Swimmers are no strangers to pain. Both the pain from a hard workout and the kind of pain from injury. This can make things tricky when deciding what to do in training when you have swimmers shoulder or another swimming related injury. For many swimmers I have worked with, they have no idea what to do with their training when they have an injury, let alone know if they should still swim at all. If you are still wondering if you should still swim when you have an injury, check out a recent blog post that talks about the criteria I use to determine if you can still swim. For most cases of swimmers shoulder, it is likely that you will still be able to keep swimming. The goal of this blog is give you some modifications that you can use in your workouts so that you can stay in the pool when dealing with swimmers shoulder.
#1 Decrease Your Training Volume
While it may sound obvious, simply decreasing your total training volume is one of the easier ways to modify your workouts when you have swimmers shoulder. Many swimmers that I have worked have been told to stop swimming all together by another healthcare provider, but this is not the best option in many cases.
When you stop swimming entirely, all of the non-injured muscles loose swimming specific strength. Meaning, all the other non injured muscles loose strength and endurance. This can lead to future injuries, decreased fitness, and increased stress. Check out a blog post for a deep dive on why I try to keep swimmers in the water when dealing with an injury for other reasons why stopping swimming entirely is a bad idea.
#2 Limit the Painful Stroke (or Activity)
In some cases when a swimmer has an injury, there is a particular stroke or strokes that are painful, while some other strokes may not cause any discomfort. For example, backstroke may be painful if you have anterior instability, but freestyle may feel normal for you. In this case, you can keep doing freestyle, but limit your backstroke for a short period to allow your shoulder to heal. Then after a week or two, gradually reintroducing backstroke, paying special attention to your symptoms would be the best plan for your training.
The painful activity does not neccesarily have to be a stroke. If your knee is bugging you during starts or ankle bothers you when wearing fins, limit those things to allow for the irritated body part to rest. Giving your body a little time to rest in the short term will help your injury heal in the long term, keeping you on track to reach your goals.
#3 Fist Drill
Fist drill is especially if help if you are dealing with shoulder pain during freestyle. Why? Because it promotes an efficient pull but also decreases the lever arm of your stroke. By pulling from your forearm, your shoulder is not stressed a little it less, making it easier for your shoulder to tolerate freestyle. For many swimmers who to come to see me for physical therapy, I will instruct them to incorporate fist drill in their warm ups or whenever their shoulder pain starts to increase.
For a swimmer who has been out of the water for a while, I will have them do fist drill for 25-40% of their yards once they are able to return to the pool. An example would be a swimmer recovering from a SLAP repair. Once they are cleared to swim, I will have them start with a 800-900. In the 800-900, the swimmer will alternate 100 fist drill-200 swim.
#4 Bilateral Breathing
The neck and shoulder are like mac & cheese, inseparable. If you have pain during freestyle, then there is a chance that you may have tightness around the neck. Whether the tightness around the neck causes swimmers shoulder or the swimmers shoulder causes the neck tightness is something that remains unknown. What we do that is that tightness, poor motor control, or weakness in one area, will change how the other area moves. Therefore, you have to address both to return back to 100%.
It is common to breath predominately to one side (I know I am guilty!). This can increase the strain of the muscles on whatever side you breath to most. Making an effort to breath bilaterally can help relieve or prevent some of the tightness around your neck, and may allow you to keep swimming. Bilateral breathing does not necessarily mean you need breath every three. Instead it can be breathing to the right on odd laps, and to the left on even laps.
#5 Increase Body Roll
Increasing body roll is an effective tool if you have pain during freestyle or backstroke. Increasing your body roll helps prevent your arm from moving past your trunk while swimming. This can prevent anterior translation of your shoulder. Excessive anterior translation can cause the shoulder to continuously rub against the biceps tendon. This can lead to biceps tendonitis or pain in the front of your shoulder. By increasing your body roll, it is easier to keep the humerus centered in the glenoid. This will decrease anterior translation of your shoulder, decreasing the strain on the biceps tendon. This will help irritation down, allowing you to still swim.
In Conclusion:
Having swimmers shoulder does not mean you need to stop swimming all together. There are multiple ways you can modify your workouts when you have swimmers shoulder. These modifications will allow you to still swim, keeping you on track to reach your goals. Some of my favorite ways to modify your swimming are
- Decrease training volume
- Limit the painful stroke
- Using fist drill
- Bilateral breathing
- Increasing body roll
Thanks for reading!
Alex Ewart
For many swimmers, using a combination of these tools is the best way to go. If you are struggling to keep swimming while you have an injury, contact me. We can get you sorted out.
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