Swimmer's Shoulder

Over the past several years, the terms "impingement" and "swimmer's shoulder" have become popular buzz words in sports medicine, replacing the previous terms of bursitis, tendentious, supraspinus syndrome, etc. All of these terms describe essentially the same phenomena: overuse and irritation of the rotator cuff.

Although other more serious causes exist, rotator cuff irritation is the most common cause of shoulder pain seen in swimming. This is largely due to a combination of factors including improper warm-up, stretching, and stroke technique. Also, because the swimmer's stroke emphasizes internal rotation of the shoulder in the underwater pull phase, a relative weakness of the muscles of external rotation is generally found. Many swimmers complain of shoulder pain radiating to the side of the arm, where the deltoid muscle inserts onto the humerus bone.

A common test to diagnose rotator cuff disorders is to keep your arms out at the sides of your body and raise them up overhead with the palms down. If you have pain which increases about midway through the movement, and then decreases near the end of the movement, you may have a rotator cuff disorder. If repeating this test with your palms up is less painful, you're even more likely to be suffering from swimmer's shoulder.

A good program consisting of warm-up, stretching, and light exercise emphasizing external rotation will often help relieve and prevent impingement. Also, be sure to have your stroke technique analyzed for proper mechanics, and apply ice after your workout. If these measures fail to resolve your problem, you should call to schedule an appointment. Surgery is rarely needed and should only be considered if conservative therapy fails. Repetitive cortisone injection should be avoided as it has been well documented to cause tendon disruption, and places you at risk of further injury for 2 to 6 weeks following injection.