Swimmer’s Shoulder

Swimmer’s Shoulder

What is Swimmer’s Shoulder?

Swimmer’s Shoulders comprises a range of painful shoulder overuse injuries that swimmer’s experience over time while training and swimming. In more detail, it is shoulder pain that arises when a connective tissue such as a tendon rubs against the shoulder blade.

Consider that swimming is an unusual sport in that in that the shoulders and upper extremities are used to propel the body forward. In the same breath, these body parts are saddled with maintaining balance, requiring above average shoulder flexibility and range of motion (ROM) for maximal efficiency. Add the fact that the average competitive swimmer may swim for 10,000 to 14,000 meters per day (7 to 9 miles), six or seven days in a week. This statistic equates to approximately 2,500 shoulder revolutions per day (or 16,000 revolutions per week), which is obviously very taxing.

The combination of these unnatural exertions often put enormous pressure on the shoulder joints, which ultimately leads to swimmer’s shoulders.

What Goes Wrong in Swimmer’s Shoulder?

The shoulder is a ball and socket joint with a rim of cartilage that goes around the socket to give it depth and stability. Surrounding the joint is the joint capsule, a fibrous material, with thicker parts of the capsule forming ligaments, that form the connective tissues.

As a highly mobile joint, the shoulder receives adequate protection from the muscles and ligaments that surround it. However, over-training, fatigue, poor stroke technique among others may strain and injure the tendon and associated muscles. With little blood reaching these extremities in the joint, it is harder for the tendon to heal itself faster, hence the pain felt from swimmer’s shoulders. Swimmer’s shoulder is caused by repeated trauma rather than a specific incident.

Signs and Symptoms

You might be experiencing swimmer’s shoulders, if you have any of the below signs or symptoms:

  1. Experiencing pain during swimming, especially performing certain swimming styles such as breaststroke, backstroke et al.
  2. Intense pain in nearby areas such as the neck and the arms
  3. Experiencing restricted motion or muscular weakness
  4. Stiffness or tenderness in the shoulder joint
  5. Experiencing pain when sleeping on the affected shoulder


While the swimmer may have a general idea about his/her condition, reaching a definitive conclusion will involve diagnostics. A medical professional, often a sports medicine physician or a physiotherapist, will conduct a series of tests (physical and otherwise) to determine the cause and extent of the injury.

Treatment Options

For as long as you continue to swim, the possibility of developing swimmer’s shoulder will exist. If you are experiencing shoulder pain, the following courses of action are recommended.

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The body has the ability to repair damage to its part when given the time to do so. As with most soft tissue injuries the initial treatment is RICE – Rest, Ice, Compression and Elevation. Your first course of action in treating swimmer’s shoulders is taking the time to rest the affected shoulder. This process will include not only taking a break from swimming but also avoiding carrying weights/heavy loads with the shoulder. This period allows for the shoulder to heal as time progresses.

Ice is a simple and effective modality to reduce your pain and swelling. Apply for 20-30 minutes every 2 to 4 hours during the initial phase, or when you notice that your injury is warm or hot.


Upon consulting a medical professional, taking medications such as analgesics and steroids help in pain relief as well as promoting tissue growth and repair.

Physical Therapy/Rehabilitation

The second goal of treatment is to restore normal strength in the rotator cuff and shoulder. Therapy is embarked upon if the pain persists. Therapeutic interventions may include stretching exercises, physical therapy for muscle strengthening as well as Acupuncture. Working with a physical therapist (PT) can be helpful, particularly one with expertise in treating shoulder injuries and swimmers, who can help the athlete transition from dry land exercises to swimming. The addition of therapist-administered therapeutic modalities, such as ultrasound, phonophoresis, iontophoresis, or electrical stimulation can help further reduce pain and inflammation during the acute phase of injury.

Surgery and Recovery

Surgical intervention is considered for severe cases of swimmer’s shoulders, in swimmer’s who continue to have shoulder pain after a minimum of 6 months of guided rest and rehabilitation. This medical intervention may involve Arthroscopy (treating/ diagnosing joint problems with the insertion of a tiny camera) and shoulder surgery to correct any abnormalities.

As with any surgery, there can be potential risks, the athlete should be cautioned about the postsurgical trade-off of increased shoulder stability for some loss of flexibility, resulting in difficulty in returning to swimming at the same level as before the injury.

Recovery from shoulder surgery usually takes about 4-6 weeks to heal in the surgically-tightened position, usually some sort of immobilization is required including an arm sling or immobilizer. Following this, a rotator cuff strengthening program in physical therapy is recommended. Return to competitive swimming is anticipated between 6 and 12 months following surgery.

If you have more questions or want to know more about this minimally invasive treatments for Swimmer’s Shoulder, please don’t hesitate to contact Saint Camillus Medical Center at 817-519-3700 or info@saintcamillusmc.com.


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