Content reviewed and contributions made by Sarah Kate Peterson, PT, DPT, SCS
Swimming is popular for many reasons. Both competitive and recreational swimmers alike recognize the benefits swimming has to offer. Not only does each session in the pool result in a whole-body workout but the fact that it is low-impact exercise makes it a life-long activity. However, even though swimming is considered a low-impact activity it does not mean that it comes without potential injuries. One such injury is “swimmer’s shoulder”, which is often described as pain over the front of the shoulder during and/or after workouts. It is a condition experienced by both competitive and recreational swimmers.
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Swimmer’s Shoulder Causes
The causes for swimmer’s shoulder are nuanced and vary by individual. Aside from swimmers performing large repetitive motions at the shoulder joint, there are several other factors that contribute to a swimmer developing shoulder pain including:
- Poor stroke mechanics
- Overtraining and lack of recovery
- Insufficient motor control
- Lack of muscle conditioning in the core, shoulders, hips and other areas in the body
One or more of the above factors may lead to shoulder pain. There are, however, preventive measures athletes can take to help safeguard against this potential problem.
Swimmer’s Shoulder Prevention Tips
Like any sport, continually building strength and mastering technique will aid in injury prevention. Swimming is no different – improving your breathing, maintaining posture and body rotation and practicing your stroke and kicking techniques will all help prevent future injuries. While these improvements are best made under the eyes of a coach, swimmers can also take proactive safety measures.
ATI swimming experts, Sarah Kate Peterson, PT, DPT, SCS, and Erica Cromwell, PT, DPT, work regularly with competitive athletes, parents and swimming coaches. They outline the following recommendations for shoulder health:
- Swim no more than 60,000 yards per week.
- If a swimmer begins experiencing shoulder pain, it is encouraged to cut mileage in half.
- Notify coaches and parents of condition to track progress.
Other measures can be taken by properly strengthening the body and stretching before jumping in the pool.
Strength Training for Swimmers Shoulder Prevention
Several important strengthening exercises swimmers include Y + T + I’s, “No Moneys” (i.e. resisted external rotation), planks and squats. Performing each of these exercises allows you to develop strength in the shoulders, core muscles and legs. Also, since swimming is an endurance sport, it is encouraged to use lower resistance/weights and higher repetitions for all exercises.
Y’s + T’s + I’s
If possible, it is suggested to use a stability ball, lay over a workout bench or do one arm at a time over the side of a bed when completing these movements. If none of the above options are available, you can complete these exercises lying on your stomach on a mat or the floor.
Complete 2-3 sets of 10, keeping your shoulder away from your ear. Work your way up to 3 x 20 reps with no weight before holding a water bottle or a can (approximately 1 pound).
Y’s: Lie on your stomach with your arms out in front of you, keeping your arms as close to your ears as possible. Together, raise your arms a few inches off the floor with your palms facing the floor at all times. Pause and then lower your arms to the starting position.
T’s: While still on your stomach, move your arms so they are directly out to the side. Your body should resemble a “t”. With your palms facing the floor, raise your arms slightly off the ground and squeeze your shoulder blades together. Pause before lowering your arms to the starting position.
I’s; Begin in the same position, lying on the floor. This time your arms should be at your sides with your palms facing up towards the ceiling. Squeeze your shoulder blades together and then raise your arms as high as possible. Hold the position momentarily before lowering your arms.
“No Moneys” (Resisted External Rotation)
You will need a piece of Theratubing to perform this exercise. Theratubing, is rubber tubing that is available at most sporting goods stores, online or through your local physical therapist.
- Stand at attention with your elbows at your sides and bent to 90 degrees with band in hand.
- From this position, gently “pull apart” your band until you feel resistance, keeping your arms parallel with the floor.
- Work up to 3 x 30 second holds before increasing the resistance or completing a 3 x 1:00 hold.
Front Planks
1.Lie on the floor with your elbows and forearms on the ground. Your shoulders should be directly over your elbows and your feet perpendicular to the floor.
2.Engage your core (i.e. keeping your muscles as tight as possible) and then push up onto your elbows and toes, maintaining a flat back and butt.
3.Complete 3 sets, each 30 seconds each to start. You may increase your time as you progress.
If holding this position is too difficult, you can begin with your knees on the ground and then gradually work your way onto your toes.
Squats
- Position your feet shoulders width apart with your feet at approximately a 45-degree angle.
- From this position, shift your weight towards the front of the heel/mid-foot to maintain proper balance. NOTE: You want to avoid your weight being too far back on your heels or on your toes, which will put unwanted pressure on the knees.
- Begin your descent, as if sitting down on a chair. Keep your chest up and knees in line with your big toe. Avoid allowing the knees to cave inward or the heels to leave the ground.
- Lower your hips until your thighs are parallel or just above parallel with the ground, depending on your level of flexibility.
- Push through the middle of your feet to standing.
- Complete 3 sets, 10 repetitions each.
As you develop your squat, you can work other variations including dumbbell(s) or a barbell.
Exercises to Avoid For Swimmer’s Shoulder Prevention
In terms of strength training, it is recommended that swimmers avoid exercises such as push ups, bench press and other forms of overhead lifting. Swimmers already put tremendous strain on their shoulders during regular activity, and performing these exercises, especially with weight, can put additional, unnecessary strain on the shoulders.
Stretches for Swimmers
In addition to regular strength training, swimmers are encouraged to properly warm up prior to entering the pool. Below are two of the most recommended stretches for swimmers.
Prayer Stretch
- Begin on your hands and knees and then sit back towards your heels, bringing your chest towards the floor.
- Extend the arms as far as possible overhead.
- Complete 3 repetitions, holding each repetition for 30 seconds.
Doorway Stretch
- Begin in a standing position in the middle of a doorway.
- With your elbows bent, place your forearms on the side of the doorway at a 90-degree angle from your sides.
- Keeping your shoulders relaxed, gently step forward until you feel a slight stretch in your shoulders.
- Hold this position for 30 seconds and complete 3 repetitions.
As with any kind of exercise program, it is crucial to properly warm up and cool down to guard against injury.
Physical Therapy for Swimmer’s Shoulder
Even with all the proper precautions, injuries can still occur. Peterson and Cromwell suggest that it is time to seek treatment if you are regularly missing practice, taking medication prior to swimming, altering your stroke/swim technique and/or racing less efficiently.
If you or someone you know is experiencing regular shoulder pain because of swimming, the experts at ATI are here to help. They have the knowledge and skills to help get you back into the pool.