A non-weight-bearing, low-impact way to condition the entire cardiovascular and musculoskeletal systems, swimming continues to be one of the more popular sports activities in the U.S. It’s also one of the safest and most effective workouts.

However, swimmers are still not off the hook when it comes to overuse injuries, points out Gopal Raghunath, PT MS, DPT, CSCS, owner and clinic director at Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C. The repetitive overhead motions, he says, puts the shoulder at risk for a condition known as swimmer’s shoulder.

“A competitive swimmer averages 10,000 yards per day, with an estimated 4,000 strokes per shoulder in just a single workout,” says Dr.
Raghunath, a former collegiate butterfly swimmer at the regional and national level. “It’s this repetitive clockwise-counterclockwise motion that, over time, results in fatigue, pain, and ultimately soft-tissue failure, leading to swimmer’s shoulder.”

Unlike a fall or a motor vehicle accident, which are isolated macro-traumatic events, swimmer’s shoulder is a micro-traumatic condition of gradual onset brought on by cumulative “wear and tear” of the rotator cuff tendons. Over a period of time, these events give rise to pain, weakness and restricted range of motion, culminating in dysfunctional movement patterns, poor stroke efficiency and reduced speed.

Predisposing factors of swimmer’s shoulder include: overuse, faulty stroke mechanics, the excessive use of training implements that cause additional strain (e.g., hand paddles), and disuse due to extended breaks from training.

“The shoulder joint is a ball-socket articulation which contains many muscular and ligamentous structures, and therefore provides the requisite mobility and stability required for everyday life,” says Dr. Raghunath. “It is this delicate balance between mobility and stability that is aptly illustrated in the repetitive overhead motions of swimming.”

A 2006 study published in the North American Journal of Sports Physical Therapy showed that 27 to 87 percent of competitive swimmers experience debilitating shoulder pain during their career. Recreational swimmers are more susceptible due to their lower conditioning base to start with, says Dr. Raghunath.

If an individual believes he or she is experiencing the effects of swimmer’s shoulder, Dr. Raghunath suggests a visit to a physical therapist for a thorough evaluation to identify the dysfunction causing the pain. Per the findings, a comprehensive treatment will follow, which may include: postural training, progressive shoulder girdle stretching and strengthening exercises, and core muscle stabilization training.

In addition, the physical therapist can work alongside coaching staff to modify his or her training regimen as necessary in an effort to complement the rehabilitation program and optimize the speed and success of recovery.

If you’ve been experiencing symptoms of swimmer’s shoulder, which has hampered your season or regular exercise regimen, consult a physical
therapist such as Dr. Raghunath. Along with offering a thorough evaluation, a physical therapist will design a plan of care to help you resume training and competition, and get you back on top of your game.