Swimming is one of the most populous recreational and sporting activities within Australia.
Swimmers shoulder is the most common injury seen in the competitive swimmer. It is a blanket term used to describe pain swimmers feel in and around the shoulder, temporally related to the act of swimming. It can involve the muscles, tendons, ligaments and any other pain producing structure around the shoulder.
Swimmers shoulder can affect swimmers of either sex, any age and can be found in the dominant or non-dominant shoulder. Pain can be felt during any part of the swimming stroke, during any stroke and at any distances of training.
Most shoulder pain in swimmers is caused by instability stemming from the demands specific to swimming. Instability is a term that is used to describe a joint that has too much movement and lacks steadiness. Unstable joints are often more prone to injury.
Swimmers need a large amount of movement in their shoulders to swim fast. They also need to be very strong in the muscles that push their arm through the water. Swimming training is very physically demanding as it involves prolonged, fatiguing, shoulder intensive training. These demands combined improve a swimmers performance, yet simultaneously reduce shoulder stability.
The human body is able to compensate for some instability through different structures around the shoulder (eg. muscles / ligaments etc). However, the body’s ability to compensate instability is finite. When the body is no longer able to compensate the degree of instability, subluxation of the shoulder joint can occur. This involves the head of the humerous moving out of the shoulder socket. Repeated subluxation can lead to unnatural stresses placed upon the tissues about the shoulder. This results in inflammation and pain. Pain can then lead to altered biomechanics which in turn leads to further instability and contributes to further subluxation. Persistent inflammation causes scarring and / or hypertrophy of the affected tissues. This can then act as a mechanical irritant and the whole problem is perpetuated.
Early diagnosis and management of shoulder pain can prevent swimmers from developing a serious pathology, enduring unnecessary pain and requiring an extensive amount of time out of the pool. Any sign of pain in the shoulder could be an early sign that swimmers shoulder is developing. If you feel any pain in the shoulder when swimming you should see your LASP Physiotherapist immediately to accurately diagnose the injury and commence appropriate treatment.
Diagnosis and management of swimmers shoulder should be made by a trained professional, such as a sports physician or physiotherapist. Initial treatment generally involves RICER and the use of anti-inflammatory medications to help settle symptoms. Biomechanical assessment and correction is needed and an intensive rehabilitation program (strengthening and stretching) will provide the swimmer with the best chance of a successful return to sport. Coaches also play an important part of the rehabilitation process as they are able to analyse the swimmers stroke and make appropriate alterations.
The best treatment for swimmers shoulder is prevention. A biomechanical assessment and physiotherapy screening of a competitive swimmer before a problem arises could prevent the swimmer developing shoulder pain and losing time in the water. LASP Physiotherapists are trained to screen swimmers for possible risk factors that may predispose a swimmer to developing swimmers shoulder. We recommend that swimmers are screened annually to prevent any problems such as swimmers shoulder developing when they could be avoided.Contact your LASP Physiotherapist for more information on (02) 4647 3373.