Swimmers’ Shoulder – Part III

4 Tips to Prevent and Fix Shoulder Pain associated with Swimming.

Written submission by: Carrie Viola, MPT

Swimming is a whole body sport with both competitive and non-competitive athletes found in all age groups and abilities. Swimmers can be found participating in open and masters level events, Sea Hiker swim pods, triathlon and in general recreation, fitness and rehabilitation programs. As discussed in the previous post, Anatomy of Swimmers’ Shoulder and Impingement, we know that the highly repetitive nature of swimming may predispose participants to overuse injuries, with shoulder impingement being the most frequent injury reported. The shoulder is most vulnerable to injury because unlike most other sports where the legs initiate the propulsive force, in swimming athletes primarily use their arms to propel forward potentially causing on overuse injury. More often than not, shoulder pain encountered by swimmers can be due to a number of factors.

Sometimes a tweak to your stroke technique is all that is needed to avoid developing shoulder pain and injury. If available, video analysis is a great tool that offers immediate feedback of your swim technique and the ability to identify what may be the source of your shoulder pain. The following four tips can be used to evaluate and correct your technique in order to avoid shoulder pain and injury.

1. Body Rotation

Good, symmetrical rotation is essential for injury free swimming. Your shoulders, chest and hips need to move as one unit. A flat position in the water while trying to propel forward with your stroke can cause you to cross the mid-line in the pull phase, which may predispose you to impingement of the shoulder stabilizers (rotator cuff muscles). Being able to adequately roll to both sides reduces stress on the shoulder muscles and ligaments, and allows greater lengthening of stoke powerhouse muscles (abdominal obliques, shoulder medial rotators and shoulder blade retractors) giving strength for the pull phase.

2. Bilateral Breathing

Bilateral breathing, or inhaling and exhaling to both left and right sides, provides a healthy balance to freestyle swimming by creating a more symmetrical stroke. Breathing to the same side all the time can build up the muscles on one side only, eventually creating a lopsided stroke. Repetitively doing this in a swimming session throws off your rotation and can then cause undue stress to your shoulder, resulting in injury. If you’re just starting out with swimming and you can only breathe to one side comfortably, try practicing by breathing to your left for one length of the pool and then to the right for the next length. This alternative gives you practice breathing on the side you’re not too confident with and doesn’t overwork the muscles on one side of your body.

3. Hand Placement in Water

Entering the water with the palm directed outwards and thumb first creates excessive internal rotation at the shoulder joint. After repetitively doing this during a swim session, it can lead to an acute shoulder pain or ‘over-use injury’. Enter the water with a flat hand, palm facing the bottom of the pool to avoid shoulder injury.

4. Posture

Paying attention to your posture is not only important in the workplace, but also in the water. Carrying over your poor postural habits from daily work life into the pool or open water can wreak havoc on your shoulders. As I discussed in my last article, How Poor Posture Hurts Your Shoulders for Swimming, a rounded shoulder position can create shoulder impingement, as the posture generates an excessive cross-over in your stroke. Think of keeping ‘chest forward and shoulders back’ to introduce a healthier and injury free position to your swimming mechanics. Working on strengthening muscles in the back of your shoulder, as well as stretching those in the front will help prevent shoulder injury.

If you are experiencing shoulder pain during or after your swimming sessions, consider being evaluated by a physiotherapist who can identify the underlying cause, as well as offer proper intervention strategies. My final post will discuss ‘dryland training’ exercises that will help rehabilitate and prevent common shoulder injuries with swimming.

This article was originally published on the SeaHiker blog on March 3, 2014.



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