Swimmers shoulder is a generic term used for what is an overuse issue for the shoulder, particularly concerning the muscles and tendons of the rotator cuff. Despite the name, this painful shoulder issue isn’t specific to swimmers but is seen in a variety of people, from those who are highly active to people who are couch potatoes.
People with swimmers shoulder generally experience a dull pain in the morning which ‘warms up’ throughout the day but may not necessarily disappear completely. You may also feel a sharp pinching pain in the shoulder with overhead activities. As with most musculoskeletal injuries, swimmers shoulder can have a number of contributing factors including load management, muscle strength and endurance deficits, stiffness or tightness, and inadequate neuro-muscular control of the shoulder.
Swimmers shoulder will often come on due to an increase in the use of the shoulder. For example a swimmer may have had a sudden increase in the amount of time they’ve been training per week, the intensity, or have been training a new stroke. In those who are less active, it may be due to things like giving the house a new coat of paint or doing some spring cleaning. The reason these rather innocuous activities may cause shoulder pain is not so much related to the activity itself but to the ability of the shoulder to tolerate what you’re asking it to do (i.e. having the strength and control of the shoulder and shoulder blade to perform the activity).
Muscle Strength and Endurance
In order for the upper limb to move freely and allow us to complete tasks like reaching up to the top shelf to grab something or to reach behind us to do up the zip on a skirt, the joint itself relies less on bony stability (like the deep ball and socket joint of the hip) and relies more heavily on active stability (muscles). When these muscles don’t have the strength and/or endurance to control the shoulder joint, we can get excess movement and aggravation of the structures surrounding the joint. Often there can be an underlying weakness, but you won’t know it until you ask the muscles to do something quite difficult or something you’re not used to, such as spring cleaning, painting or a sudden increase in training load.
Range of Motion and Control
Although a sudden increase in activity is usually the catalyst, there are other factors that can leave you more susceptible to this issue and these should be targeted in terms of treatment. Tightness at the front of the chest, weakness of your upper back muscles, thoracic cage mobility and shoulder blade control all may have some contribution to a swimmers shoulder issue. As with many musculoskeletal issues, swimmers shoulder is a complex pathology which requires thorough assessment in order to identify the contributing factors. Once these have been identified, a thorough rehabilitation plan targeting the contributing factors is paramount in achieving the best outcomes for you and your shoulder moving forward. If you think you have a case of the swimmers shoulder, come in and see one of our physiotherapists for a comprehensive assessment and treatment plan that targets your specific goals!