Have you ever tried butterfly with swimmers shoulder? Chances are, it did not go well. This was exactly the case for James. James is an avid swimmer, who recently was having some major time drops. James recently switched teams and had upped his training volume. And so far, everything was going great. But one day, while he was training for the butterfly stroke, he started to feel a sharp pain in his shoulder. Despite the pain, he continued to train, thinking it was just a minor injury that would go away on its own.
However, the pain only got worse, and James started to struggle with the butterfly stroke. The once powerful and graceful movement was now slow and awkward. James was unable to complete a full length of the pool without feeling pain. He was devastated. He had worked so hard this season and now it seemed like his dreams of qualifying for junior nationals were slipping away.
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So What Did James Do?
James went to go see a local physical therapist just down the street from the pool. James spent 3 weeks there, but wasn’t seeing any improvement. On top of this, when he asked the physical therapist about what he can still do in the pool and they couldn’t give a good answer because did not understand swimming.
How frustrating! This led James to reach out for a consult with The Swimming PT. This blog will cover three of exercises that had the great impact of James ability to do butterfly, without pain.
Why Did James Have Pain During Butterfly?
Butterfly is considered as one of the most challenging strokes in swimming, and it requires a great deal of strength, coordination, and technique. It puts a lot of stress on the shoulder due to the powerful arm movements and overhead reaching required to perform the stroke. Knowing this, it makes total sense why if you have swimmers shoulder, that butterfly can be exceptionally hard!
What Exercises Did James Do?
After talking with James more and watching him complete a battery for performance assessments. It turns out that James had weakness in a couple of keep swimming muscles. Those muscles were the deltoids, serratus anterior, and the trapezius. While what James was doing before at PT wasn’t wrong, the treatment was focused more on the smaller muscles around the shoulder, the rotator cuff. Without strengthening the he deltoids, serratus anterior, and the trapezius, James would keep having swimmers shoulder during butterfly. If you want to read about some of the other causes of swimmers shoulder, check out this blog post.
While we cycled through other exercises as well, the three exercises below seemed to have the biggest impact. Each of these exercises address the specific deficits James had.
Military Press
The Military Press is beneficial for swimmers as it improves shoulder power and tricep strength, both of which are essential for generating efficient strokes and preventing injury. Specifically, the military press really works the deltoids. Which was one of James weakness. Typically, I will not start a swimmer with swimmers shoulder off with military press. James went through an exercise progression first that established the requisites needed to do military press. Some of those requisites are near symmetrical serratus anterior strength, pain free push ups, and full pain-free range of motion.
Incline I/T/Y
Incline I-T-Ys are a great exercise for strengthening the trapezius, rhomboids, and the back of the deltoid. These muscles are are crucial for generating power during butterfly. By strengthening these muscles, swimmers can improve their ability to lift their arms out of the water and complete the arm recovery phase more efficiently.
The exercise is performed on an incline bench, with the lifter lying face down and reaching overhead to form an “A” shape with their arms, then lowering the arms to form a “Y” shape, and finally lowering the arms to form a “T” shape.
Body Saw on Swiss Ball
Body Saws on a Swiss ball is a great exercise for the serratus anterior muscle. You performe this movement by starting in a a plank position on the Swiss ball with your feet on the ground. You then move your elbows forward and backward, while maintaining a plank. This exercise requires the serratus anterior muscle to work to maintain stability and control of the scapula as you move the swiss ball back and forward. !
By targeting the serratus anterior, body saws on a Swiss ball help to improve the stability and control of the scapula, reducing the risk of injury during swimming. As added bonus, this a great core exercise too!
So What Happened with James?
After mastering these movements and gradually progressing the amount of butterfly done in the pool, James was able to start doing butterfly without pain. He went on to crush the reason of the season and accomplished his goal of qualifying for junior nationals. This story is a great example of why you need to target specific muscles in your rehabilitation plan. This story also shows that you cannot simply blame the rotator cuff for shoulder pain in swimmers. Many times, swimmers shoulder is just assumed to be rotator cuff tendonitis, but this could not be further from the truth.