Shoulder Pain in Swimmers (Part Two)
Swimming is highly demanding on the shoulder complex. With repetitive overhead motion, the shoulder joint must endure significant forces making it prone to injury. By understanding and addressing key aspects like load management, mobility, strength and technique, swimmers can maintain healthy shoulders and enhance their performance.
Strategies to improve shoulder health for swimmers:
1. Load Management: Building Resilience
Effective shoulder care starts with proper load management. Swimmers need to focus on varying the load across their training week to build a broader capacity for handling different intensities. By progressively increasing their tolerance to various workloads, they reduce the risk of injury caused by sudden spikes in intensity.
Key tips:
• Include exercises that mimic swimming-specific motions with varied resistance.
• Focus on recovery and adjust load to avoid overtraining the shoulders.
2. Enhancing Leg Drive
Strong lower body engagement reduces strain on the shoulders by offloading some of the propulsion work. Developing adequate glute and leg strength, as well as optimizing the leg drive, can significantly ease the burden on the upper body.
Key tips:
• Emphasize exercises that strengthen the lower limbs and glutes.
• Teach swimmers to rely more on their leg drive during strokes.
3. Improving Thoracic Mobility
Decreased thoracic spine mobility can lead to a decrease in body roll during freestyle, resulting in a larger shoulder joint range of motion which may increase mechanical stress on the shoulder.
Key tips:
• Perform exercises to improve thoracic extension and rotation, especially in movements related to streamlining and breathing.
4. Incorporating Open and Closed Kinetic Chain Exercises
Both open kinetic chain (OKC) and closed kinetic chain (CKC) exercises have their place in a swimmer’s shoulder health program. These exercises target different aspects of shoulder strength and control.
5. Practical Adjustments During Training
Swimmers often need on-the-spot modifications to manage shoulder discomfort without compromising their training.
What can they do?
• Stroke selection: Avoid strokes that involve painful ranges of motion.
• Kick sets: Focus on leg-driven swimming to give the shoulders a break.
• Fins: Add fins to offload the shoulders by increasing propulsion efficiency.
• Snorkels: If the swimmer struggles with end-range overhead reach, a snorkel can help by reducing the strain on the shoulder of the preferred breathing side
Increasing tolerance (once pain has settled):
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Paddles: Use hand paddles later in rehabilitation to gradually increase drag and strengthen shoulder control.
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Pool bouy: Place between legs to increase load and demand through shoulder.
These are aspects that should be avoided during the early or painful stages of a shoulder injury or issue.
8. Technique Optimization
Proper swimming technique is the cornerstone of injury prevention. Given that up to 90% of propulsion comes from the arms, small adjustments can go a long way:
• Hand entry position: Focus on a shorter hand entry to avoid excessive internal rotation (IR). Enter the water with the pinky or middle finger first rather than the thumb.
• Avoid crossing the midline: Ensure the arm stays aligned with the body to reduce strain.
• Head position: Avoid lifting the head too much during strokes to prevent additional shoulder tension.
Shoulder health is critical for swimmers, both for performance and longevity in the sport. By focusing on load management, strengthening the lower body, improving thoracic mobility, and refining technique, swimmers can protect their shoulders while enhancing their swimming efficiency. Remember to listen to your body and adjust training as needed—prevention is always better than rehabilitation.