Swimming is a popular sport and exercise enjoyed by all ages, across varying levels of experience and ability. Swimming is a great form of exercise, combining upper and lower limb strength with cardiovascular benefits.

Even though swimming is a non-weight-bearing form of exercise, swimmers are unfortunately still prone to a range of injuries. Most swimming injuries are classified as overuse injuries, more commonly known as repetitive strain injuries.

This article will provide information about one of the most common injuries for swimmers, the swimmer’s shoulder.

What is swimmer’s shoulder?

Swimmer’s shoulder is the most common musculoskeletal injury in swimmers. It is a painful condition whereby repetitive activity of the shoulder can gradually cause microtrauma in the muscles and tendons within the shoulder. Commonly, the rotator cuff and/or biceps muscle group is affected. Due to the structural and biomechanical complexity of the shoulder, many factors relating to the variety of swimming strokes can contribute to pain and dysfunction of the joint.

The onset of swimmer’s shoulder may be due to:

Poor stroke mechanics
Poor breathing technique
Weak rotator cuff and surrounding shoulder muscles
Overtraining in frequency & intensity
Insufficient rest periods
Insufficient nutrition, hydration, and sleep

Swimmer’s shoulder can be a painfully disabling condition, affecting not only your ability to swim but also your daily life and activities. In fact, it can even have a huge impact on sleep, especially if you tend to sleep on your injured side.

The key to solving swimmer’s shoulder is to seek early assessment for a diagnosis, advice, and an exercise treatment plan. Early assessment is key to identifying the causes for swimmer’s shoulder, and a corrective rehabilitation program can be recommended to get you back in the water sooner.

However, this can take time, especially if you have been suffering with shoulder pain for a while. Chronic shoulder injuries can often persist anywhere between 3 to 12 months if early assessment and intervention are delayed.

How to manage swimmer’s shoulder

If you’re currently suffering from swimmer’s shoulder, or you believe you may be, our number one piece of advice would be to book an appointment with a Physiotherapist. The common fitness phrase ‘no pain no gain’ does not apply to this type of injury. Powering through could worsen your pain and prolong recovery time.

However, these two tips may be helpful in the interim, before your initial assessment with a Physiotherapist:

Try a different swimming stroke

If you have been performing the front crawl excessively for the past few weeks, and this has aggravated your shoulder pain, try a different stroke at a lower intensity on your next session. The aim is to find a swimming stroke that is relatively pain-free on your shoulder, allowing you to continue swimming without further aggravating your injury.

However, if you try various different swimming strokes, and each one is just as painful as the last, this is the unfortunate sign that you’ll need to temporarily stop swimming altogether to allow your shoulder some time to recover and seek the guidance of a Physiotherapist.

Increase your recovery days between swimming sessions

If you’re suffering from swimmer’s shoulder, but can carry on swimming using a less aggravating stroke, you will need to allow your musculoskeletal structures more time to recover between training sessions to avoid further injury. Generally, allowing 2 rest days after a swimming session is a good starting place to avoid chronic overuse when injured. However, your Physiotherapist will be able to advise you further once they have completed their assessment.

Swimmer’s shoulder strengthening exercises

The prevention of swimming injuries first depends on where your physical deficits lie, the risk factors in your training regime, and your swimming technique. For example, if you are swimming on consecutive days with insufficient rest, you increase your risk of developing the overuse injury, swimmer’s shoulder. Similarly, if you are weak in your rotator cuff, a group of muscles in your shoulder, this would also increase your risk of developing swimmer’s shoulder.

In your initial assessment with your Physiotherapist, they will be able to advise on the risk factors present in your lifestyle and training regime. Additionally, they will complete a full mobility, flexibility, and strength assessment to highlight any deficits which can be targeted in your exercise rehabilitation programme.

The following two exercises focus on the flexibility and strength of your shoulder which, when integrated into a full exercise regime tailored for swimmers, will help to reduce your risk of injury:

Pectoral Chest Stretch

The pectoral muscle is a large muscle in the front of the chest which inserts into the front of the shoulder. If this muscle is particularly tight, it can change the biomechanics and flexibility of the shoulder, increasing your risk of an overuse injury.

Pectoral Chest Stretch (holisticbodyworks.au)

It can be helpful for swimmers to regularly stretch their pectorals as part of a pre-swimming stretch routine. To do this:

Stand with your feet shoulder-width apart, right leg in front of the left, at the end of a wall or doorway.
Bring your arm up to shoulder level and position your palm and the inside of your arm against the wall or doorway.
Gently press your chest forwards to feel the stretch. You can intensify the stretch by moving your arm higher or lower.
Repeat on the other side.

Hold this stretch for 30-60 seconds and complete 3-5 repetitions on each side.

Rotator Cuff Overhead Flexion With Band

The rotator cuff is an integral group of muscles in the shoulder that aid overall shoulder strength, support, and stability. Weakness in the rotator cuff is a risk factor for the vast majority of shoulder injuries.

Rotator Cuff Overhead Flexion (trainingbeta.com)

It is extremely important for swimmers to have a strong rotator cuff due to the repetitive motion of the shoulder throughout the range of swimming strokes. Rotator Cuff Overhead Extension exercises are a great way to support shoulder strength.

To complete this exercise you’ll need short exercise bands. Place your hands into the band, creating tension, then slowly raise your arms directly above your head, keeping your arms straight and tension intact. Slowly lower your arms back to their original position.

Complete 3 sets of 10 slow repetitions, with a short break in between each set. This is a great exercise to complete as part of your overall strength training program, and can be performed on days when you’re not swimming to help avoid injury.

Sports Physiotherapy at Katie Bell Physio

Here at Katie Bell Physiotherapy & Wellness, we have a range of expert Sports Physiotherapists who will be able to complete a thorough history and physical assessment of your shoulder in order to identify the cause of your injury. Your Physiotherapist will then be able to guide you through a step-by-step rehabilitative programme to get you back in the water with honest, realistic, and achievable timeframes. Our Physiotherapists will use a variety of treatment techniques including exercise, sports massage, acupuncture, and other treatment techniques to aid your recovery.

How to Manage Swimmer’s Shoulder