Preventing Swimmers Shoulder

by Jen Adley

Swimmer�s shoulder is an inflammatory condition caused by the mechanical impingement of soft tissue between the acromion and the corocoid process of the scapula (also known as the coracoacromial arch). Repetitive overhead arm motion of the freestyle stroke can cause this overuse injury, but there are ways to prevent this type of impingement.

Poor swimming technique is a major contributor to shoulder pain. If a swimmer crosses mid-line upon hand-entry, this may cause impingement of the long head of the biceps tendon. If a swimmer's hand enters the water with the thumb pointing down and the palm facing outwards, this can result in the same type of impingement. By addressing proper entry this condition may be avoided.

Over training can lead to shoulder inflammation and pain. If the swimmer continues to swim with fatigued muscles the condition may worsen. As the muscles fatigue they work less efficiently, which has two undesirable consequences. First, the muscles will have to work harder in a weakened condition. Second, the swimmer will have to perform more strokes to cover the same distance, which again overuses already fatigued muscles perpetuating the cycle. Combined these two factors can result in swimmer's shoulder.

Unilateral breathing may also cause swimmer's shoulder. Swimmers that consistently turn their heads to one side are risking shoulder pain in the opposite shoulder. This shoulder has to work harder to support forward movement with the head turned to the side. Unilateral breathing transfers this load to both arms.

Overuse of training equipment may cause shoulder pain. Using hand paddles that are too large place great strain on the shoulder muscles during the pull-through phase of freestyle. Using a kickboard with arms fully extended in front of the swimmer can place the shoulder in a position of impingement. The more often or longer the swimmer uses these devices, or uses them incorrectly, the greater the risk of shoulder impingement.

Swimmers should avoid rapid increases in training distances or frequency of training, as this is likely to over fatigue the shoulder muscles leaving them at risk for impingement and shoulder pain.

Strengthening shoulder and upper back muscles and stretching shoulder, chest and neck muscles will help to prevent a swimming posture that is conducive to impingement

Swimmer's shoulder may primarily be prevented by using proper freestyle stroke. The hand should enter the water with the tips of the fingers first and the palm facing downward. When the hand enters the water it should not cross the middle of the body. For further stroke instruction, seek the advice of an experienced swimming coach.

Jen Adley earned her BS in Biology and a Masters degree in Physical Therapy. She is a practicing board certified physical therapist for Body Pros Physical Therapy and is coaches athletes for The Sport Factory. She is licensed by USA swimming with over 10 years coaching experience. Jen has twice received an honorable mention ranking from USA Triathlon.