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August 11, 2007

Shoulder Pain Caused by Swimmers' Shoulder

Shoulder pain is an affliction of many modern athletes.  Swimming is no exception.  Swimming typically involves a fair amount of freestyle swimming stroke.  It has been said that high level competitive swimmers will have as many as 16,000 arm rotations a week.  This activity of forward movement in the shoulder and the repetitive fashion does cause significant strain on the shoulder.  Swimming coaches and swimmers will know frequent episodes of anterior and superior shoulder pain, both during the swimming and as the process worsens throughout the day.

What is going on here?  Firstly, swimming, an excellent form of exercise and a very popular competitive sport, has to some degree some possibility for over use of the shoulder.  Over use is defined as using a body part in a repetitive way beyond which it was designed.  This stress can, at times, lead to impingement upon the superspinatus tendon, therefore, setting off a cascade that leads to full blown rotator cuff tendonitis. This condition causes significant shoulder pain.  It more frequently limits a swimmer’s training schedule due to shoulder pain. 

How are swimmers able to prevent shoulder pain caused by swimmer’s shoulder?   A few things are very helpful in understanding the anatomy of the rotator cuff.  Firstly, the superspinatus is only one of four muscles comprising the rotator cuff.  It also is the muscle that is most stressed and at times the one most warn down by repetitive use of free stroke swimming.  Swimmers need to understand that there are three other muscles of the rotator cuff that need to be strengthened.  Trying to balance out the amount of freestyle with at least increasing the amount of backstrokes when swimming will relatively strengthen some of the other three muscles, particular the infraspinatus.  Additionally, I typically recommend that swimmers include a very slightly weighted jump rope at the end or beginning of their swimming workout.  The jump rope by keeping the arms low and particularly when used in a very rapid fashion will strengthen the other three muscles of the rotator cuff.  This allows for balance within the very complex shoulder joint and specifically the structure of the rotator cuff.  This will go a long way towards helping prevent swimmer’s shoulder.  Specifically, I typically recommend the blue jump rope put out by Lifeline Fitness.  It’s called a speed/workout jump rope.   

Problems with shoulders are common with both high level and low level competitive and fitness swimming.  It is important to address this problem early.  It is important to understand that the shoulder needs balance in its strength.  Again, I recommend to my swimmers that they employ usually some increase backstroke and again I recommend using a weighted jump rope for ten minutes of jumping rope at the beginning or end of their practice. This will hopefully prevent shoulder pain, shoulder disease, and allow people to enjoy the rather incredible and unique sport of swimming which I uniformly recommend as an excellent form of low impact exercise.


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Swimming is an interesting sport. Most coaches seem to prefer the philosophy that the more laps you swim the better.

Also there is a lot of concentric muscle work and not a lot of eccentric.

I think you are right on that in order to prevent over training of some muscles while neglecting others it is important to vary your training routine e.g. the backstroke.

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