Shoulder pain is one of the most common complaints among swimmers, both competitive and recreational, with a prevalence rate ranging from 40% to 91%. (1) This is due, in part, to the highly repetitive nature of this sport. In a competitive year, a swimmer may perform as many as 11,000 yards per day resulting in as 30,000 shoulder rotations per week. (2) The frequency at which pain occurs within this demographic led to the term “swimmer’s shoulder” coined by Kennedy and Hawkins to describe anterior shoulder pain during and after workouts. Due to the repetitive activity, this condition is generally gradual in onset and can be caused by a variety of reasons including muscular imbalances, glenohumeral laxity and postural faults to name a few. How can you help your athletes and patients improve or prevent this condition?
The two main regions which are mainly affected by overuse injuries in swimming are the rotator cuff muscles, the primary stabilizers of the glenohumeral joint, and scapular stabilization muscles including the trapezius, rhomboid, levator scapula and serratus anterior.
The following exercises can be used to help strengthening these muscles:
#1 Stability Ball Rows at 90 degrees
This exercise can help strengthen the trapezius and rhomboid muscles.
#2 Lower Trap Exercise
This exercise helps to activate the posterior deltoid, teres minor, infraspinatus, rhomboids and the trapezius.
#3 Resisted Wall Slides
This exercise helps to activate and strengthen the serratus anterior.
Here are some general guidelines for working with patients with previous or existing shoulder pain:
- Never exercise through pain.
- Groove appropriate and perfect motion and motor patterns before adding load or other challenges.
- Start by taking gravity out of the equation; start supine or prone, quadruped, kneeling then standing.
- Increase intensity or time, but not both.
- Intensity can be increased by either changing resistance or changing stability.
It is important to recognize that the success of a corrective exercises program is dependent on the frequency and the duration of the program. It takes consistency and time to restore optimal muscle function and improvements might only be noticed after 6 – 8 weeks of training. The ideal exercise frequency depends on the condition but will be typically 3-5 times per week. Therefore, it is recommended that your patient complements the in-office treatment with a specific home exercise program. Providing your patients with easy-to-understand exercise instructions, pictures and video demonstration can help patients from being overwhelmed or frustrated when exercising on their own.
Interested in learning more about how to keep your patients engaged and compliant with their home exercise program? WebExercises offers an extensive service for home exercise programs, patient engagement and provider education.
1. Bak K. The practical management of swimmer’s painful shoulder: etiology, diagnosis, and treatment. Clin J Sport Med. 2010;20(5):386-390.
2. Beach ML, Whitney SL, Dickoff-Hoffman SA. Relationship of shoulder flexibility, strength, and endurance to shoulder pain in competitive swimmers. J Orthop Sports Phys Ther. 16(6):262-268.
About the author: Dr. David Cruz practiced as a sports chiropractor for 18 years treating athletic injuries, from weekend warriors to professional athletes. He received his bachelor’s of science degree in athletic training and has completed graduate course work in kinesiology. He is a Certified Strength and Conditioning Specialist (CSCS) as well as having both FMS and SFMA certifications. The combination of his background in sports medicine and interest in technology made him passionate about bringing these two worlds closer together, resulting in the foundation of his company WebExercises in 2005. WebExercises provides a systematic approach to exercise prescription for health and wellness professionals. It is available online and is also integrated with several EHR companies. In addition to WebExercises, Dr. Cruz is co-founder and partner of two other software businesses within the health care and technology industry.