Beacon Orthopaedics: Proper Swimming Technique Helps Avoid Shoulder Injury

Swimming is often called a "perfect exercise," but that doesn't mean there aren't injury risks.

What is Swimmer’s Shoulder?

As with “tennis elbow” hurting non-tennis players, swimmers are not the only ones who get the dreaded “swimmer’s shoulder” diagnosis. Anyone’s shoulder muscles and tendons can become inflamed and painful because of overuse or poor technique. Very simply put, when an athlete’s muscles in front of the shoulder overpower those in the back, he or she can develop swimmer’s shoulder. For the non-medical person, that’s the rotator cuff, the group of muscles and tendons which hold the upper arm (humerus) in the shoulder (scapula). If those muscles grow tired or the athlete uses incorrect technique, the joint can become slack and then, the bones move incorrectly and can injure soft shoulder tissues. This is when the pain and inflammation occur. And it doesn’t take a doctor to know that pain and inflammation are bad. 

We often hear that swimming is the “perfect exercise” because it is aerobic, is non-weight-bearing, uses many muscles simultaneously and is low-impact. And that is all true. However, whether a swimmer or not, caring for the shoulders before they become painful is important to overall health. For example, a shoulder rotates about 10 times when swimming 25 yards of “front crawl” (freestyle). That means that for a moderate 50 lengths workout, each shoulder rotates about 500 times. Multiply this by a few swim sessions per week, and you see that it quickly adds up. A low-impact exercise regimen – even swimming -- needs to be informed by a thoughtful and personal training plan that helps you reach your goals without putting too much strain on your rotator cuffs.

Causes for Swimmer’s Shoulder

You don’t have to be Michael Phelps or Katie Ledecky to get swimmer’s shoulder. So, what causes swimmer’s shoulder for world-record-holders and non-Olympians, alike?

•    Incorrect technique
•    Over-training
•    Training volume sudden increases
•    Training intensity sudden increases
•    Unbalanced strength training 
•    Overzealous stretching

Prevention

Knowing all of this, how should the weekend warrior protect that rotator cuff – in and out of the water? Of course, not all injuries can be prevented, but if possible, an athlete should seek to use correct technique. Doing repetitive motion in a healthy way (whether for sports, yard work or work) is important. The doctors and physical therapists at Beacon Orthopaedic & Sports Medicine say you should avoid over-training or purposefully over-tiring your muscles. Yes, getting and staying in shape is a good goal, but ignoring pain is never a good model. 

It’s also important to work with professionals when devising a healthy and meaningful workout. That experienced input will help the novice avoid sudden increases in amount or intensity of the shoulder-stressful workouts, while maintaining a meaningful workout.

Keep your training regimen balanced. That means spreading out what parts of the body you train, how hard you work each and how often you do so. For instance, swimming especially strengthens your chest muscles and the shoulder’s internal rotators. Those then become stronger but also shorter than their antagonists. To compensate for this, you should stretch the chest and the shoulder’s internal rotators and strengthen the scapular stabilizers and the shoulder’s external rotators. Stretching some muscles and strengthening others is just one example of smart workout management. Be smart when you jump in the pool. Your body is a system and system’s require wise maintenance to stay in good working order.

While you are keeping up with your body’s required maintenance. Be sure to do the things that still make sense. Eat healthfully. Drink a lot of water. Exercise responsibly. And do not ignore your body’s “early warning system” -- pain.