Shoulder Injuries In Swimmers- An Overview

I wanted to talk a little bit about shoulder impingement, shoulder tendonitis, rotator cuff tears, rotator cuff tendonitis and swimmer's shoulder, and other common shoulder injuries! These injuries are extremely common and can often be prevented by effective prehab and conscious training adjustments. 

When it comes to swimmers, our rotator cuff muscles are typically the culprits of shoulder injuries and irritations. The rotator cuff consists of 4 muscles:

• Teres Minor: Assists in other motions, helps move your arm out and stabilizes the joint.
• Infra-Spinatus: Rotates your arm out.
• Supraspinatus: Starts motions coming out from the side.
• Subscapularis: Rotates your arm in. 

These muscles are used in almost every motion in swimming; particularly, your subscapularis muscle should be firing 100% of the time. 

 Rotator Cuff Impingements:

Think of your shoulder blade like a ball and socket, when you reach overhead, a space is created between the top of your shoulder blade and collar bone. Your subscapularis muscle lives inside of this space. That space should remain there, with no pain, pinching or irritation. During overhead movements, the space decreases. During an injury, that muscle or any structure inside of there becomes pinched and irritated, creating inflammation. Another kind of impingement occurs in the back of the shoulder, when the muscles pull backward, pinching the back of that area. 

When swimmers complain of shoulder pain in the front, they are feeling pain in their biceps and biceps tendon. The top part of that tendon runs just under that space by the rotator cuff and also can become inflamed. 

Rotator Cuff Tears:

There are multiple versions of tears, and all of them revolve around the percentage of muscle torn and damage done. Think of our muscles are almost like a rope. If you were to cut a rope with a dull butterknife, eventually the outside of that rope will begin to fray, yet maintain the integrity of the inside of the rope. This can be considered a “minor” tear.

When a swimmer is averaging about 3,000 to 4,000+ yards, with a minor irritation, that already inflamed muscle is under HEAVY and REPETITIVE pinching, leading to more severe tears. The job of the other rotator cuff muscles below that space pull the “ball and socket” down a little bit, clearing that space up during overhead motions. During swimming, these muscles become over fatigued and stop firing as effectively, causing the ball and socket to cut into these already inflamed muscles during repetitive motions. 

BUT...

These tears respond excellently to conservative strengthening treatment! Focusing on preventing these irritations by strengthening these muscles, and treating them before they progress can help prevent these injuries. 

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