If you’ve ever felt a sharp pain in your shoulder while doing freestyle, you know just how frustrating it can be. But what if we told you that your shoulder pain might actually be caused by something else entirely? Meet Sarah (not her real name), a fellow swimmer who recently consulted with me about her right shoulder pain. Here’s the catch: Sarah’s pain wasn’t actually in her shoulder at all! As she described her symptoms, it became clear that she was experiencing neck pain while swimming – a surprising culprit for what is commonly known as “swimmer’s shoulder.”
How can you tell if your shoulder pain is coming from your neck? There were a couple clues from Sarah’s story that revealed that her pain was coming from her neck, not her shoulder.
- Sarah’s shoulder pain was worse in freestyle, but felt no pain during every other stroke
- When asked where Sarah’s shoulder pain was when swimming, she circled an area around her trapezius and around the base of her neck.
- Sarah also mentioned that sometimes she feels her shoulder pain while she is in school, but only at the end of the day.
- Sarah’s main complaint while swimming is that she felt like her right shoulder would get really weak, especially long, aerobic freestyle days.
- Based off what Sarah said, it seemed like Sarah was not having shoulder pain when swimming. Instead, Sarah was having neck pain when swimming.
Why Would A Swimmer Have Neck Pain?
In many cases of swimmers shoulder, there is some sort of tightness around the neck that can lead to altered shoulder mechanics. For swimmers this makes sense. Why? Because think about how many times you move your neck each practice. Except for backstroke, you have to move your neck in order to breath. With how many yards a swimmer does each practice, that adds up to a lot of neck movements!
Does Your Neck Really Change How Your Shoulder Moves?
YES! Tightness in the neck can have a significant impact on a swimmer’s shoulder movement. There are several common culprits of neck tightness, including the levator scapulae, scalene muscles, suboccipitals, and sternocleidomastoid muscles. Typically, these muscles become tight for two reasons: they’re trying to compensate for weak scapular muscles or because of improper breathing mechanics while swimming.
To achieve optimal shoulder strength and stability, the serratus and trapezius muscles are essential, particularly when it comes to upward rotation. However, when the neck muscles, such as the levator scapulae and scalenes, become tight, they can interfere with the movement and prevent the activation of the serratus and trapezius muscles. This can lead to decreased strength and stability in the swimmer’s stroke.
How Do You Know If Your Neck Is Causing Your Swimmers Shoulder?
To answer this, let’s go back to clues for Sarah’s case.
Clue #1 Pain Only During Freestyle.
What is the difference between freestyle and all of the other strokes? Freestyle is the only one where you have to rotate to breath! Naturally, this requires more effort from the muscles surround your neck. The increase in effort can lead to increased tightness of those muscles, impacting how your shoulder moves. Since the other strokes are less demanding on the neck muscles, they may not be as painful.
If a painful muscle or tendon in the shoulder was the driver behind your pain, you would except it to be amplified during butterfly or backstroke. Both of these strokes require the same, if not more, strength and power of the shoulder muscles. The increase in demand of the shoulder muscles during butterfly or backstroke would lead to more irritation if it was truly a shoulder injury.
Clue #2 Pain Location
Sarah is experiencing pain in the trapezius and the base of her neck, which are commonly known to refer pain from the neck. A picture below displays various areas that may be painful depending on which part of your neck is affected.
When a muscle, tendon, or ligament around the shoulder is painful, the pain is usually concentrated in one area. However, when the neck is the source of the pain, the discomfort tends to be more vague. Sarah is unable to identify a specific area of pain, which is a common symptom of neck pain.
Clue #3 Pain in School
In school or at work, you may find yourself sitting for prolonged period, causing your neck to remain in the same position for over 7 hours a day. This can result in neck irritation, and the longer you stay in this position, the more intense the pain becomes, as Sarah pointed out.
Moreover, you may not use your shoulder muscles extensively in school, which usually does not lead to shoulder irritation. Therefore, if your shoulder is the root of your discomfort, then sitting in school should not aggravate it
Clue #4 Type of Practice Where Pain is Worse
This is connected to clue #1, which indicates that Sarah experienced little to no discomfort during her IM or stroke practices. If Sarah’s shoulder was the primary source of her discomfort, then she would have experienced pain during these practices as well, not just during long aerobic workouts.
For swimmers who have an inflamed muscle or tendon, days that require a lot of butterfly or backstroke can exacerbate their pain. This is due to the fact that butterfly and backstroke are just as demanding, if not more demanding not the shoulder compared to freestyle. Therefore, the fact that Sarah did not experience any discomfort during her IM or stroke practices suggests that her shoulder may not be the root cause of her pain, further highlighting the connection between neck pain and swimmer’s shoulder.
What Should You Do If You Have Neck Pain When Swimming?
Here are some of my favorite exercises that will help get rid of your neck pain when swimming.
Diaphragmatic Breathing
Diaphragmatic breathing is one of the first exercises to do if you have neck pain when swimming. By getting the diaphragm to do most of the work when breathing, you are taking stress off the muscles around the neck. By taking stress off the neck, you will optimize the function of your shoulder muscles, allowing you to return to pain free swimming faster.
Thoracic Extension Over Foam Roller
Recent studies have highlighted the notable advantages of incorporating thoracic mobility exercises into the routine of individuals experiencing neck pain. These exercises can help alleviate the pressure on your neck by ensuring that your mid-back region remains supple and limber.
One particular exercise that can be beneficial is thoracic extension over a foam roller. This exercise helps counteract the adverse effects of prolonged sitting by promoting the proper movement and extension of the thoracic spine. You can also perform this exercise over a chair, which helps maintain movement in your thoracic spine and neck throughout the day. Incorporating these exercises into your daily routine can significantly contribute to reducing neck pain and discomfort.
Face Pulls
Incorporating face pulls into your exercise regimen can help strengthen the muscles located in the mid-back region and promote the upward rotation of the scapula. By strengthening these muscles, you can provide your neck with a more stable foundation to move from, ultimately reducing the stress placed on your neck and minimizing the likelihood of experiencing neck pain. This exercise is particularly beneficial for those looking to alleviate neck pain by focusing on strengthening the muscles in their mid-back region.
What To Look For When You Swim?
The biggest stroke error you will see in a swimmer who has neck pain is that they will lift their head while breathing. Cueing the swimmer to breath with one google in the water and one google out of the water is a classic cue that is helpful in this situation. Having a coach or teammate film you to make sure you are not excessively lifting your head while you breath can help ensure you are not putting excessive strain on your neck. If you want to see some of the other stroke errors that may lead to pain when swimming, check out another post, the top three freestyle mistakes that lead to swimmers shoulder.
The Wrap Up:
In some cases, swimmers may attribute their shoulder pain to their actual shoulder. When, in reality, it may be their neck that is the source of the discomfort. There are several indicators that can help differentiate between neck and shoulder pain. Some of these indicators include the type of strokes that cause pain, the location of the pain, and whether or not the pain is present outside of swimming.
By analyzing these indicators, you can get a better understanding of the root cause of your pain. If you suspect that your neck may be the cause of your discomfort, consider trying some of the exercises outlined in this article to see if they help alleviate your pain. Remember, identifying the true source of your discomfort is crucial for developing an effective treatment plan and preventing further injury.