder blade bone. Friction on the shoulder blade can cause bone spurs (bony growths) to develop. Swimmer’s shoulder is a type of shoulder tendinitis.

Symptoms and Causes

What causes swimmer’s shoulder?

Repeated strain in the shoulder joint irritates tendon and muscle tissue. Tiny tears develop, leading to inflammation and scar tissue. This damage prevents the joint from moving smoothly. Left untreated, swimmer’s shoulder can cause a labral tear or rotator cuff tear.

Does swimmer's shoulder only affect swimmers?

High-performance swimmers may swim up to nine miles a day, putting them at risk for overuse injuries such as shoulder impingement. But anyone who uses their shoulders to repeatedly lift or reach overhead can develop the condition. Baseball players, tennis players, construction workers and electricians are prone to shoulder tendon pain.

What are the symptoms of swimmer’s shoulder?

Swimmer’s shoulder symptoms include:

  • Muscle weakness or fatigue.
  • Reduced range of motion.
  • Shoulder instability.
  • Shoulder pain.

Diagnosis and Tests

How is shoulder impingement diagnosed?

A healthcare provider will review your symptoms and perform a physical exam. The provider may press on different areas of the shoulder to check for pain, swelling or tenderness. Your provider will also check your shoulder’s mobility and range of motion.

Imaging exams detect more serious bone or soft tissue injuries. An X-ray checks for broken bones or dislocated bones (bones knocked out of place). A CT scan or MRI reveals tendon tears.

Management and Treatment

How is swimmer’s shoulder treated?

Conservative treatments — treatments without surgery — usually relieve shoulder pain and help inflamed tendons heal. Your healthcare provider may recommend rest, ice, heat or pain medication. Other treatments include:

  • Ergonomic adjustments: Reducing the need for repetitive movements can help your shoulder. Try to change your environment at home or work. For example, move items you frequently need to lower shelves so you don’t have to reach overhead.
  • Steroid injections: Shots of steroid medication can reduce inflammation in the shoulder joint. Steroid injections provide temporary pain relief while you rest and heal.
  • Physical therapy: Stretches, strength training and joint stabilization exercises can help your shoulder heal. A physical therapist or sports therapist can provide strategies to prevent re-injury.

Will swimmer’s shoulder need surgery?

Most people with swimmer’s shoulder don’t need surgery. But surgery may be an option if shoulder pain doesn’t improve with conservative treatments. A surgeon can perform a procedure called subacromial decompression. It removes inflamed tissue and bone spurs in the shoulder.

In some cases, surgeons can take a minimally invasively approach for the treatment. During arthroscopic shoulder decompression, a surgeon makes several tiny incisions (cuts) around the shoulder. The surgeon accesses the shoulder joint using a thin, lighted tube called an arthroscope. This technique allows the surgeon to operate without a large incision.

Prevention

How can swimmer’s shoulder be prevented?

You can reduce your risk of developing swimmer’s shoulder by:

  • Avoiding repeated stress on the shoulder whenever possible.
  • Practicing proper body mechanics when exercising or working.
  • Resting when your shoulder joint feels tired or overused.
  • Stretching and warming up before swimming or other sports.

Outlook / Prognosis

How can swimmer’s shoulder be prevented?

You can reduce your risk of developing swimmer’s shoulder by:

  • Avoiding repeated stress on the shoulder whenever possible.
  • Practicing proper body mechanics when exercising or working.
  • Resting when your shoulder joint feels tired or overused.
  • Stretching and warming up before swimming or other sports.

Living With

When should I contact the doctor about swimmer’s shoulder?

Contact a healthcare provider right away if you:

  • Have pain with shoulder movement.
  • Notice swelling or bruising around your shoulder.
  • Think you have a broken or dislocated shoulder.

A note from Cleveland Clinic

Most shoulder injuries aren’t cause for alarm. You use your shoulders for a lot of activities, so occasional stiffness and soreness are natural. But if shoulder pain is affecting your quality of life or your ability to stay active, it’s time to get help. There are a range of treatments available for conditions like swimmer’s shoulder. Talk to your healthcare provider about a care plan that fits your needs.

Last reviewed by a Cleveland Clinic medical professional on 12/16/2020.

References

  • American Academy of Orthopaedic Surgeons. Shoulder Impingement/Rotator Cuff Tendinitis. (https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis) Accessed 12/22/2020.
  • American Chiropractic Association. Shoulder Impingement: The Keys to Dealing With Swimmer’s Shoulder. (https://www.acatoday.org/News-Publications/ACA-News-Archive/ArtMID/5721/ArticleID/140/Shoulder-Impingement-The-Keys-to-Dealing-With-Swimmer-Shoulder) Accessed 12/22/2020.
  • Tovin BJ. Prevention and Treatment of Swimmer’s Shoulder. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953356/) North American Journal of Sports Physical Therapy. 2006;1:166-175. Accessed 12/22/2020.
  • /2020.Chaudhury S, Fox AJ, Rodeo SA, Wanivenhaus F. Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435931/) Sports Health. 2012; 4:246-251. Accessed 12/22/2020.

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