Swimming is one of the few, if not only, sports that utilizes the upper
body and shoulders to move the entire body forward. Swimmers, both male and
female, tend to be very flexible and have more range of motion in their
shoulders than the average athlete. Swimming is also unique because the water
gives resistance that the air does not. The reliance on the upper body, coupled
with the resistance of the water and repetitive use of the shoulder can lead to
a spectrum of overuse injures termed “swimmer’s shoulder”.
Swimmer’s shoulder rarely results in permanent injury requiring surgical
intervention. The most common swimmer’s injury found on MRIs of the shoulder is
tendonitis. Tears of the rotator cuff or labrum are much less common.
Anatomy
In order to better understand swimmer’s shoulder, we need to
review the anatomy of the shoulder. The key muscle group of the shoulder is the
rotator cuff, which consists of the subscapularis, supraspinatus,
infraspinatus, and teres minor. The primary role of the rotator cuff is to
function as the dynamic and functional stabilizer of the glenohumeral joint.
The muscles and the attached tendons of the rotator cuff can
be overused and injured in shoulder dominant activities such as swimming. The
most commonly injured portion of the cuff is the supraspinatus. On the other
hand, the "power muscles" of the shoulders, including the latissimus
dorsi, pectoralis, and deltoid, are responsible for moving the arm through
space or water, but rarely sustain significant injury.
Treatment
Treatment protocol for swimmer’s shoulder is as follows:
- Oral anti-inflammatories to decrease inflammation of the shoulder
- Strength training of the shoulder and rotator cuff
- Maintaining range of motion in the shoulder
The above is normally achieved with physical therapy or a physician
directed home exercise program. It is important to consult a physician before
adopting a treatment plan. Without guidance, one can potentially make the
injury worse.
Prevention
Swimmer’s shoulder may be avoided with a regimented dry land program in
the off-season. Training programs should focus on strength training and
flexibility of the rotator cuff and other shoulder blade muscles.
For more information on shoulder injuries and conditions, please visit
our website, www.advocaredoctors.com/orthosportsmed
