Just the other day, I was working with an elite level swimmer who is rehabbing back from a gnarly shoulder injury. This swimmer had tried PT somewhere else, but wasn’t making any progress. This whole time, they were not able to tolerate swimming and was told to simply just rest. Fortunately, that swimmer was able to make a good bit of progress once we started to work together. After a couple of weeks of working together, I started to think this swimmer would be able to return to swimming soon.
This swimmer was itching to get back in the water. They were even starting to miss distance freestyle days (Says who?!). As the rehab progressed, there were a few boxes that needed to be checked in order to ensure a successful return to the pool. This will blog will cover how to know when a swimmer can start to swim again being out of the pool due to an injury.
Knowing when it is safe to return to the pool is tricky. It is even trickier if you are not working with a medical professional who is well versed in swimming. If you return too soon, you run the risk of flaring up the painful area. If return too late, you miss valuable time in the pool. Missed time in the pool can decrease the chance you that you will be standing on podium, qualifying for nationals, or hitting that elusive goal time.
How Do You Know If You Are Ready to Return to Swimming?
1. Full Range of Motion
Once you have full range of motion with minimal pain at the very end of the motion, then you may start to consider returning to swimming. Swimming requires your shoulders to go through large range of motion. Not only that, but you go through a large range of motion a lot. If you take 14 strokes a lap and swim for 4,000 yards, that is 2240 times your shoulders have to move up overhead!
If moving your arm without any resistance and that causes pain, it is likely that your pain will only get worse once you start swimming again. Especially considering your arms have to move pull against resistance (the water!) with every stroke.
2. Resting pain levels
A previous blog post, How to Know If You Should Still Swim with Swimmers Shoulder, talked about pain levels while swimming. The blog discussed if your pain is less than a 4/10, you may still be able to still swim. If your pain is above a 4/10 at rest or goes above 4/10 during activities of daily living. Then swimming at the point may not be best idea.
3. Near Symmetrical Strength
What I have noticed a physical therapist, is that swimmers who strength is nearly the same between each side at the time of returning to swimming have a much better return to swimming. This could be for numerous reasons. Symmetrical strength could indicate better tissue healing or decreased irritation/inflammation of the injured side. Both of which could lead to a better response upon returning to swimming as opposed to nearly symmetrical strength.
Many of you do not have access to hand held dynamometer, which one of the best ways to measure strength. Other ways you can monitor your strength is to complete a single arm exercise, like single arm military press, and complete as many reps as possible. You can also do exercises like push ups or pull ups, and pay attention to see if one side of your body fatigues faster. While not as accurate, any significant differences could indicate a strength imbalance between each side.
4. You Are No Longer Taking Medications for Pain
If you are taking medications to lower your pain, then returning to swimming may not be the best idea. If you are taking medications, it can assumed that the painful area is still highly irritatible. With a muscle, tendon, or ligament that is highly irritable, returning to swimming may cause more harm than good. It will keep the injured area painful, prolonging your recovery. The blog post, How to Know If You Should Still Swim with Swimmers Shoulder, also discussed this.
The Wrap Up:
If you are swimming or triathlete dealing with swimmers shoulder, knowing when to return to swimming can extremely tough. Going through some of the points in this blog may help make your decision a little more clear. Those points are…
- Do you have full range of motion?
- What is your resting pain levels?
- Is there a difference in your strength between each side of your body?
- Are you taking medications for pain?
Remember, everyone will be different and have other things to take into consideration.
Thanks for reading!
Alex Ewart
Please note: This is NOT medical advice. If you are dealing with an injury, please see a licensed medical professional.