While you cannot guarantee many things in life, you can guarantee one question that a swimmer will ask at the end of a physical therapy evaluation. That one question is “can I still swim?.” The answer is complex, but whenever possible (and safe) a physical therapist should try to keep you in the water. Check out a previous post on why keeping a swimmer in a water is a good idea. However, there are certain times when complete rest is more advantageous than staying in the pool. This blog will cover a series of questions to ask yourself to see if it is a good idea to still swim with swimmers shoulder.
The questions to see if you should still swim with swimmers shoulder are as follows…
- Are you taking any medications in order to keep your pain down when swimming?
- Is your pain level less than a 4/10?
- Does your pain worsen as practice goes on?
- How long does your pain last after swimming?
- Do you change your technique because of the pain?
Let’s take a deeper dive into each question.
Please note: This is NOT medical advice. If you are currently dealing with an injury, please consult a licensed medical professional.
#1 Are you taking any medications in order to keep your pain down when swimming?
If you are taking any medications just to keep your pain down when swimming, then swimming is probably not the smartest idea. If you are doing this, then taking some time to rest and not swimming would be the best course of action.
#2 Is Your Pain Level Less Than a 4/10?
While you may have been told in the past to avoid any pain while swimming, pain has been shown to be a poor indicator of tissue damage for some injuries. What this means for you is that a lower level of pain may not necessarily mean you are damaging the injured area any more.
If you pain when swimming is less than a4/10, you may be able to still swim. If you answered no, then consider how much swimming you can do before your pain levels rise above a 4/10. Swimming until that point will help maintain your endurance and strength of the non injured areas. If your pain is above a 4/10 at rest, then swimming may not be the best idea.
#3 Does your Pain Worsen the More you Swim?
If your shoulder pain is a result of irritation of a muscle or tendon, then your pain may actually improve as your workout goes on. In this case, you can and should still swim! If your pain worsens after a while and goes above a 4/10, then stopping and resting will help prevent further irritation of your shoulder. If you pain is above a 4/10 when you start to swim and doesn’t get any better, then resting may your best option.
#4 How long Does Your Pain Last after Swimming?
Let’s say you finish a workout and have a 3/10 pain in your shoulder. If the pain goes away within an hour of practice, then you can still swim at the same intensity and yardage. In this scenario, your shoulder proved tolerance to that given workout, but any increases in volume or intensity may be too much for your shoulder.
If you finish the workout and your 3/10 pain lingers into the next day, decreasing your training volume or intensity would be the best option. In this case, the increase in pain indicates that the workout you last did may have been too much volume and/or intensity. Pain lingering into the next is your body telling you that it needs more recovery. Note, this does not mean stop swimming. It simply means taking your workout easier the next day.
This is question becomes particularly helpful when a swimming starts to swim again after having not been in the pool for a while. Adjusting your workload based off how your body responds to each workout will allow for an optimal recovery and prevent a secondary injury from occurring.
#5 Does your Shoulder Pain Alter Your Swimming Technique?
The last question to ask yourself is whether the pain in your shoulder is altering your swimming technique. This a tell tale sign that your body is attempting to compensate for a weakness, pain, or a combination of both. If you find your technique changing because of pain, this is your body telling you to rest! In this scenario, give your body what it wants… some rest!
While this is easier said than done, you will thank yourself later for taking some rest early on. This can prevent your shoulder pain from getting more intense, which could keep you out of the pool for longer. Resting does not mean you have to stop swimming, instead it can be decreased yardage, intensity, or a shorter practice.
You Answered the Questions, What Do You Do Now?
Look at your answers again and see if there is a pattern that emerges. If you have pain levels above a 4, your pain worsens while you are swimming, and you technique is changing when you swim, then you should probably not swim with swimmers shoulder. On the other hand, if you have a little bit of pain (1/10) and it improves with swimming, then you should swim! Your answer will not always be clear cut, and you will have to use your best judgement. Use these questions to help guide your decision. When in doubt, reach out to a medical professional for a thorough examination.
If You are Unsure, Let’s Get in Touch and Help you Get Back to Pain Free Swimming
References:
Woolf C. J. (2010). What is this thing called pain?. The Journal of clinical investigation, 120(11), 3742–3744. https://doi.org/10.1172/JCI45178