“SWIMMERS SHOULDER” Is it really the shoulder?

“SWIMMERS SHOULDER” Is it really the shoulder?

The shoulder complex is indeed complex and is more than just a ball and socket joint. The joint sits unhinged at either side of our trunk and relies heavily on the relationship of the surrounding tissue and joints to achieve great ranges while preserving stability. Injuries to the shoulder can often occur when the balance between these two has been compromised. The majority of shoulder injuries result from participation in contact sports such as football, in which high-speed collisions and falls are common. However, chronic-overuse shoulder injuries can occur in any activity that requires the shoulder to perform similar motions repeatedly. Swimmers shoulder is a common shoulder complaint which is no surprise when a competitive swimmer can exceed 4000 strokes for one shoulder in a single workout!

The SWIM FOR A MILE charity event happening this April in aid of Temple Street is a fantastic opportunity to focus on achieving your fitness goals in 2020 as well as helping a well-deserved charity. However some individuals may be predisposed to swimmer’s shoulder if they already have musculoskeletal impairments or engage in improper training methods. The shoulder is required to carry out continuous upper arm circumduction in clockwise and counter clockwise directions during almost every stroke. To allow such a sequence to occur smoothly, it is helpful to consider all the components that contribute to shoulder mobility as to view this joint in isolation is to only view the tip of an iceberg!

Research shows that we have a greater chance of experiencing shoulder pain in the sixth decade of life with the most common clinical diagnoses being rotator cuff defects (85%) and/or impingement syndromes (74%). A shoulder injury can occur over time due to impaired movement stemming from the trunk and subsequently can become pathological. We should consider that the thoracic spine (upper and middle back) connects directly to the glenohumeral joint (shoulder), scapulae (shoulder blades), lumbar spine (lower back) and cervical spine (Neck). Muscles that affect respiration, stroke propulsion and shoulder stabilisers are all affected by the thoracic spine function.

There are also other lifestyle and metabolic influences that can affect the health of our shoulder tendons and may predispose a swimmer to becoming susceptible to shoulder pain and dysfunction. Studies have shown that smoking, waist circumference and waist-to-hip ratio were related to an increased prevalence of shoulder pain in both genders. Other extrinsic factors such as when a swimmer has taken a period of time off without training resulting in muscle weakness or altered neuromuscular control of their shoulder complex.

What we as physiotherapists can help identify is the most likely impairments or a possible training error. Additionally it is also important that we rule out any significant tissue pathology that would warrant a referral onwards. However normally a comprehensive rehabilitation program is almost always sufficient for shoulder injuries which will include strengthening the rotator cuff, scapular stabilisers, improve thoracic mobility and implement activity/training modifications in order to help you achieve your 2020 goals.


  1. Maintain neutral head – looking up will slow you down
  2. Push your chest down – helps to keep your legs horizontal
  3. Roll from side to side – using the muscles of your back & not just your shoulder
  4. Use High elbow + forearm vertical for better grip in the water
  5. Avoid overreaching

If you feel you have a shoulder injury, call us now @ 7128863 to book an assessment with anyone of our physiotherapists.



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Rechardt M, Shiri R, Karppinen J, Jula A, Heliövaara M,  Viikari-Juntura E. Lifestyle And Metabolic Factors In Relation To Shoulder Pain And Rotator Cuff Tendinitis: A Population-Based Study; Bmc Musculoskeletal Disorders Volume 11, Article Number: 165 2010
Stocker D, Pink M, Jobe Fw. Comparison Of Shoulder Injury In Collegiate-And Master’s-Level Swimmers. Clin J Sport Med. 1995;5:4–8
Tovin B J, Prevention And Treatment Of Swimmer’s Shoulder. N Am J Sports Phys Ther. 2006 Nov; 1(4): 166–175.