Swim out of Pain – Part 2

What is Swimmer’s shoulder?

Swimmer’s shoulder is an umbrella term covering all rotator cuff injuries. There are many overuse injuries that affect swimmer’s shoulder; over-training, fatigue, hyper-mobility, poor stroke technique, weakness, tightness, poor everyday posture, stiffness and stress.

If any of these go ignored for an extended period, more serious injuries such as rotator cuff impingement, tendinopathy, rotator cuff tears, bursitis and or ligament damage can occur. The shoulder is a very mobile joint, and being so mobile, it needs to be well controlled and protected by the muscles and ligaments that surround it.


The Rotator Cuff


How does injury happen?

An overuse injury is caused by repeated poor position rather than a specific incident. What is key to highlight here is that if there are postural issues on dry land you will undoubtedly experience problems in the water. In my experience, prevention is always better than cure so addressing these areas out of the water is what I like to do. I use mindful techniques to identify potential areas that need attention before symptoms set in or worsen.

Over one third of top level swimmers experience shoulder pain that prevents them from normal training. The rehab can be slow and tedious. There are well documented phased recovery protocols. In my experience, failure to progress is common, hence recovery can be frustrating, even for the elite athlete.


Swimmers Shoulder in action… supraspinatus tendon over load!


What next?

Your shoulder is causing you pain in the water, making your swims unenjoyable or even painful. One option is to have surgery. An arthroscopic ‘decompression’ is where the sub acromial space is shaved away to make more space for the rotator cuff tendons (supraspinatus tendon). This can take 6-8 weeks of immobilisation for recovery. Devils advocates would ask the question, is it the rest or the procedure that helps heal the injury?

Usually, corticosteroid injections are offered before surgery to relieve symptoms and give the swimmer a pain free window for rehab.This does not directly treat the problem, it masks it. Injections combined with intense physiotherapy, while rarely prescribed, have been proven to be more beneficial than injection alone.  


A responsible Swimmer on his mat!


Ultimately, the responsibility of staying injury free (and not ignoring early tell-tale signs) lies with the swimmer. This leads neatly back to my practice of mindful movement, combined with solid, reliable evidence based physiotherapy. I believe in the power of correcting bad/old postural patterns and establishing new ones. 

Take a moment right now, while reading this, to notice your posture. Where are your shoulders? Is one sitting higher? Where is your head facing? Poking chin?  Equally, these dry land problems resonate at sea. Postural awareness is the first step to affect change. Be aware, your brain lays down new patterns (both good and bad!).  Your aim should be to create better patterns of movement and erase poor technique while swimming.

Tune in for Part III where I give you detailed instruction on mindful movement techniques specific to swimming.

I will also include a video demonstration.


Thanks for reading!



to “Swim out of Pain – Part 2”

  1. John Dineen says:

    Living this blog series Karen. Really tempting me to give sea swimming a try

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