SwimmingWhat You Should Know About Swimmer’s Shoulder

What You Should Know About Swimmer’s Shoulder

What You Should Know About Swimmer’s Shoulder

By Lianne McCluskey, Swimming World College Intern (Archived Feature)

We all know that swimmers are susceptible to shoulder injuries. Whether we have proper stroke mechanics or not, it can happen to anyone. Missy Franklin, to name one star, is an example of an elite athlete and Olympic champion who dealt with regular shoulder issues.

The title “swimmer’s shoulder” is a general term for a variety of impairments that can develop in the shoulder of a competitive swimmer. Without getting too technical, it’s helpful to understand the shoulder movement of the competitive swim strokes at a biomechanical level.

The shoulder joint is a ball-and-socket joint with movement in all three planes and around all three axes of the body. It is one of the most moveable joints, making it one of the least stable.

Swimming requires several different shoulder motions, most of which are performed during circumduction in clockwise and counter-clockwise directions with varying degrees of internal and external rotation and scapular protraction and retraction. Arm strokes are divided into two primary phases: pull-through/propulsion and the recovery.

Photo Courtesy: Bond Clinic, PA

As stated in a research study on prevention and treatment of swimmer’s shoulder by Brian J. Tovin, the shoulder complex is designed to achieve the greatest range of motion (ROM) with the most degrees of freedom of any joint system in the body. For swimmers, this means there needs to be a balance between shoulder mobility and stability.

Swimmer’s shoulder is classified as a microtrauma, a condition with a gradual onset due to repetitive activity over time. There are multiple factors that can come into play regarding the development of swimmer’s shoulder. The onset of symptoms may be associated with impaired posture, glenohumeral joint mobility, neuromuscular control, or muscle performance. Overuse, misuse, abuse or disuse over time during training may also contribute to this condition.

Intrinsic Factors

Many overhead sports such as throwing, racket sports, and volleyball require two or three overhead movement patterns. In swimming – due to the change in demands of the glenohumeral joint – impingement can occur, stressing the tendons of the shoulder. Swimmer’s shoulder most commonly presents as subacromial impingement involving the rotator cuff tendon, bicipital tendon, or subacromial bursa. Muscle fatigue is often the cause of injury in these cases; it’s not necessarily because the motion has been done improperly.


Photo Courtesy: PhysioHealth

Extrinsic Factors

Extrinsic factors are the impairments in stroke technique that contribute to the shoulder injury. A clinician must determine if the microtrauma is due to overuse, misuse, abuse or disuse in swimming. Excessive body roll with arms crossing the mid-line is a common error that leads to shoulder impingement. Lack of body roll also can cause pain, since the humerus compensates by moving into further horizontal adduction to create adequate propulsion to move forward. Excessive force of the shoulder tissue can also abuse the shoulders and lead to shoulder pain.

Hodding Carter

Photo Courtesy: Hodding Carter, current head coach at Camden Hills Regional High School.

How do we avoid and treat swimmer’s shoulder?

“I think ninety percent of the time, real shoulder issues can be avoided or treated through technique changes,” says former competitive swimmer and current swim coach Hodding Carter. Carter swam for Kenyon College and has since performed at the national level in U.S. Masters Swimming.

Hodding swimming

Photo Courtesy: Lianne McCluskey

Carter adds:

Besides trying to focus on whole-body swimming – mainly meaning core and hip timing – when a swimmer has or looks like he or she is headed toward shoulder problems, we focus on technique fixes. Many times it’s as easy as stopping a swimmer from turning his or her palms out at the beginning of the catch or similar mistakes that lead to shoulder problems.

Swimming World did a Q&A with Dr. Angela Tate on swimmer’s shoulder, where she gave her opinion and advice on the condition based on her experience as a physical therapist working with competitive swimmers.

Whether you’re training for Olympic Trials or your next dual meet, prehabilitation of the shoulder can prevent unforeseen injuries and assist in achieving optimal swimming performances.

All commentaries and research was conducted by the the author and do not necessarily reflect the views of Swimming World Magazine nor its staff.

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