Causes and Consequences
Swimmer’s shoulder is a somewhat general term for the kinds of rotator cuff problems caused by swimming technique. Over a career, between 30% and 90% of swimmers will suffer from shoulder problems related to their swimming.
Freestyle swimming overtraining or form error is the most common cause of swimmer shoulder problems.
There are a few common form errors in freestyle that can lead to impingements and other rotator cuff problems:
- When the hand enters the water off target, there is extra strain placed on the stabilising muscles of the rotator cuff as compared to a more ideal angle closer to 12 o’clock.
- Dropping an elbow too early in the pull through will also place excess strain on the rotator cuff by not forcing the stronger muscles of the back and chest to do the work.
- Pulling out with an overly straightened arm rather than a slightly bent elbow.
Manual therapy and rehabilitation out of the water are very important before returning to competitive training. The best approach to rehabilitation involves being pain free and at full power in land exercise and a gradual, watchful return to the water under the eye o fan experienced swim coach. Initially, stroke drills at small distances need to be emphasized in order to train out any swim form problems, before gradually increasing to previously swam distance. This can then be followed by interval and cardiovascular training for both cardio and muscular fitness. Kickboard, pull bouys and paddles are not appropriate aids when returning to the water after a shoulder injury but may be used much later after returning to competitive level swimming as long as the shoulder remains pain free during and after swimming. There are respected and well researched ‘Return To Swimming Protocols’ that would be used by competent coaches.
They key to rehabilitation is communication between the swimmer, therapist and coach. This would prevent unnecessary relapse and delay in training caused by progressing too quickly.
Swim Coach Soreness Rules
No soreness = distance increases of 200m/day
Sore during warm up but then passes in first 800m, repeat previous workout instead of progressing
If sore during that work out, stop and take a few days off. Reduce next workout by 200m.
If sore for more than an hour after swimming, or the next day, skip a day, and reduce by 200m the last pain free workout.
If this persists, get a re-evaluation.
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