Top swimmers have a significantly higher risk of developing shoulder injuries. These shoulder problems are due to the different swimming strokes as well as the high number of repetitions required during training. This type of overuse injury describes swimmer’s shoulder. A patient with swimmer’s shoulder often has pain in the shoulder and around the shoulder blade, although other pain complaints and symptoms also occur. Rest, ice, pain relief, and physical therapy usually resolve symptoms, but surgical intervention is sometimes necessary. The results of the treatment are good, although recurrence sometimes occurs. Finally, a top swimmer can best do preventive exercises in consultation with a sports physiotherapist to prevent shoulder strain.
- Causes of shoulder pain
- Risk factors of swimmer’s shoulder
- Symptoms: Pain in shoulder and around shoulder blade
- Diagnosis and examinations
- Treatment of shoulder pain due to swimming
- Non-surgical
- Surgery
- Prognosis of shoulder problems due to overuse
- Prevention of shoulder injury in top swimmers
Causes of shoulder pain
Poor swimming technique, warm-up, posture and core stability cause a possible onset of the shoulder pain associated with swimmer’s shoulder. A sudden increase in training, constant swimming at a high intensity, swimming too hard and little variation in swimming strokes are also associated with the development of pain complaints. Finally, structural abnormalities in the shoulder may cause shoulder complaints in a top swimmer.
Risk factors of swimmer’s shoulder
Swimming is a unique activity in that it primarily requires the upper body for propulsive power, with shoulder strength being especially needed. Each swimming stroke requires extreme movements of the shoulder while also exerting enormous muscle force on the shoulder. Swimmers who swim at top levels in particular suffer from this condition. A swimmer’s shoulder is a type of overuse injury that is caused by excessive strain on the shoulder. A top swimmer swims up to ten kilometers on average every day.
Symptoms: Pain in shoulder and around shoulder blade
A patient with swimmer’s shoulder experiences pain complaints:
- in the upper arm
- in the neck-shoulder area
- in the shoulder
- around the shoulder blade
In addition, a changed feeling of water may occur.
Diagnosis and examinations
Physical Examination A thorough physical examination is necessary to diagnose swimmer’s shoulder. The shoulders should be checked for atrophy (muscle loss), symmetry, and range of motion. The doctor also looks at the position of the shoulder blades at rest and in motion. Strength tests are likely to cause pain. In advanced stages of swimmer’s shoulder, the shoulder cannot withstand the force of the examiner. Special tests are often necessary to gain more insight into the disease and also to rule out another generalized condition.Diagnostic examinationThe doctor takes plain X-rays to rule out abnormal anatomical changes. An MRI scan is then needed to better identify a problem in the muscles, tendons, ligaments and cartilage or to rule out other structural causes, such as labral cysts. An MRI scan is also useful in confirming a diagnosis or when shoulder pain appears to have more than one source.
Treatment of shoulder pain due to swimming
Medicines relieve pain / Source: Stevepb, Pixabay
Non-surgical
For swimmer’s shoulder, the patient initially treats with ice, NSAIDs (nonsteroidal anti-inflammatory drugs), and rest. These self-care measures prevent progression of the condition. If pain persists or worsens, a 7-day to 10-day course of NSAIDs and rest is ideal. For some patients, a corticosteroid injection is beneficial for reducing pain. Exercises are also necessary under the supervision of a sports physiotherapist. As muscular endurance and strength improve, the patient may later return to low distance training at low speeds, as long as the swimmer is pain free and progressing slowly, until he or she can compete again.
Surgery
Surgery is suitable for structural causes of swimmer’s shoulder. However, patients may need to permanently reduce their swimming afterwards to prevent pain.
Prognosis of shoulder problems due to overuse
Although some causes of swimmer’s shoulder can be treated symptomatically with ice and NSAIDs, athletes with persistent pain may need more aggressive treatment. Most swimmers have a good result with the treatment, but a recurrence is not uncommon.
Prevention of shoulder injury in top swimmers
As a top swimmer, it is important to address the possible causes and risk factors of swimmer’s shoulder. A competitive swimmer therefore not only works on warming up swimming, the gradual build-up of training and the correct swimming technique. He works best with a physiotherapist to reduce the risk of an overuse injury. This means that a swimmer works on posture, agility, spinal mobility, land training. Finally, it is important to consult a doctor immediately if you have any shoulder problems, otherwise there is a risk of long-term complaints.
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