SHOULDER PAIN: A SWIMMER’S COMPLAINT
The most common complaint from swimmers is shoulder pain.
But sometimes it isn’t coming from the shoulder.
When a swimmer has slight pain at end of range shoulder movements but no loss of shoulder strength it is always best to examine the cervical spine (neck) and ensure there is no involvement coming from there – and if that is clear, we move on a little further down the body.
Key assessment point for swimmers with shoulder pain:
Upon examination, if there is some tightness in thoracic spine extension (backwards) movement, which can be demonstrated in a reduced combined elevation test.
If there is a reduction in thoracic range, the mild sub-acromial shoulder impingement we are being presented with can be possibly brought on by tightness in the swimmer’s abdominal muscles – that in turn are reducing thoracic extension…. are you still with me?
When there is tightness limited his thoracic spine movement, there is some extra difficulty in achieving full shoulder range of movement.
In swimming, the streamlined body position underwater is crucial for good efficient swimming. Obtaining an ideal body position reduces the drag forces applied on the body, as they will slow the swimmer and force them to work much harder to generate enough force to propel their body through the water and get to the end. The extra work to overcome these drag forces is a large contributing factor to overload injuries, especially in shoulders;
A good streamline body position has a number of key components:
Upper body: sufficient shoulder flexibility, thoracic spine extension / mobility / strength, adequate abdominal muscle length Lower Body: enough hip extension (ability to move hip / thigh backwards), ankle plantar flexion (pointing toes like a ballerina) and core control – hello abs!
Here is an exploration of the upper body components:
Adequate Arm & Shoulder Flexibility The ability to get your arms into an extreme position above your head with ease is essential for a good streamlined position. Tightness through your shoulder muscles, especially your latisssimus dorsi, pectorals (major and minor) and the rotator cuff (shoulder blade) muscles will make this difficult. So get stretching
Adequate Thoracic Spine Extension / Mobility / Strength This describes the ability of the portion of the spine near the shoulder blades to straighten up. This allows the spine to get longer and the shoulders to achieve their maximum position overhead more easily. Thoracic spine mobility is often comprimised by habitual poor sitting postures (school, work desks).
Adequate Abdominal Muscle Length
But aren’t we just meant to have abs of steel? Not quite!
Strength and control is also very important but often in our attempts to achieve improved strength (eg. hundreds of crunches), we actually tighten these muscles and compromise their length.
This can lead to the rib cage being pulled down / forwards and difficulty expanding the chest when breathing. This makes it difficult for the swimmer to obtain thoracic spine extension and thus, a streamlined body position.
If you think some of these characteristics may apply to you and your swimming and / or you would like further information, please feel free to contact me