Keep moving . . . Swimmer’s shoulder

Jeff Albertson
Jeff Albertson

By Jeff Albertson

If you’re anything like me, you couldn’t get enough of the Olympics. We had it on at the clinic all day. It’s one of the only times my kids are allowed to watch TV during the week. I love it!

With rivalries, drama, and cupping bruises, swimming was especially fun to watch this year. This has inspired me to write a piece on swimmer’s shoulder.

What is it?
Swimmer’s shoulder is so common among swimmers that even recreational or seasonal lake swimmers may experience it. The term swimmer’s shoulder does not describe one specific tissue pathology; rather, it describes a set of symptoms including pain along the front, top and/or side of the shoulder.

What causes it?
Due to the large range of motion required of swimmers’ shoulders, some athletes may experience a gradual weakening of the ligaments, capsule, and a portion of the rotator cuff that support the front of the joint.

A competitive swimmer can exceed 4,000 strokes for one shoulder in a single workout! The associated repetitive strain accumulates, and these tissues begin to over-stretch. Sloppy joint movement results in further tissue strain and inflammation.

What to do?
If you are already experiencing symptoms, lower your volume or stop completely.

Some simple strategies:

  • Avoid swimming fatigued
  • Do not use hand paddles
  • Consider the use of training fins
  • Warm up properly before training
  • Check your swimming form:

    • Avoid over-reaching
    • Avoid entering the water in a thumbs down position
    • Avoid crossing mid-line with arms during pull through

    How to avoid it?
    The physical demands on the shoulders are considerable. Even with perfect form, the shoulder spends 25% of the stroke cycle in a vulnerable position. The competitive swimmer must be properly conditioned for the task!

    Have your strength evaluated. Swimming demands a high level of coordination and endurance from the rotator cuff muscles and the muscles that stabilize the shoulder blade.

    Have your mobility evaluated. Correct swimming form requires the shoulder to move through a very large range of motion. Proper mobility relies on many pieces of the biomechanical chain. This includes the shoulder joint itself, the shoulder blade, collarbone, the neck, mid-back and ribcage.

    Finally, consider your training schedule. Swimmer’s shoulder is often a result of overuse, misuse, or a combination thereof.

    If shoulder pain is interrupting your swimming regimen, address it early!

    See our blog at for more extensive information including sample exercises and self-treatment recommendations.

    As always, I invite the reader to email me directly with any thoughts on this subject, injury-related questions, or ideas and requests for future articles.

    Jeff Albertson is a sports physical therapist and the director of physical therapy at VASTA Performance Training and Physical Therapy in South Burlington. See for information on services or for more tips on remaining injury free.