Swimmer’s shoulder is very common in young competitive swimmers. In this condition, several soft structures in the shoulder—the bicep tendon, the rotator cuff and the bursa—are impinged, or compressed, by the bony parts of the joint and become inflamed and painful. The condition can affect any swimmer, but those who specialize in freestyle or butterfly develop it most often because of the overhead motions involved in those strokes.
Because younger swimmers often get more intense technique instruction than older ones, it is important to identify what phases of which strokes are causing pain and then work with the swim coach to be sure every stroke is being performed with the proper technique. As the young athlete increases his or her swimming distance and becomes fatigued, even small technical flaws can contribute to shoulder stress.
Beyond the perfection of stroke technique, dry-land conditioning is crucial. Young swimmers would most likely benefit from a program of strength training for overall fitness, but especially those exercises designed to strengthen the shoulders’ rotator cuffs and the muscles that stabilize the shoulder blade.
Proper posture is important, too, because swimmers often develop somewhat rounded shoulders, which can also contribute to impingement. Stretching exercises make the neck and chest muscles more flexible and help counter that postural tendency.
Drills involving kickboards (by positioning the arms overhead) and hand paddles (by increasing muscular demands) can contribute to swimmer’s shoulder, although one might think that using these aids takes pressure off the upper-body joints. Instead, these drills—especially if done too often—can put stress on the shoulder and make the condition worse. Thus, it is important for the swim coach to work with us to design a training program that keeps the young swimmer as free of pain as possible.