Swimmers shoulder is a vague term covering a range of painful shoulder overuse injuries that occur in swimmers.The average collegiate swimmer performs 1 to 2 million strokes annually with each arm. Over 1/3 of top level swimmers experience shoulder pain that prevents them from normal training. 90% of complaints by swimmers that bring them to the doctor /physiotherapist are related to shoulder problems.
The pain in the shoulder can be anything from a local pain near the shoulder joint, to a spreading pain that travels up your shoulder and neck or down into your arm. Being an overuse injury, it is caused by repeated trauma rather than a specific incident.The shoulder is a very mobile joint, and being so mobile, it needs to be well controlled by the muscles and ligaments that surround the joint. Over-training, fatigue, hypermobility, poor technique, weakness, tightness, previous shoulder injury can lead to your muscles and ligaments being overworked. If this goes on, injuries such as hyperlaxity, scapular dyskinesis, subacromial impingement, labral damage, suprascapular nerve entrapment, or glenohumeral rotational imbalances occur.
CHARACTERISTICS OF SWIMMER’S SHOULDER
- Inflammation of the supraspinatus and biceps tendon within the subacromial space leading to a shoulder impingement syndrome.
- The onset of symptoms is often associated with altered posture, glenohumeral (shoulder) joint mobility, neuromuscular control, or muscle performance.
- Training errors such as overtraining, overloading, and especially poor stroke technique may also contribute to this condition.
- However, all swimmers develop muscle imbalances where the adductors and internal rotators of the arm over-develop (due to the nature of swimming). This leaves a relative weakness of the external rotators and scapular stabilizers as they don’t get used as much. Consequently, this muscle imbalance overuse and/or poor technique results in an anterior capsule laxity causing an irritation/impingement.
PHYSIOTHERAPY ASSESSMENT AND TREATMENT
Your physiotherapist will check and assess your posture, range of motion, muscle strength and will do a detailed biomechanical assessment. The treatment varies from individual to individual. At Heal Institute, we personalize a special treatment programme depending upon patient’s symptoms. A common approach of treatment is to release the tight muscles. Research has proved that myofascial release leads to reduction in the pain level of the patients. Depending upon the cause, we would also start with stretching exercises for the tight muscles and strengthening exercises for the weak muscles.
The common principles for the treatment are:
- Increase thoracic spine mobility
- Improve Scapular Stability
- Strengthen your rotator cuff muscles mainly work on your external rotators and abductors of the shoulder joint
- Matzkin E, Suslavich K, Wes D – Swimmer’s shoulder: Painful shoulder in competitive swimmer, Journal of the AAOS. August 2016 volume 24 issue 8
- Edward J, Weldon MD, Richardson MD, Allen B. – Upper extremity overuse injuries in swimming: a discussion of swimmer’s shoulder. Clinic in sports medicine volume 20 issue 3, 1stjuly 2001 page 423-438
- PT Marilyn M. Pink, MD James E. Tibone ,The painful shoulder in the swimming athlete, Orthopedic clinic of North America Volume 31, Issue 2, 1st April 2000, Page 247-261
- Bak , Claus MD – The practical management of swimmer’s painful shoulder: Etiology, Diagnosis and Treatment, Clinical journal of sports medicine, September 2010, Volume 20, Issue 5, Page 386-390