Swimmer's Shoulder

Autor: RAFAŁ CZEPUŁKOWSKI
Consultation DOMINIK SOJAK
Date added 25.12.2024
Date of last revision 25.12.2024

Table of contents:

The shoulder is one of the most complex joints in the human body, and its anatomical structure allows for a very wide range of motion. Swimming is a sport where flexibility and a large range of motion can significantly impact performance. Training in water is excellent for the whole body, enhancing endurance, strength, and cardiovascular fitness. Although it rarely negatively affects the musculoskeletal system, there is one condition that occurs quite frequently among both recreational and professional swimmers: swimmer's shoulder.

Table of contents:

Swimmer's Shoulder - Causes

Shoulder pain is the most common orthopedic issue among swimmers, affecting 50-80% of these athletes. Swimmer's shoulder, commonly referred to as painful swimmer's shoulder syndrome, is associated with repetitive adduction and internal rotation movements of the shoulder joint, which occur during freestyle (crawl) and butterfly strokes. Competitive swimmers cover over 10 km daily in training, resulting in thousands of arm rotations. When combined with warm-ups, dry-land training, and daily activities, these factors lead to gradual, overload-induced damage to the anterior part of the glenoid labrum, resulting in stretching of the joint capsule and subsequent anterior subluxation of the joint.

It is worth noting that swimmer's shoulder does not occur exclusively in swimmers. Anyone who repeatedly lifts or reaches overhead may develop this condition. In sports, volleyball and tennis players, and in professions, construction workers and electricians, are prone to shoulder pain.

Swimmer's Shoulder - Symptoms

The initial symptoms of swimmer's shoulder are often mistaken for muscle soreness after intense training, so it is important to distinguish between fatigue symptoms and overload-related injuries. The main symptom is shoulder pain that appears while swimming, especially after the arm is extended and internally rotated during the water pull phase at shoulder height. In swimmer's shoulder, functional instability of the shoulder joint leads to damage to the anterior part of the labrum, which may become frayed or even completely torn and displaced into the joint, while maintaining the function of the rotator cuff and other joint structures, such as the long head of the biceps tendon.

Symptoms of Painful Swimmer's Shoulder Syndrome:

  • Shoulder pain
  • Muscle weakness or fatigue
  • Reduced range of motion
  • Signs of shoulder instability
  • Pain during overhead arm movements
  • Increasing pain when lying on the affected shoulder
  • Tenderness

Diagnosis of Swimmer's Shoulder

To properly diagnose shoulder pain that does not resolve on its own and negatively impacts training performance, sleep, or daily activities, an orthopedic consultation is recommended. The doctor will conduct a physical examination to assess pain, swelling, or tenderness and perform appropriate tests. They will also evaluate muscle strength, mobility, and the range of motion in the shoulder. Based on the results, further imaging diagnostics may be ordered, such as X-rays, ultrasound, MRI, or CT scans, to rule out anatomical causes, including bone, joint, muscle, or tendon injuries, as well as damage to ligaments or the rotator cuff.

Treatment of Swimmer's Shoulder

Swimmer's shoulder is most often treated non-surgically. The first step is to relieve acute symptoms. Since the clinical picture typically includes pain related to inflammation, initial treatment may involve ice packs, anti-inflammatory medications, and manual therapy techniques performed by a physical therapist to strengthen the shoulder and restore mobility. Postural dysfunctions caused by chest muscle tightness and thoracic spine stiffness are common issues. It is also necessary to address joint stiffness, excessive joint mobility, and weakened strength and endurance of the rotator cuff. The primary goal of swimmer's shoulder treatment is to restore proper muscle balance through exercises. Shoulder strengthening can begin with isometric exercises, followed by dynamic strengthening in various positions. Resistance can be applied using resistance bands or weights. A strength and conditioning coach can assist in selecting appropriate exercises.

Athletes often need to modify their training programs. Reducing the distance swum in a single session or the frequency of training can be beneficial. Changing training patterns to reduce repetitive stress on the shoulder may also help eliminate muscle imbalances. Consulting a swimming coach can be very helpful. The doctor may also recommend rest and advise reviewing ergonomics for repetitive movements at home or work, such as placing frequently used items on lower shelves to avoid overhead reaching. Most people diagnosed with swimmer's shoulder do not require surgery. However, surgery may be necessary if shoulder pain persists despite conservative treatment. A surgeon can perform shoulder arthroscopy, allowing for the removal of the pain source. The surgical technique is tailored to the individual patient.

Swimmer's Shoulder - Prevention

  • Avoid repetitive overhead movements that overload the shoulder
  • Practice proper body and shoulder mechanics during training
  • Rest when symptoms suggest the shoulder joint is "tired"
  • Stretch and warm up properly before swimming
  • Engage in general fitness training
  • Ensure proper recovery

Related Articles:
Learn about other possible shoulder injuries and conditions.

References:

Autor
RAFAŁ CZEPUŁKOWSKI
RAFAŁ CZEPUŁKOWSKI

Specjalista do spraw content marketingu, dziennikarz sportowy i medyczny. Redaktor naczelny magazynu „Poradnik Zdrowie i Sport”, członek Dziennikarskiego Klubu Promocji Zdrowia, współtwórca wielu artykułów medycznych z zakresu ortopedii i urazowości w sporcie.

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Konsultacja merytoryczna
DOMINIK SOJAK
DOMINIK SOJAK

Lekarz w klinice Rehasport, specjalizuje się w ortopedii i traumatologii narządu ruchu z ukierunkowaniem na staw kolanowy, skokowy i barkowy. Pasjonat sportu, szczególnie sportów walki i piłki nożnej. Licencjonowany lekarz PZPN opiekujący się piłkarzami Lechii Gdańsk.

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