How to rehabilitate your Swimmer’s Shoulder by Rachel Whittaker @TriathlonPlusUK

So many Triathletes suffer from Shoulder pain… so here’s how to avoid and rehabilitate this common injury TriathlonPlus 17th August 2015

Swimming predominately uses the upper body muscles (back, chest, shoulders and arms) to generate power and speed. Shoulder and neck issues are the main areas of concern for swimmers often as a result of poor technique, which are frequently compounded by inappropriate training.

The shoulder is a very mobile joint, and being so mobile, it needs to be well controlled by the muscles and ligaments that surround the joint. Over-training, fatigue, hypermobility, poor stroke technique, weakness, tightness, previous shoulder injury or use of hand paddles can lead to your muscles and ligaments being overworked. If this goes on, injuries such as rotator cuff impingement and tendonitis, rotator cuff tears, bursitis, capsule and ligament damage, or cartilage damage can occur. Getting the correct diagnosis is very important in order to get the best treatment, and to get you back in the pool quicker.

Swimmer’s shoulder is an umbrella term covering a range of painful shoulder overuse injuries that occur in swimmers. Because there are various parts of your shoulder that can be injured from your swimming stroke, your pain can be anything from a local pain near the shoulder joint, to a radiating pain that travels up your shoulder and neck or down into your arm.

Being an overuse injury, it is caused by repeated trauma rather than a specific incident. Over a third of top level swimmers experience shoulder pain that prevents them from normal training. On onset of pain it is important that you consult an Orthopaedic specialist or a Physiotherapist to assess the shoulder in order to seek the appropriate management of your pain. Your physiotherapist will run through tests on the structures of the shoulder to determine what part of the shoulder is causing your pain. They will also look at what has caused your shoulder to become painful in the first place and correct this.

To prevent “swimmer’s shoulder” work on lengthening tight muscles in the shoulder complex, strengthening the upper limbs and shoulder blade area and improving/maintaining your thoracic (upper back) mobility. Beneficial exercises include use of a foam roller to roll the upper back muscles, foam roller thoracic extensions, seated thoracic rotations, arm openings. For strengthening, you need to focus on scapula setting, rotator cuff strengthening using weights and resistance bands, pull ups, push ups and bicep/tricep strengthening. Stretches pectoral muscles, latissimus dorsi and tricep muscles are beneficial. Maintaining strength and mobility will not only will this increases speed through the water, but also delays the onset of fatigue and helps reduce levels of lactic acid accumulation.

The key take home message for prevention of injuries is to follow a suitable training regime, avoid over training and to keep your body mobile and strong in the correct areas to assist your performance. Always remember to also cross train in the gym to challenge you Cardio-vascular system adequately, even on with exercises that are different to swimming, running and cycling. Pilates is also a fantastic way to keep strong and mobile to facilitate your training.

Six Physio

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