The shoulder is one of the most complex joints in the body. A healthy shoulder allows us to
perform a wide range of movement, unlike any other joint. The success of the overhead
swim stroke is dependent upon several anatomic components working together to ensure
smooth, pain free motion.
A painful shoulder in a swimmer is often the result of cumulative trauma in the presence of weak or
tight muscles. The soft tissues surrounding and supporting the shoulder are the most common culprits
in a repetitive motion sport such as swimming.
ANATOMY OF THE SHOULDER
Most swimming injuries of the shoulder involve one or more soft tissue structures: muscles and
tendons, bursae, joint capsule, or fascia.
The Rotator cuff is a series of four muscles and their tendinous insertions into the outside of the
humerus, or arm bone. The rotator cuff functions as a unit to stabilize the shoulder throughout range
of motion, especially those involving overhead activities.
The muscles of the rotator cuff are the Supraspinatus, Infraspinatus, Teres minor, and Subscapularis.
While the rotator cuff gets all of the press when it comes to shoulder injuries, it is usually
weakness in the muscles attached to the scapula, neck, and upper back which cause excess
compensatory strain on the rotator cuff. When muscle problems are ignored injury will follow.
Bursae are fluid filled pouches found throughout the musculoskeletal system in areas where tissues lie
against other structures. If not for the cushioning of bursae, our tendons would experience constant
friction and inflammation.
The joint capsule is a protective girdle of soft tissue that envelopes and stabilizes the joint. An
overstretched or loose capsule can cause problems related to instability.
Fascia is tough connective tissue which covers and separates every muscle in our body. Old injury,
tight muscles, or poor training can cause restriction in the fascial tissues.
DYSFUNCTION OF THE SHOULDER
The shoulder sacrifices stability in order to achieve wide range of motion such as the overhead
swim stroke.
The shoulder is an inherently unstable joint. Unlike the deep ball and socket structure of the hip, the
shoulder ball and socket is like a golf ball sitting on a tee.
As an unstable joint, the shoulder depends on more then a dozen muscles which keep it centered and
stabilized through broad range of motion. A failure in this stability system leads to familiar diagnoses
such as tendinitis, tendinosis, bursitis, and impingement syndromes.
Causes of shoulder pain:
Acute trauma-
Patients with an acute injury will can typically identify the moment in which the injury
occurred. Reaching into the back seat, a fall on an outstretched hand, and poor weight
lifting techniques are common mechanisms for shoulder injuries.
Repetitive trauma-
By far the more common injury, repetitive strain injuries occur when the amount of trauma to
the tissues occur at a greater rate then healing. Tendinitis, shin splints, and stress fractures are
classic examples.
The "terrible toos" are usually to blame:
Too much Too soon
Too frequent Too little attention to pain
EXERCISES FOR SHOULDER INJURY PREVENTION
The exercises described below should be used by those looking
to implement a routine for shoulder injury prevention. If you are
currently experiencing shoulder pain, consult a qualified sports injury
specialist before beginning an exercise routine.
FREQUENCY: 3-5 days per week, for prevention
REPETITIONS: 15-20
SETS: 2-3
Emphasize quality over quantity. If your form breaks down and you feel yourself cheating, lower
the number of repetitions.
Do not perform the exercise if you experience sharp pain.
External rotation
B
A
-Secure a piece of exercise rubber tubing to w door handle with a secure knot (A)
-With the elbow bent at 90 degrees, perform the motion of external rotation by turning your elbow and
forearm out
(Perform the exercise to a comfortable end range of external rotation without moving your entire body)
-When beginning this exercise, the elbow should not leave the side of the body
-An alternate way of doing this exercise is side-lying with a light weight. Start with 1-2 lbs.(B)
Scaption
-Assume a side lying position as shown with one leg bent over the other
-Arm should remain in the plane of the scapula (as shown, in front of the body).
-Keep the elbow straight and raise weight just above height of the bent knee.
Standing Scapular Retraction Standing Scapular Depression
-Pinch the shoulder blades together -Elbows straight, hands slightly above head
-Be sure NOT to shrug the shoulders -Depress the shoulder blades by attempting
-Return to neutral and repeat to pull them down and back
-This can be performed with rubberband resistance
(as shown above)
Standing Row
-Secure a piece of exercise rubber tubing to a door handle
-With the elbows straight, pull pinch the shoulder blades together (scapular retraction)
-Continue the motion by pulling the elbows past the body, completing the row exercise
-In the gym, this would be equivalent to the seated row machine
There are many exercises one can include in a shoulder strengthening program.
A comprehensive routine will emphasize strength, endurance, flexibility, and core strength.
The above exercises are a good place to start your preventative shoulder injury program.
perform a wide range of movement, unlike any other joint. The success of the overhead
swim stroke is dependent upon several anatomic components working together to ensure
smooth, pain free motion.
A painful shoulder in a swimmer is often the result of cumulative trauma in the presence of weak or
tight muscles. The soft tissues surrounding and supporting the shoulder are the most common culprits
in a repetitive motion sport such as swimming.
ANATOMY OF THE SHOULDER
Most swimming injuries of the shoulder involve one or more soft tissue structures: muscles and
tendons, bursae, joint capsule, or fascia.
The Rotator cuff is a series of four muscles and their tendinous insertions into the outside of the
humerus, or arm bone. The rotator cuff functions as a unit to stabilize the shoulder throughout range
of motion, especially those involving overhead activities.
The muscles of the rotator cuff are the Supraspinatus, Infraspinatus, Teres minor, and Subscapularis.
While the rotator cuff gets all of the press when it comes to shoulder injuries, it is usually
weakness in the muscles attached to the scapula, neck, and upper back which cause excess
compensatory strain on the rotator cuff. When muscle problems are ignored injury will follow.
Bursae are fluid filled pouches found throughout the musculoskeletal system in areas where tissues lie
against other structures. If not for the cushioning of bursae, our tendons would experience constant
friction and inflammation.
The joint capsule is a protective girdle of soft tissue that envelopes and stabilizes the joint. An
overstretched or loose capsule can cause problems related to instability.
Fascia is tough connective tissue which covers and separates every muscle in our body. Old injury,
tight muscles, or poor training can cause restriction in the fascial tissues.
DYSFUNCTION OF THE SHOULDER
The shoulder sacrifices stability in order to achieve wide range of motion such as the overhead
swim stroke.
The shoulder is an inherently unstable joint. Unlike the deep ball and socket structure of the hip, the
shoulder ball and socket is like a golf ball sitting on a tee.
As an unstable joint, the shoulder depends on more then a dozen muscles which keep it centered and
stabilized through broad range of motion. A failure in this stability system leads to familiar diagnoses
such as tendinitis, tendinosis, bursitis, and impingement syndromes.
Causes of shoulder pain:
Acute trauma-
Patients with an acute injury will can typically identify the moment in which the injury
occurred. Reaching into the back seat, a fall on an outstretched hand, and poor weight
lifting techniques are common mechanisms for shoulder injuries.
Repetitive trauma-
By far the more common injury, repetitive strain injuries occur when the amount of trauma to
the tissues occur at a greater rate then healing. Tendinitis, shin splints, and stress fractures are
classic examples.
The "terrible toos" are usually to blame:
Too much Too soon
Too frequent Too little attention to pain
EXERCISES FOR SHOULDER INJURY PREVENTION
The exercises described below should be used by those looking
to implement a routine for shoulder injury prevention. If you are
currently experiencing shoulder pain, consult a qualified sports injury
specialist before beginning an exercise routine.
FREQUENCY: 3-5 days per week, for prevention
REPETITIONS: 15-20
SETS: 2-3
Emphasize quality over quantity. If your form breaks down and you feel yourself cheating, lower
the number of repetitions.
Do not perform the exercise if you experience sharp pain.
External rotation
B
A
-Secure a piece of exercise rubber tubing to w door handle with a secure knot (A)
-With the elbow bent at 90 degrees, perform the motion of external rotation by turning your elbow and
forearm out
(Perform the exercise to a comfortable end range of external rotation without moving your entire body)
-When beginning this exercise, the elbow should not leave the side of the body
-An alternate way of doing this exercise is side-lying with a light weight. Start with 1-2 lbs.(B)
Scaption
-Assume a side lying position as shown with one leg bent over the other
-Arm should remain in the plane of the scapula (as shown, in front of the body).
-Keep the elbow straight and raise weight just above height of the bent knee.
Standing Scapular Retraction Standing Scapular Depression
-Pinch the shoulder blades together -Elbows straight, hands slightly above head
-Be sure NOT to shrug the shoulders -Depress the shoulder blades by attempting
-Return to neutral and repeat to pull them down and back
-This can be performed with rubberband resistance
(as shown above)
Standing Row
-Secure a piece of exercise rubber tubing to a door handle
-With the elbows straight, pull pinch the shoulder blades together (scapular retraction)
-Continue the motion by pulling the elbows past the body, completing the row exercise
-In the gym, this would be equivalent to the seated row machine
There are many exercises one can include in a shoulder strengthening program.
A comprehensive routine will emphasize strength, endurance, flexibility, and core strength.
The above exercises are a good place to start your preventative shoulder injury program.
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