Shoulder Pain

Shoulder the Load: Avoiding and Managing Swimmer’s Shoulder

Other than insanity, swimmer’s ear, stings, neck pain, chaffing and rashes, the most likely problem you will experience whilst preparing for or doing your Rotto swim is swimmer’s shoulder. The incidence of the problem is unclear, research figures varying from 3 – 80% of swimmers affected. About 30% of elite and high level swimmers experience shoulder problems that disrupt their swimming at some stage.

What is Swimmer’s Shoulder?

Bursitis, rotator cuff tendonitis and impingement syndrome are all loosely in the diagnosis of swimmer’s shoulder. Essentially the problem is breakdown or degeneration of the tendons (rotator cuff) or inflammation of the protective lubricant sacks (bursa) around the shoulder joint. Medicos now generally agree that the tendons do not get a true inflammatory process.

Pulling your body through water with your arms is hard work. The resultant repetitive “friction” and loading on these shoulder structures during freestyle swimming, particularly with a poor swimming technique, can cause the problem. The risk with butterfly is higher, breastroke and backstroke lower.

Swimming is not the only cause of swimmer’s shoulder. An inappropriate gym program may initiate problems. A gym program should be aimed as much at reducing injury risk as making you swim faster. Good advice from someone with insight into swimming needs and risk, is needed.

Is Swimmer’s Shoulder Preventable?

Yes. In most cases you can significantly reduce your risk of problems. The commonest cause of problems relates to your freestyle technique. Getting skilled advice and changing your stroke technique will significantly reduce risks. There are also some simple strength and flexibility exercises that help. Print the pdf file at the bottom of this page for instructions on these. However, you may need your shoulder assessed and specific exercises recommended by a physiotherapist with knowledge of swimming. Your mates don’t always understand your problem and, what is right for them, is not always right for you.

What Does It Feel Like?

If you start getting shoulder pain during or after your swims, do something about it immediately. Once problems start, they tend to worsen unless you do something to stop the rot! Initially pain is during or after your training session, sometimes only with sprint activity, sometimes only when warming up. Pain tends to be in the shoulder or upper arm. If it is accompanied by pins and needles or tingling anywhere in the arm, your neck may also be involved. If things worsen, you will notice pain on movements behind the line of the body and overhead. Aching may increase and you may be disturbed at night, particularly if you lay on the painful side. Ultimately, worsening pain will force you to stop swimming.

Avoiding the Problem

The best thing to do is to prevent the onset of any symptoms. Implementation of the following points will significantly reduce your risk of Swimmer’s Shoulder:

• Pre-training muscle/posture assessment and advice from a ‘swimming smart’ physio
• Use the exercises on this web site.  You may require some more specific advice
• Stroke correction is absolutely essential
• Use a simple pre-swim stretch program
• Correctly implemented gymnasium program. Remember, your gym program should be directed towards avoiding injuries as well as making you swim faster
• If you start getting symptoms, early management is imperative. Don’t let the problem worsen before getting advice

What To Do

You will need to identify the causes of your problem. This may require advice from a physiotherapist, doctor and swimming coach.

Your problemYour solutionAsk Who?
Over-training / coaching faults
Poor stroke technique

Unilateral breathing
Modify your swimming style
modify your training – less distance, less often, less sprint
Swim coach
Knowledgeable friend
Knowledgeable physio
Not the internet
Inappropriate gym programAlter program. Right exercise, right technique, right amountKnowledgeable physio
Knowledgeable gym instructor
Knowledgeable swim coach
Poor core (trunk) stability
Muscle imbalance
Poor posture
Specific personalized exercise programKnowledgeable physio
Inadequate warm up
Inadequate pre-stretch
Increase warm up period
Perform appropriate stretches
Knowledgeable physio
Knowledgeable swim coach
Knowledgeable friend
Specific injury, any pain or uncertain what to doGet help NOWKnowledgeable physio














If you become symptomatic and there is inadequate response to conservative management such as stroke correction and specific exercises, further investigation and treatment may be necessary. This may require the use of anti-inflammatory medication, x-ray, ultrasound scan, MRI and possible steroid injection. Be advised by your physio or doctor. Remember, get good advice. Google doesn’t know your problem!