Understanding swimmers shoulder; 5 exercises that can improve shoulder function and reduce the risk of pain and injury.

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Swimmers' shoulder develops after many hours of practice without adequate recovery time.   It is typically not seen in casual swimmers but is often considered to be a problem of overuse or is it?

What is swimmers' shoulder?

According to Wikipedia; "The most common type of injury individuals associated with swimming is pain felt within or around the shoulders, most commonly known as swimmer's shoulder. However, while this type of injury may be the most well-known injury there are also a few other common injuries associated with swimming. These include knee problems also known as Breastroker's knee and lower back pain also known as Butterfly swimmer's back." Read more here. The truth is, swimmers' shoulder often encompasses the function of the core muscles, which includes the gluts, the erector spinae, quadratus lumborum, the pelvic floor, the diaphragm, and to a smaller extent, the abdominal muscles.  Looking at the shoulder, and ignoring the lower parts of the body including a person's stance and the way they walk is setting them up for failure.   According to Wikipedia, there are other conditions associated with swimming such as swimmers back and breaststrokers knee, that result from distortion of the core, poor accommodation of the muscle and fascia in the core, and a rolling forward of the shoulders which results in impingement in the shoulder girdle muscle, most commonly the supraspinatus. Treating swimmer's shoulder often involves working on the tightened fascia in the core muscles which will pull the shoulder forward and can cause impingement with each stroke, as the tendon of the supraspinatus grinds in the grove it goes through into the humerus.  The fascia surrounds the muscles and other tissues and is what guides movement, not the muscles themselves. Our office employs methods such as myofascial release since this improves movement and firing patterns to the shoulder girdle and the core, improving flexibility and power which translates into faster swim times as we improve body efficiency. What every competitive swimmer ultimately wants is a faster time with the same amount of effort.  This ultimately is what wins races, along with conditioning and good technique. The supraspinatus is important because it initiates the abduction movement through the first 60 degrees.   When the shoulder is pulled forward, the fascia surrounding the scapula will also tighten, as well as the joint capsules in the shoulder which all inhibit proper movement and can cause pain.  A muscle called the subscapularis (located under the armpit) is the main stabilizer of the shoulder that will often become dysfunctional as scar tissue is created by the repetitive movement required by swimming.  Adhesions at the subscapularis destabilize shoulder movement and cause the other muscles in the shoulder to malfunction and tighten with additional training, eventually resulting in a loss of power and pain from impingement.  This is the mechanism behind the classic swimmer's shoulder, rather than the swimming itself, although high-level athletes will swim through pain anyway until something breaks.  The good news is that with the right guidance, we can avoid many of these injuries even during seasons with high levels of training with proper advice and seasonal management. What was just described is just the shoulder involvement, but what about the lower body as well?   Treating a shoulder problem while ignoring compensations in the lower body can result in poor treatment outcomes since a poorly functioning core will again tighten the shoulders, and cause lower back and knee problems as well.  A thorough evaluation is important to fully understand and diagnose why the pain exists and to get the shoulder and the body working properly.

What can a competitive swimmer do by themselves?  5 simple exercises you can do to improve shoulder function while you swim.