Member Case Study: Swimming Shoulder Pain

author : AMSSM

comments : 1

Most swimmers who develop shoulder pain do so because of relative rotator cuff and shoulder blade muscle strength deficiencies.

Question from Cbarnes

I am experiencing shoulder pain mostly in the left shoulder but a little in the right too.  The pain is located in the far outside area and slightly to the rear of the larger muscle. It seems to have started a few months ago as I began to add to my swims. I have avoided the use of paddles and have worked to correct my swim stroke, I keep a high elbow, I no longer cross over on the pull. A contributing cause may be that I run very tight in the upper body and have not been able to achieve a relaxed gait. The pain is there most of the time always in the morning and sometimes during the swim itself.
Thanks
Clifford

Answer by Robert J. Johnson MD 

Member AMSSM

You’ve made appropriate modifications in your swimming stroke. Nevertheless, most swimmers who develop shoulder pain do so because of relative rotator cuff and shoulder blade muscle strength deficiencies. Just as repetitive running training can result in overload to running muscles, the same problem can occur in the swimmer’s shoulder muscles. Most typical strength training programs of the bench press, military press, lat pulls, biceps curls, etc., fail to adequately strengthen the muscles of the rotator cuff and the shoulder blade stabilizing muscles.

The shoulder blade is the site of origin of the muscles of the rotator cuff and serves as the base for all overhead shoulder function. Exercises to strengthen these two groups of muscles are not difficult to perform. The rotator cuff and shoulder blade stabilizing muscles respond well to low resistance, high repetition programs. Typically these exercises focus on (but are not limited to) middle and lower trapezius, rhomboids, lower aspects of the latissimus dorsi, and serratus anterior muscles.

I encourage you to meet with a physical therapist to learn these exercises; then, perform them three to five times a week. Symptoms usually improve within 3-4 weeks. As long as the shoulder pain is not increasing, it is okay to continue your swimming training.

Robert J. Johnson MD
Director, Hennepin County Primary Care Sports Medicine Fellowship

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date: April 11, 2007