Swimmer’s Shoulder Causes and Prevention

Swimmer’s shoulder is an injury of the shoulder’s muscles and tendons due to overuse or bad swimming technique. It manifests itself as pain and inflammation.

A man holding his aching shoulder
Swimming lots of freestyle can strain your shoulders

Even though swimming is a low-impact sport, it uses the shoulders extensively and puts them at risk. For example, a shoulder rotates about 10 times when swimming 25 yards of freestyle. That means that for a moderate 50 lengths workout, each shoulder rotates about 500 times. Multiply this by a few swim sessions per week, and you see that it quickly adds up.

The shoulder is the most mobile joint of the body. This mobility is due to the shoulder’s anatomy. It is like a golf ball (the head of the upper arm bone, the humerus) placed on a tee (the lateral scapula) held in place by a set of stabilizing muscles and tendons called the rotator cuff.

If the rotator cuff muscles grow tired or incorrect technique is used, the joint can become lax, and the humerus then moves incorrectly and can injure soft shoulder tissues.

Causes

Swimmer’s shoulder can develop with the freestyle stroke, and to a lesser degree with the backstroke and butterfly stroke.

Incorrect technique can cause the injury. In freestyle, this is the case if the hand enters thumb first or crosses the middle of the body when it extends to the front.

Overtraining, sudden increases of training volume or intensity can also lead to this condition, as the rotator cuff muscles tire more quickly than the propulsive muscles and the articulation then becomes unstable.

Unbalanced strength and flexibility development of the muscles is also a cause, as well as unilateral breathing in freestyle, overuse of swim paddles and overzealous stretching.

Swimmer’s Shoulder Prevention

First of all, make sure you swim with correct technique. A qualified swimming professional or experienced swimmer can asses your stroke and highlight mistakes. For example, in freestyle, make sure that you enter the hand flat in the water during the recovery and that it doesn’t reach past the middle of the body during the pull phase.

You shouldn’t overtrain or train with tired muscles, as this means that the stabilizing muscles of the shoulder don’t work correctly anymore and the shoulder can be injured. Also, avoid sudden increases in amount or intensity of the swim workouts.

Avoid the overuse of swim paddles, as they put additional strain on your shoulders. And don’t kick too much holding a kickboard with arms extended forward, as it puts the shoulders in a weak position.

Swimming especially strengthens your chest muscles and the shoulder’s internal rotators. Those then become stronger but also shorter than their antagonists.

To compensate for this, you should stretch the chest and the shoulder’s internal rotators and strengthen the scapular stabilizers and the shoulder’s external rotators. More about this in the related pages section below.

9 thoughts on “Swimmer’s Shoulder Causes and Prevention”

  1. Joseph Caruso

    I have been using the Finis hand paddle every work out for 30 laps using breaststroke and crawl. I swim every day for over a mile each day and now have pain and discomfort in my left chest muscles. What to do?

    I just starting training with these hand paddles and don’t plan on ever using them again. Please advise.

    1. Hi Joseph,

      If the symptoms persist, I’d advise seeing a doctor. I also advise to only use swim paddles sparingly in certain circumstances to correct arm stroke movements. And in that case, you should only stroke in a relaxed manner to internalize the movements without straining the shoulders.

      The problem is that the extended overhead arm position used in crawl and breaststroke puts the shoulder joint in an unstable with possible rotator cuff impingement, etc. Swim paddles put additional strain on the shoulder, hence the recommendation to only use them sparingly.

  2. Hello — Thanks very much for this article. I believe that I’ve developed swimmer’s shoulder in my left shoulder, which is a relief (I was fearing that it was a more serious injury such as a tear or even something like bursitis). I appreciate the tips on proper technique.

    Typically I swim 1.5 miles nonstop 2-3 times per week with a crawl stroke. I had been out of the pool for several weeks consecutively in the summer, but jumped back in immediately to that distance in Fall 2017.

    Can you suggest if/how I can train in the pool and simultaneously let my shoulder heal? I’ve got a couple triathlons in later Spring 2018, so i’d prefer to spend as little time out of the pool as possible.

    Thanks again and Regards.

    1. Hi David,

      I think the best would be to seek a health professional for medical advice on how to handle your shoulder.

      Good luck!

  3. Hi Christophe. I’m about to turn 74. I swim in a mixed age group with a coach twice weekly and once with my husband. Altogether, over 2.5 hours, I swim around 4 kilometres. My distances have dropped a bit from 5 kms a few years ago. My right shoulder has been a little sore when swimming for some months, but yesterday at squad it was sore for the whole hour. Should I stop squad swimming for a while, just swim 30 minutes at a more leisurely pace as I do with my husband at the weekend? Stop swimming for a while altogether, see a doctor or physiotherapist, take ibuprofen? I’d appreciate your advice
    Cheers
    Jenny

    1. Hi Jenny,

      I’d advise for you to see a doctor first, as he may be able to pinpoint the exact problem you’re having.

      Best,

      Christophe

  4. bob mcconnaughey

    My question/situation is somewhat different; rather than an overuse injury I had 8 anchors put in my shoulder 11 months ago after a hard fall which completely detached just about every tendon/muscle in my left shoulder.

    Because it was a traumatic injury and because 60+ years of swimming had left me with fairly strong shoulders the surgeons involved were optimistic (as am I) about an overall recovery. But it turns out the full range of motion (as defined by a PT evaluation) was/is rather less than the range of motion I had before surgery and still have in my right shoulder.

    So butterfly is surely gone for good. But though I can do free and back – on many days there will be a distinct “twinge” which my physical therapist said was a signal to “stop” to avoid tendinitis. Breaststroke (as others have found) is pretty much pain free; but prior to surgery most of my laps were either back or kicking.

    I keep on wondering if this is just a matter (still) of time and/or if others have found other modalities helpful. I’m thinking of acupuncture in particular as my rheumatologist (a younger jock who recently had knee replacement) is a believer and thinks it helped get her back onto the tennis courts rapidly. So I’m very curious about what might have helped other folk get back into full swimming mode. My left shoulder remains substantially weaker than my right, though it’s gradually improving.

  5. Hi Christophe,

    My daughter swims around seven times per week for 2 hours each time. But for the last few months, she has been experiencing pain about halfway down her shoulder blade at the back of the edge of the blade. Which usually comes on after swimming for around 1 1/2 hours. Once she stops swimming the pain usually goes after a short time but is still sore to touch.

    I have done the rotator cuff test where you raise your arm, but she has no pain in doing that also the palm of her hand does not turn forward on lifting up it stays straight to the ceiling.

    She gets this problem about once a week, but the tenderness is there most of the time.

    Do you have any suggestions what might be causing this?

    Thanks, Carol.

    1. Hi Carol,

      I’d take an appointment with a doctor. Additionally, as she swims every day, her body has never the time to recover and repair itself. I don’t think it is a good idea to swim every day.

      Best,

      Christophe

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