Transcript:
Hey, everyone! Alex Ewart here. Today, we’re going to help you determine if your shoulder pain is actually stemming from a neck issue. It’s quite common for swimmers to mistake their shoulder pain for a shoulder problem when, in fact, the root cause is often related to their neck. This realization can come as a surprise to them, but let me explain why it happens so frequently.
Let’s start by discussing a swimmer I recently saw as an example. This particular swimmer was a high school student who had been performing exceptionally well and achieving great speeds during the summer. However, when fall arrived and they continued their practice sessions, their performance started to decline. While they didn’t experience significant discomfort, they did feel some lingering discomfort around the base of the neck and the top of the shoulder, but it wasn’t too severe.
Is this a Shoulder Problem?
This swimmers “shoulder pain” was mainly noticed during freestyle, particularly during distances longer than 200 meters. Interestingly, they didn’t experience any pain during butterfly, backstroke, or breaststroke. Now, if we analyze the mechanism of these strokes, we can distinguish between a shoulder issue and a neck issue. A shoulder problem would typically cause pain during most strokes, except maybe breaststroke. On the other hand, a neck issue could be more selective, especially considering that freestyle requires head rotation for breathing, which involves more neck movement.
Do You Have More Pain When Sitting for a Long Time?
Another instance when this swimmer felt a similar kind of pain was when they were sitting in class. Naturally, using your shoulder extensively during classes is uncommon unless you’re actively participating by answering numerous questions. So, the fact that the pain occurred mainly when they twisted their head or sat in class led me to suspect a neck issue rather than a shoulder problem.
Now, let’s discuss what factors make the pain worse or better. If it’s a neck issue, you’re likely to experience increased discomfort when holding a position for an extended period, such as sitting in class or at work. On the other hand, if it’s a shoulder problem, you might feel pain when raising your shoulder and using it repeatedly. In terms of alleviating the pain, sometimes individuals with neck discomfort find that elevating their arm above their head helps relieve pressure on the lower part of their neck, thus providing some relief.
What Make’s Your Pain Worse?
Lastly, let’s consider pain provocation tests. If you can perform various shoulder movements without experiencing an increase in pain, it’s less likely to be a shoulder problem. In the case of a neck issue, you may find that most movements cause some irritation, but they don’t necessarily worsen the pain, unlike a shoulder problem where specific muscle or strength tests can pinpoint affected structures. If everything feels slightly painful without a significant increase, it’s probably more related to the neck than the shoulder.
The Final Touch:
To summarize, by considering the mechanism, what exacerbates or alleviates the pain, you can start narrowing down the possible causes. Performing certain tests that focus on the shoulder or neck will further help you determine the extent to which each area is involved. In many cases, it’s not just one or the other; it’s a matter of evaluating the contribution of each. Therefore, when dealing with swimmers, it’s crucial to thoroughly assess the neck alongside the shoulder. Too many times, swimmers think they have shoulder pain, when it actually is a neck issue.
If you want to read another article on how your neck can be the root cause of your swimmer’s shoulder, click here.
Happy Swimming,
Alex Ewart
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