How to Identify Imbalances in Swimmers that May Lead to Shoulder Pain

Are you training swimmers? If so, here are the top three things you need to know to train them safely and avoid imbalances that cause swimmer’s shoulder.

  1. Swimmers are at risk for developing shoulder pain.
  2. Swimmers are at risk for developing upper crossed syndrome also known as “swimmer’s posture”.
  3. There is a high correlation between swimmer’s posture and shoulder pain. 
  4. Tune in next month to discover the fourth must-know tip for training swimmers!

Shoulder Pain Risk

When training athletes, always consider what injuries the athlete is at risk for.  For swimmers, shoulder pain is the most common injury.

  • 50% of swimmers at the college or master level have shoulder pain for at least 3 weeks a year.
  • 10% of competitive youth athletes develop shoulder pain. 
  • 26% of national swimmers have shoulder pain.

Musculoskeletal Imbalances in Swimmers

Swimmers who do not get enough specialized dryland training have a tendency to develop swimmer’s posture. Swimmer’s posture is characterized by forward head position, increased shoulder kyphosis, shoulders that are both rounded forwards and elevated. Vladimar Janda called this Upper Crossed Syndrome, which decreases the subacromial space in the shoulder. Therefore, increasing the risk of a rotator cuff impingement.

Swimmer’s Posture aka Upper Crossed Syndrome

Swimmer Shoulder Pain
© 2015 Craig E. Morrris All Rights Reserved

Upper Crossed Syndrome is characterized by:     

  • Muscles that are tight (hypertonic) and need to be stretched
  • Muscles that are weak (hypotonic) and need to be strengthened. 

Muscles needing “corrective strengthening”:

  • Neck flexors
  • Rhomboids
  • Middle and low traps
  • Serratus anterior

Muscles needing “corrective stretching”:

  • Neck muscles (suboccipitals, scalenes, levator scapula, sternocleidomastoid, upper traps)
  • Pec major and pec minor

In addition to poor posture, research shows swimmers also have range of motion imbalances in the shoulder. Swimmers typically have:

  1. Decreased shoulder internal rotation
  2. Decreased shoulder horizontal adduction
  3. Excessive external shoulder rotation.
  4. Decreased shoulder flexion as a result of increased kyphosis and elevated scapula. 
  5. The strength coach should be screening both swimmers posture and evaluating shoulder range of motion as an injury prevention method.

Part two of this series covers how to choose exercises to correct and prevent shoulder pain in swimmers.

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