Thursday, December 28, 2023

Swimmer's Shoulder

Swimmer’s shoulder is any of a few types of shoulder issues that cause pain, weakness and instability. Providers group them together as swimmer’s shoulder because it’s common among high-level swimmers or people who train competitively. You’ll need at least a few weeks of rest, at-home treatments and physical therapy to help your shoulder heal.

Overview

Swimmer’s shoulder is a broad term that providers use to describe irritation and damage in your shoulder joint.
Swimmer’s shoulder happens when extra stress irritates tissue in your shoulder. The irritated tissue develops tiny tears.

What is swimmer’s shoulder?

Swimmer’s shoulder causes shoulder pain, weakness and other symptoms in your shoulder joint. It’s a broad name for a few different issues that cause similar symptoms.

It gets its name from who it usually affects — swimmers and other athletes who use their shoulders a lot to move their arms overhead.

Your shoulder is a complex joint where bones, muscles and connective tissue (tendons and ligaments) come together to let you move your arms. If you swim, play another sport that puts stress on your shoulder or do physical work, you’re more likely to irritate tissue in your shoulder.

Visit a healthcare provider if you have shoulder pain that lasts longer than a week.

Types of swimmer’s shoulder

Healthcare providers refer to several different shoulder conditions as swimmer’s shoulder. Your provider might say that you have a more specific issue, including:

  • Shoulder impingement syndrome: Pain that happens when the top outer edge of your shoulder blade (scapula) pinches your rotator cuff beneath it.
  • Rotator cuff tendinitis: Rotator cuff tendinitis is exactly what its name sounds like — tendinitis that affects your rotator cuff. Tendinitis is swelling or irritation of a tendon.
  • Shoulder labrum injuries: Your shoulder labrum is a layer of cartilage that protects and stabilizes your shoulder joint.
  • Shoulder muscle strains: Muscle strains (pulled muscles) are injuries that cause a muscle to tear.
  • Pinched nerves: Pinched nerves happen when tissue around a nerve traps it or puts too much pressure on it and makes it send pain signals to your brain.

How common is swimmer’s shoulder?

It’s hard to know exactly how common swimmer’s shoulder is because providers use the term as a catch-all for so many different types of shoulder issues. Experts estimate that at least one-third of elite competitive swimmers have had some type of swimmer’s shoulder.

However, it’s probably even more common than that, especially among amateur athletes, people who play other sports and people who hurt their shoulders doing physical work.

Symptoms and Causes

What are swimmer’s shoulder symptoms?

The most common swimmer’s shoulder symptoms include:

  • Shoulder pain.
  • Muscle weakness.
  • Reduced range of motion (how far you can comfortably move your shoulder).
  • Shoulder weakness or instability.

What causes swimmer’s shoulder?

Swimmer’s shoulder happens when something puts repeated stress and strain on your shoulder joint. Over time, the extra stress irritates your tissue. The irritated tissue develops tiny tears, leading to inflammation and scar tissue. This damage prevents your joint from moving smoothly.

It might sound obvious, but swimming is the most common cause of swimmer’s shoulder. More specifically, training competitively or swimming often for exercise causes it. Swimming is great exercise, but it can put a lot of pressure on your shoulder joints — especially if you’re intentionally pushing your body to improve your strength, speed and race times.

Any activity or job that makes you use your shoulder for a repetitive motion with your arms over your head can cause swimmer’s shoulder. It’s common in sports that require lots of throwing (like baseball) or physical jobs (like swinging a hammer or using heavy tools).

Diagnosis and Tests

How is swimmer’s shoulder diagnosed?

A healthcare provider will diagnose swimmer’s shoulder with a physical exam. They’ll examine your shoulder and ask about your symptoms. Tell your provider when you first noticed pain or other symptoms and if any activities make them worse.

Your provider will also check your shoulder’s range of motion (how far you can move it) and strength. They’ll compare it to your other, uninjured shoulder.

Swimmer’s shoulder tests

You may need imaging tests to take pictures of your shoulder joint and the tissue around it, including:

Management and Treatment

What are swimmer’s shoulder treatments?

Your provider will suggest treatments to relieve your pain and reduce stress on your shoulder joint. The goal of treating swimmer’s shoulder is to prevent more damage inside your joint and to help your shoulder regain its normal function. The most common swimmer’s shoulder treatments include:

  • Rest: Stop physical activity that uses your shoulder — especially the sport or activity that caused the swimmer’s shoulder. Your provider will tell you how long to take a break from training or working.
  • Physical therapy: A physical therapist will give you stretches and exercises to strengthen your shoulder and improve its range of motion. As your shoulder heals, they’ll give you exercises to strengthen the muscles around your shoulder.
  • Icing: Apply ice or a cold pack to your shoulder. Wrap ice packs in a thin towel to avoid putting them directly on your skin. Your provider will tell you how often (and for how long) you should ice your shoulder.
  • Pain relievers: Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) can relieve pain and reduce swelling. Don’t take NSAIDs for more than 10 days in a row without talking to your provider.
  • Corticosteroids: Corticosteroids are prescription medications that reduce inflammation. You may need cortisone shots injected directly into your shoulder joint.
  • Ergonomic adjustments: You might need to change how you do certain motions or activities. If you’re a competitive athlete, you may need to tweak your posture or positioning when you’re training or competing.
  • Swimmer’s shoulder surgery: Your provider might recommend surgery if other treatments don’t relieve your symptoms. They’ll tell you which type of procedure you’ll need and how long it’ll take to recover.

Can swimmer’s shoulder be cured?

Swimmer’s shoulder isn’t cured the same way some infections are — there’s no set end date when your provider can say that you’ve taken a full course of antibiotics and the infection is gone. But it’s usually a temporary issue.

Most people with swimmer’s shoulder start to feel better in a few weeks after starting treatment. Don’t return to swimming or other training before your provider says it’s safe, even if your symptoms are improving.

How can I prevent swimmer’s shoulder?

The best way to prevent swimmer’s shoulder is to avoid overusing your shoulders:

  • Stop training or physical activities as soon as you feel pain. Never force yourself to train or play through pain.
  • Stretch, warm up and cool down before physical activities.
  • Keep your rotator cuff and back muscles strong to support your shoulders.
  • Wear the right equipment for all sports and physical work.
  • Follow a diet and exercise plan that’s healthy for you.
  • Visit a healthcare provider as soon as you notice pain or other symptoms.

Prevention

How can swimmer’s shoulder be prevented?

You can reduce your risk of developing swimmer’s shoulder by:

  • Avoiding repeated stress on the shoulder whenever possible.
  • Practicing proper body mechanics when exercising or working.
  • Resting when your shoulder joint feels tired or overused.
  • Stretching and warming up before swimming or other sports.

Outlook / Prognosis

How long does swimmer’s shoulder take to heal?

Everyone has a different swimmer’s shoulder recovery time. How long it’ll take depends on how quickly your shoulder heals, and how much irritation or damage there was inside your joint.

It usually takes at least a few weeks to recover enough to resume training, but it can take a month (or longer) for your shoulder to heal completely.

Living With

How do I take care of myself while I’m recovering?

Don’t resume swimming or other physical activities before your healthcare provider says it’s safe. If you stress your shoulder again before it has time to heal, you’re more likely to reinjure it. This can increase your risk of more severe injuries like a torn rotator cuff or SLAP tear.

When should I see my healthcare provider?

Visit a healthcare provider as soon as you notice symptoms like pain, swelling or a decreased range of motion in your shoulder.

When should I go to the ER?

Go to the emergency room if you’ve experienced trauma, can’t move your shoulder or think you might have a dislocated shoulder. Never try to force your shoulder back into place on your own.

What questions should I ask my provider?

You may want to ask your healthcare provider:

  • Which type of swimmer’s shoulder do I have?
  • Will I need any tests?
  • Which treatments will I need?
  • Will I need surgery?
  • How long should I take a break from training or practicing?

A note from Cleveland Clinic

Any injury is frustrating for an athlete. That’s especially true when you’re training to perform your best and end up hurt. Swimmer’s shoulder might mean you have to take a break from training or working out for a few weeks, but that time off is worth it.

Don’t rush your recovery — listen to your body and give your shoulder all the time it needs to recover. The damage in your shoulder is temporary, but your shoulder needs time to heal before you can dive back into your training.

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