Swimmer’s Shoulder

Swimmer’s shoulder is a general term that used to describe the shoulder pain and dysfunction experienced by swimmers due to repetitive overhead movements. It is a debilitating painful condition of the shoulder, in athletes that swim either in an amateur or in a competitive level.

It’s characterized by pain and limited range of motion, with rotator cuff tendonitis being a common issue. The condition arises from the unique demands of swimming, which require a wider range of motion and place stress on the shoulder joint, potentially leading to instability and impingement.

Swimmer’s shoulder symptoms are common in people who regularly do activities that involve raising an arm above their shoulder, such as swimming or throwing and it appears in approximately 35% of professional swimmers.

Swimmer’s shoulder pain arises from a combination of factors that cause excessive stress on the shoulder joint during swimming. This stress can lead to rotator cuff tendonitis, shoulder instability, and eventually impingement syndrome. Key contributing factors include improper swimming technique, potential muscle imbalances, and shoulder instability caused by the sport’s demands.

The main symptom of swimmer’s shoulder is the pain in the shoulder. Initially, this pain is felt during or immediately after swimming. Swimmers often ignore it, leading to the pain becoming more persistent, even at rest or during sleep. In minor and adolescent athletes, swimmer’s shoulder usually appears after an increase in the intensity of the training program in preparation for a competition.

“Swimmer’s shoulder” can be characterized by pain that resembles shoulder tendonitis. The pain can be difficult to pinpoint exactly, but is often described as being deep within the joint. In some cases, the pain is specifically related to a certain arm position during the swimming stroke. The presence of a click or grinding sensation, along with the pain, could suggest damage to the glenoid labrum, a ring of cartilage that stabilizes the shoulder joint.

Swimmer’s shoulder is diagnosed through a combination of clinical examination and imaging tests. The clinical examination assesses range of motion, strength, and stability, while an MRI can reveal any possible underlying pathology.

Swimmer’s shoulder, a common overuse injury in swimmers, typically begins with conservative treatment that includes the following:

• Rest and Avoidance: The initial step involves resting the shoulder and avoiding activities that exacerbate the pain.
• Anti-inflammatory Medication: In adult swimmers, short-term use of anti-inflammatory drugs can help manage pain and inflammation.
• Physical Therapy: A targeted physical therapy program focusing on improving range of motion, strengthening shoulder muscles, and improving scapular stability is crucial.
• Biomechanical Analysis: Working with the athlete’s coach to identify and correct technical errors in swimming strokes is essential.
• PRP Injections: In cases of shoulder tendonitis, injections of platelet-rich plasma (PRP) may be used to promote healing.

Swimmer’s shoulder is treated surgically only in two cases:

• Failure of Conservative Treatment: Surgery is considered if conservative measures, including PRP injections, do not provide adequate relief within 6 months.
• Labral Tears: Surgical intervention is necessary when there is damage to the labrum, a ring of cartilage that stabilizes the shoulder joint. This is typically addressed with shoulder arthroscopy.

Athletes can typically return to normal activity within a few months after successful rehabilitation. The recovery timeline after surgery depends on the extent of the procedure, but usually ranges from 6 weeks to 3 months.