Shoulder injuries are common in swimmers because upper body motion is used in swimming as the primary form of locomotion. A common shoulder injury seen in swimmers is called Swimmer’s Shoulder. Swimming itself requires a lot of shoulder range of motion (ROM) and flexibility. This is often associated with an undesirable increase in joint laxity or instability. Swimmer’s Shoulder is used as an umbrella term covering a range of painful overuse injuries that occur to swimmers.
The shoulder is a very mobile joint, and because it is 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 or use of hand paddles can lead to your muscles and ligaments being overworked. The driving factor of swimmer’s shoulder is hypermobility or laxity of the joint allow for excessive stress on a number of different tissues which may become painful or damaged. The other difficulty lies in the fact that there may be multiple causes of swimmer\’s shoulder. A swimmer can have a tear, tendinitis and cartilage damage occurring all at once. These injuries are all overuse or repetitive stress injuries meaning that they come from the repeated motions that a swimmer\’s shoulder goes through while at practice.
Types of Swimmers Shoulder
Since the term Swimmer’s Shoulder is used as a broad term, diagnosing a specific pathology becomes difficult. Swimmer’s Shoulder can encompass:
- Rotator Cuff Tears
- Rotator Cuff Impingement and tendonitis
- Bursitis
- Capsule and ligament damage
- Cartilage damage
- Tendinitis
Treatment
Treatment for Swimmer’s Shoulder will depend on the type of injury but since it is an overuse injury, rest is the first required treatment. While there may be other activities that can be performed, rest must be taken from the amount of strokes that a swimmer performs in a day. Continuing to practice and repeat the same motions over and over again, will only lead to a worsening of the actual condition and possibly even more conditions being caused. Physical therapy is required to treat Swimmer’s Shoulder conservatively or after surgery. A physical therapist can help modify activities to help avoid re-aggravation of the structures involved. Physical therapy will also involve strengthening the muscles controlling the shoulder. This helps to promote proper movement of the joint. Getting into a quality physical therapy program early on, the involves exercises and hands-on treatment will minimize the time that the swimmer will need to stay out of the water. In fact the swimmer can actually come back and see time drops from improving the shoulder strength and making it a stronger, more efficient joint. When an individual is ready to return to swimming, a physical therapist can assist in assessment of swimming mechanics. Ensuring that there are proper mechanics used in the swim stroke will help prevent the overuse of the muscles and irritation of the joint structures like had occurred before. Places such as Total Performance Physical Therapy will use specialized video equipment to get an underwater stroke analysis. For more information on physical therapy visit www.totalperformancept.com.
