It has been estimated that up to 65 percent of competitive swimmers will experience a problem with their shoulder at some point in their careers. This is not surprising when you consider a competitive swimmer may swim 6-8 miles a day and easily hit up to one million strokes per year. Put this together with the fact that the shoulder complex is very mobile, and it is no wonder there are high incidents of overuse syndromes and other biomechanical abnormalities.
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 pathology (such as decreased range of motion, weakness, 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 a swimmer continues to work through and ignore the pain, the inflammatory response will increase and make the pain more global. This makes it harder to pinpoint a diagnosis and focus the treatment on the source of the problem.
Another important aspect of injury prevention and rehabilitation is strength and conditioning. Due to the unstable nature of the shoulder, a strong and stable scapula (shoulder blade) is a necessity. Scapular weakness can contribute to an abnormal scapulohumeral rhythm (faulty stroke) and put increased stress on the rotator cuff and biceps. Two areas to pay special attention to are the internal rotators of the shoulder and the scapular stabilizers, which have been shown on EMG studies to be more prone to fatigue in freestyle swimmers. See the exercises below for some strengthening suggestions.
One final thought to keep in mind to minimize risk of injury is to be cautious with stretching. Most swimmers are not lacking flexibility and actually have a tendency to by hypermobile. Try to avoid partner stretching, which has a tendency to be too aggressive. A gentle 5-10 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.
Hopefully, these suggestions will help reduce the chance of experiencing a shoulder injury or minimize the extensiveness of an injury
Strengthening exercises for swimmers
Protraction in 90 degrees of flexion Attempt to push arms straight up to ceiling with 0-5 lbs. while keeping back against floor and elbows straight.
Active Resistive Internal Rotation
Using tubing, and keeping elbow at side, rotate arm inward across body. Be sure to keep forearm parallel to floor.
Push-Up with Press-Up
With toes on ground, feet together, hands shoulder-width apart, and chest on floor, push up by straightening arms. Continue by pressing up shoulders and arching upper back. Return to start position with chest to floor.
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