Shoulder pain, or swimmer's shoulder, is a serious concern for swimmers. Shoulder pain can develop in swimmers as young as 10 or 11 and plague the careers of more seasoned athletes. More than 60 percent of experienced swimmers have some degree of shoulder pain, which can prevent training, encourage poor body mechanics and lead to disability. Shoulder pain must not be ignored.
Here are 10 signs a swimmer needs to see a physical therapist.
1. Irritability in the shoulder after extensive training
If a swimmer experiences significant shoulder pain that persists after training, it is time to get out of the pool and seek medical attention.
2. Painful shoulder movements in the pool
If a swimmer feels pain in any phase of the stroke, the pain may be caused by impingement. Pain is often caused by extension and pressure against the affected area of the shoulder. Just because the pain goes away after the phase of the stroke is completed does not mean the pain is gone for good. Swimmers must be cognizant of the location of the pain, when it occurs, and at what phase of the stroke it subsides.
3. Limited range of motion
A swimmer who experiences limited range of motion or impingement needs a physical therapist to identify and remedy the cause of the impingement that is preventing the swimmer from successfully completing a stroke.
4. Current or previous injury
Sometimes swimmers suffer shoulder injuries outside the pool. Poor dryland training or falling at home can injure a shoulder. If a swimmer suffers an injury out of the pool, his or her training team and physical therapist should be notified to prevent further injury.
5. Pain deep in the shoulder that increases with activity
If a swimmer feels deep pain within the shoulder that increases with activity, even after rest, he or she in the final stages of deterioration, and intervention is necessary.
6. Pain affects training
Many times swimmers adjust their strokes to avoid pain. It won't work. Too many swimmers push through the pain, hoping it will resolve or work itself out. It won't happen. Any pain during training must be articulated and addressed with a rehabilitation plan and rest.
7. Pain prevents participation
This is a serious stage. If a swimmer has made it to this point, swift intervention is required.
8. Shoulder instability
Shoulder instability is the result of overuse and sudden injury. Weak tendons and muscles are incapable of holding the shoulder in place, which can cause dislocations. Dislocations may be full or partial. Swimmers must talk to their physical therapist about previous shoulder dislocations, pain from a shoulder injury, slipping or looseness in the shoulder, and the feeling of the shoulder "giving out" when under any degree of pressure.
9. Pain or discomfort in the front of the shoulder
Swimmers who feel mild pain in the front of the shoulder that has not previously been present may be experiencing inflammation of a tendon. The swimmer typically feels the pain during warm-ups, but it subsides during training and doesn't reappear until after practice or competition is over. Too often, because the pain subsides while swimming, the swimmer dismisses it or does not associate the pain with shoulder trouble.
10. Constant Pain
If you have pain that doesn't resolve with rest, you probably have inflammation and need to see a physical therapist for a diagnosis and a treatment plan to resolve it.
There are many reasons why a swimmer needs to see a physical therapist. What a swimmer should not do is wait until the pain intensifies or he/she has to miss practices. Ignoring shoulder pain can lead to disability sooner than expected. The sooner a swimmer addresses and reports shoulder pain with the coaching staff and physical therapist, the more accurate the diagnosis and treatment options.
To learn more about shoulder pain and pain relief techniques, keep reading here.
Becker, T. J. (2011). "Overuse Shoulder Injuries in Swimmers." J Swimming Research, 18.
O'Donnell, C.J. (2005). "Identifying and Managing Shoulder Pain in Competitive Swimmers." The Physician and Sportsmedicine, 33(9).
Tovin, B. J. (2006). "Prevention and Treatment of Swimmer's Shoulder." North American Journal of Sports Physical Therapy : NAJSPT, 1(4), 166–175.
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