How to prevent ‘swimmers’ shoulder’
Swimmers’ shoulder is a term used to describe rotator cuff tendonitis. The rotator cuff muscles are those, which stabilize the shoulder and provide rotation of the arm inward (internal rotation) and outward (external rotation.) The term tendonitis means inflammation (-itis) in the tendinous portion of the muscle (that is the fibrous portion at the end of each muscle which attaches it to the bone). When the muscle becomes tight and short it pulls on the tendon-bone attachment and creates the inflammation.
Although it is termed ‘swimmers’ shoulder’, it can occur in any sport that involves at lot of forward or internal rotation due to the anatomy in the area. Swimmers are particularly prone to this injury in freestyle and butterfly and it is most often due to the following:
- A sudden increase in meters;
- A change in stroke mechanics;
- A stroke which is too wide or which crosses over in front;
- A lack of sufficient roll in freestyle;
- Unilateral breathing (breathing only to one side) in freestyle;
- Poor posture with shoulders rolled forward;
- Or due to other activities outside of swimming.
The swimmer will describe it as pain in the front or top of the shoulder and may have some feelings of numbness, aching or heaviness in the arm, possibly all the way down to the hand. Initially, they will only have discomfort/pain during longer Freestyle or Butterfly sets. If left to progress, eventually they will have to stop during sets and will start to have pain after swimming and gradually all of the time.
Actions to take are as follows:
- If ANYTHING hurts, ice it!!! — My Motto.
- If you are told to ice, do it*.
- Tell the coach that your shoulder is sore**.
- If you have been given stroke corrections it is because incorrect mechanics cause injuries over a lot of meters so concentrate!!!
- Stretch and watch your posture. This is important because all strokes involve rolling your shoulders forward. To counteract this, you need to stretch out the front of your shoulders and chest a few times per day. If you need examples of swimmers’ posture look around at a swim meet and see all the slumped over people-–Yuck!!!
- Chiropractic care, massage, laser therapy, ultrasound are also important especially when the pain begins interfering with workouts and post-workout.
*Attention parents! If your swimmer is younger than 13 or 14, don’t just expect them to ice it because “it’s their shoulder and it hurts so they should remember themselves.”
They have probably never had an injury before and may not even tell you or the coach until it hurts too much to swim.
In my experience, if it’s not hurting when they get home they forget about it (Just a note: adults do that, too!). I guarantee you will have to remind them or put up a schedule or both. As they progress through the swimming groups there is a huge learning curve for all things and this is part of the learning.
**Let’s talk about telling the coach. I’m talking about localized pain in one shoulder. If both your shoulders are generally tight, it is probably normal (stretch pre and post work out and get there for warm ups and warm downs as well as heating a tight muscle to relax it.) Anytime you have pain on only one side of your body or in one area there may be a problem. Don’t ignore the signs; rather take the steps listed above.
If you have any questions, ask the coach or feel free to call my office and I will return your call as soon as possible.
