All swimmers at one time or another have gotten out of the pool after a long grueling race, or after the week of Christmas training with a throbbing or stabbing pain in their shoulder. College swimmers can seek attention from their Certified Athletic Trainer on campus, but many club swimmers shake it off and push through the pain. Pain is the body’s way of telling you there is something wrong. Most swimmers know what soreness feels like, but when that soreness turns into a throbbing aching, or stabbing pain, then it would be wise to seek attention. As my Athletic Trainer at Limestone says, “Preventative medicine is the best medicine.”
Today, we will focus on four of the most commonly injured muscles in the shoulder and what you can do to help strengthen and stabalize you shoulder and prevent injury.
Rotator Cuff
What is the Rotator Cuff?
The Rotator Cuff is made up of 4 muscles: Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. The muscles account for a majority of the actions that take place during the swimming stroke. All four of these muscles start from your shoulderblade and attach on the head of your humerus, or arm. The control shoulder abduction (moving away from the body), external rotation (holding your elbow in at the side with your elbow bent, moving your hand away from the body), and internal rotation (same position as external rotation, but moving hand towards the body). These are three very important movements to every stroke.
How do I strengthen it?
There are many great exercise to strengthen these muscle groups, but the best overall rotator cuff exercises are all included in the Jobe Shoulder Exercises. This program was originally created by Dr. Frank Jobe, the orthopedic surgeon behing the Tommy John Surgery (a common baseball injury), but has been expanded upon to include the entire shoulder and can apply to most overhead athletes, including swimmer. This program will also strengthen your Deltoid (the muscle that rounds your shoulder on top) and your Rhomboids (muscles between the shoulderblades) as well. There are 13 Jobe Exercises and a pdf of those exercises can be found here. These exercises should be performed 3 times a week for maximum benefit.
What can I do when it hurts?
The best way to treat is RICE. RICE stands for: Rest, Ice, Compression, and Elevation. While no serious athlete wants to rest, using the other three principles can assist in the healing process and get you back out in the pool in less time. Stretching of the entire shoulder joint as well will help keep those muscles free of knots and help in your recovery as well.
When is it time to see a doctor?
This is one of the toughest questions to answer as each person will see pain in a different light. Athletes should seek out assistance from a Certified Athletic Trainer, Physical Therapist, or Orthopedic Physician when one of these three things occurs.
1. Your range of motion begins to decrease and is causing you to modify your stroke.
2. Your pain gets to the point where you have to modify your stroke to reduce the pain.
3. You have a uneasy feeling of your arm feeling like it’s going to slide out.
Modifying your stroke in anyway, unless instructed by your coach, usually means that it is time to seek assistance as something is affecting your shoulder in such a way that it can’t do what you want it to.
Hopefully this will get you started on your way to taking care of your shoulders. If you have any questions about this or any other injury prevention/treatment, feel free to write me at [email protected]
The wisdom of preventative medicine is brilliant and logical. The use of bands for shoulder joint balance is pragmatic — bands are cheap. But Doc Counsilman and Glen Henson designed isokinetics for swimmers in the 1970’s because tubing and weights are not sufficient in balancing through the whole range of motion. Like swimming, there is accommodation depending on the position and speed of movement. Tubing is easy at the beginning of a reverse arm wrestle, for example and gives you much much more resistance at the end of the movement. Isokinetics, like the Minigym 101 or 190 or rotating swim bench provides resistance equal to the force you put on it and adapts each centimeter from beginning to end. You… Read more »
I do agree, but unfortunately a $350 machine is not practical for everyone. While the eccentric contraction, which for those who don’t know is a muscular contraction where the muscle elongates even though the muscle is trying to shorten due to a greater force than the muscle can overcome. I believe that if the contractions made by the athletes during these exercises, which with strength exercises can provide both a concentric and eccentric contraction, in a slow and controlled manner, then these exercises can also be beneficial to strength, prevention, and rehab. At school we like to use our Biodex isokinetic dynomometer to measure strength and also provide an exercise platform that is indeed better than simple weights or bands.… Read more »
I’m really looking forward to more articles about preventative maintenance. I’ve been working on modifying my dryland routines for my age groupers to focus on fortifying the joints (especially shoulders and knees) before they age up. That way, when they move into higher yardage groups, their bodies are more able to handle the increased training load and less likely to be injured. Anyway, good stuff, keep it coming!
It’s not just about the rotator cuff! Swimmers need to have adequate core stability, scapular stability and control, trunk rotation, pelvic mobility, and hip range of motion (flexion/extension and rotation). This can all be assessed by a physical therapist, please look for one knowledgeable in swimming as it is VERY different from any other overhead sport (baseball, volleyball). Many states have direct access, meaning you can go directly to a physical therapist for evaluation without seeing a doctor first. If necessary, the PT will advise of the need for a medical evaluation. Recovery should include active rest, continuing to swim but modifying activities according to pain levels, and should be a collaborative effort of the swimmer, coach, and PT.
I completely agree, there is plan to go more into the other topics in future posts.
It’s not just about the rotator cuff! Swimmers need to focus on good core stability, good scapular stability and control, adequate rotation of the trunk, and good pelvic and hip mobility. A program of active rest should be implemented with the PT, coach, and swimmer focusing on pain levels during the recovery period. It is essential for a swimmer with shoulder pain to see a physical therapist with a good understanding of swimming. Many states have direct access and a swimmer can see a PT without seeing a doctor first.