Swimming with shoulder pain

Swimming is a fantastic sport for people who suffer from injuries like knee pain and back problems. It's one of the few sports that don't require significant strain on your various muscle groups or joints. It's one you can do well into your golden years. But what do you do when swimming caused your injury? Some swimmers believe they need to stop swimming due to injuries, but this isn't true. Even with shoulder problems or issues with legs, ankles or back, you can modify your workouts to fit. This will benefit you in the long run because you will stay fit, continue to have good feel of the water and actually help reduce your recovery time. 

I always like to share this story with young swimmers about an experience I had growing up. When I was 7, I was swimming, trying out waterpolo and playing a few other sports that involved rotating my shoulder forward continuously. Then one day, I woke up and couldn't lift my right arm. It had essentially fused in place. I could lift it forward, backwards, sideways, up or down. It was one of the scariest moments of my childhood. Thankfully, my mother got me with a doctor quickly and we got the referral for physiotherapy right away. But it was over 6 months of hard work to bring my shoulder back to having full range of motion. It's also continued to plague me off and on over the course of my swim career. Never quite as bad but still to the point of having to stop using my arm for a particular practice. Once even in the middle of a 200 backstroke race. 

The one thing though that stayed consistent during this traumatic experience for me was that I continued to swim. My coach and I worked on modifying the daily workouts to fit my recovery and technical needs. I spent a large portion of this time kicking or doing one arm drills. Needless to say, that all those kick sets made my legs extremely strong and helped shape the type of swimmer I became.

Types of Shoulder pain

A lot of swimmers suffer from shoulder problems throughout different parts of their careers. But not all shoulder problems are the same. In fact, the causes of this pain aren't the same either. For instance, you can have pain on the top part of your shoulder and that is usually something that you don't need to worry too much about. This one is usually related to overuse and fatigue. A weekend off or a few days of slightly easier workouts should be enough to fix this issue.

The next more suffer case of shoulder pain stems from rotator cuff issues. This includes impingement or tendonitis, rotator cuff tears, bursitis, capsule and ligament damage, or cartilage damage. All can have various degrees of pain to a swimmer. The pain usually feels like a severe pinching sensation in the front of the shoulder between the chest muscle and the humerus bone. It's usually very acute.

The third feels like and can be diagnosed as one of the rotator cuff issues mentioned above, but actually has very little to do with the shoulder. This is the one I'm most familiar with and conscious of in my swimming. A lot of shoulders tend to hold a lot of stress within their trapezius, especially through the upper parts around the neck. This tension through your neck can get so tight that it can feel like acute rotator cuff pain. This can also easily be misdiagnosed by doctors and physiotherapists. The treatments I've seen work for this pain have included improved posture and head position in the water, releasing the tension through massages and light neck stretches. Definitely talk to your physiotherapists about appropriate stretches to relieve the pain.     

In-water causes and prevention

If you are suffering from shoulder problems, try these 4 approaches that will change your stroke and release the tension put on your shoulders. The first correction is body rotation. By developing a symmetrical body roll, you'll be executing on a bilateral breathing pattern. Swimmers without a bilateral breathing pattern tend to swim flatter in the water. This limits the rotation along the long axis of the spine causes the arms to swing around the side during the recovery phase. This swinging action results in significant amounts of internal rotation at the shoulder joint which is a major source of impingement and rotator cuff issues. 

The next is hand placement. Maybe swimmers, especially swimmers growing up in the sport prior to the 2000s, will suffer from this taught technique. We were all taught to enter thumb first, rather than having a flatter hand entry. The reason this was taught was that it was believed at the time that the pull in Freestyle should be a sweeping motion that created a question mark or "S" shape in the water. By entering with your thumb first you could achieve this movement much quicker than if your hand was placed differently. It has since been discovered that by entering fingertip first with a flat hand will help prevent the acute pain from overuse.

Swimmers aren't known for having great posture. This is usually compounded with poor daily work/school life. Poor posture can lead to impingement, often through a severe cross over at the front of the stroke. It's never too early or too late to work on flexibility in your shoulder and chest muscles. Doing this together with improved stabilisation of the muscles at the back of the shoulder can help improve posture and removes cross-over at the front of the stroke. A good rule of thumb to think about while you swim is shoulders back, chest forward. This will help improve your alignment and posture meaning that you will be able to generate more power in the pull phase of your stroke. The reason is that you'll be applying more propulsion straight backwards rather than downwards.

Shoulders Back, Chest Forward

Finally, the catch and pull can play significantly into shoulder injuries. This is an area of mystery for a lot of swimmers. It's the one area that feels one way but can look completely different. You can really only get the full picture of your stroke through underwater video analysis. The typical mistakes swimmers make include dropping the elbow or have an extremely straight arm pull. By doing either of these things, the swimmer is putting significant load on their shoulders as the majority of their pull is being used to push downwards. Work on having a high elbow catch with an enhanced posture will help you utilize the larger more powerful muscle groups like your back and chest.  

Wrapping Up!

Shoulder pain and issues should never be taken lightly. The pain can range in severity and treatments. If you start to feel any sort of pain in your shoulders, be sure to talk to your coach immediately. The treatment might be some simple changes to your stroke technique or it might be something a bit more that requires a physiotherapist's help. Never keep this pain to yourself. You could be shortening your swim career if you do. Focus on proper technique while you swim will help you prevent any pain from ever occurring.