Swimmer’s shoulder

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One of the worst injuries a swimmer can sustain is to the rotator cuff. Known as ‘swimmer’s shoulder’ this is a common problem that is often caused by overuse and misuse of the correct swimming technique.

Symptoms of Swimmer’s Shoulder

The usual symptoms of swimmer’s shoulder are; impaired posture, lack of glenohumeral joint mobility (shoulder joint), neuromuscular control, or reduced muscle performance. The problem can often be caused when the swimmer frequently practices without giving the body enough time to recover, which is known as an overuse injury.

Why does Swimmer’s Shoulder happen?

The reason for why this injury can happen is due to a subacromial impingement, which happens when the tendons of the shoulder are strained or injured. Primary subacromial impingement involves the compression of structures between the acromion (bony part of the scapular) and the greater tuberosity (upper end of the humerus bone). Overtraining this area of the body or using the wrong technique causes the muscles to fatigue, making injury more likely to occur.

Injury prevention of Swimmer’s Shoulder

To avoid this problem, injury prevention techniques are required to help swimmers prepare their bodies before training. In competitive swimmers, a pre season training programme is needed to target injury prevention of these specific areas.

Seeing as the shoulder is so closely linked in with the scapular and thoracic spine, exercises targeting all these areas are optimal. The first area to target will be correcting abnormal shoulder posture. If you have poor posture outside the pool, it’s likely that it’ll be poor in the pool. Scapular stabilisation exercises can help correct postural abnormalities.The next step will target thoracic spine mobility. Thoracic spine mobility is extremely important for a swimmer, and a limited amount can lead to excessive strain placed on the shoulders, neck and lower back as they try to compensate to complete your swim stroke. Two rather large muscles that are often tight in swimmers are the Pectoralis (Major and Minor) and Latissimus Dorsi. These muscles are often very tight as they play a large role in many of the swim strokes, particularly Freestyle and Butterfly. Finally restoring the strength of the Rotator Cuff muscles is very important.

Some exercises targeting all these areas can be seen below,

  • Scapular Stabilisation 1: Stand with your elbows bent to 90 degrees, tucked in by your side (thumbs pointing towards the sky). Squeeze your shoulder blades and slowly raise and straighten your arms at a 45-degree angle to you body.
  • Scapular Stabilisation 2: Single arm high Theraband row. Tie a Theraband at roughly a door height above you head. Take up the slack of the theraband by stepping backwards slightly. Pull your shoulder blade back, hold this position throughout. Pull your arm back towards your side, bending at the elbow. Slowly return to start position.
  • Thoracic Mobility: Quadruped Rotation – Begin on all fours. Place one hand behind your head. Slowly rotate your upper back downwards, by bring your elevated arm towards the elbow of your weight-bearing arm. Reverse this movement and continue past the start position and try point your elevated arm (elbow) to the ceiling.
  • Pectoralis Stretch: Stand in a doorway, and bend you elbow. Place this arm vertically along the doorway. Lean forward slightly and feel a stretch across the chest.
  • Latissimus Dorsi Stretch/ Thoracic Extension Mobility: Kneel on the floor. Place your arms straight on a slightly raised object in front of you eg. Bench, exercise ball, chair. Sink your torso towards the ground, feeling a stretch in the mid and upper back.
  • Functional Rotator Cuff Strengthening: With your feet on a step arrange yourself in the press-up position. Secure a theraband to your foot. Squeeze the shoulder blades together. Take the theraband in one arm and mimic a freestyle stroke, maintaining that squeeze in the shoulder blades throughout.

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