Swimmer’s Shoulder-Prevention and Dryland Training Strategies

In the culture of swimming, it’s often expected to “train through the pain” in order to get to the top¹. If you consider yourself a competitive swimmer, you likely have experienced shoulder pain at some point in your career, with it being the most common musculoskeletal complaint in swimming with an incidence ranging from 52% to 73% in elite swimmers². A competitive swimmer usually exceeds 4000 strokes for one shoulder in a single workout³! Needless to say, the shoulder can make or break a swimmer’s season and athletes should focus on prevention to avoid a season-ending injury.

Swimmer’s shoulder usually involves impingement or pinching of the rotator cuff muscles by the acromion bone as they pass through a narrow opening called the subacromial space (see figure below).

Shoulder impingement can be the result of a number of causes, including inflammation of the rotator cuff tendons, increased shoulder joint mobility/laxity and weak muscle stabilizers around the scapula (shoulder blade). Prevention should address swimming form and biomechanics in the water as well as strength training on land.

In the Water: Focus on Form

Competitive swimmers average approximately 18,000 shoulder revolutions per week, mostly from freestyle training⁴. Regardless of stroke specialty, approximately 80% of practice time is made up of the freestyle. The freestyle stroke is traditionally broken down into 3 distinct phases: hand entry, pull-through, and recovery.

Watch out for the following biomechanical errors during each stroke specialty²:

On Land: Strengthen and Stabilize

Swimmers are subject to shoulder impingement for approximately 25% of their freestyle stroke cycle, even when using proper biomechanics⁴. For prevention, focus on stretching and strengthening the following: rotator cuff muscles, scapula (shoulder blade) stabilizer muscles, and the core as well as correcting postural imbalances⁶. Below are some great examples from the athletic trainers at BridgeAthletic. You can also complement your training with yoga and pilates to help with core, balance and flexibility.

Rotator Cuff Exercises: The goal is to strengthen the four rotator cuff muscles of the shoulder.  Below is an example of the External Band Rotation.  The external rotator muscles of the shoulder are usually weaker than the internal rotators in swimmers.