Swimmers, Why Do Your Shoulders Hurt?

All of those dedicated hours in the pool to get ready for your next big meet. Have you ever wondered why your shoulder hurts when you swim? I am going to write a series of blogs discussing some of the causes of shoulder pain in swimmers and what you can do about them. 

Shoulder Impingement

Anatomy of the Shoulder

Anatomically the shoulder joint is a very unstable joint. I equate it to a golf ball sitting on a golf tee. The ball is the head of your humerus (upper arm bone) and the tee is the glenoid fossa ( socket which is part of the scapula or shoulder blade). The shoulder relies heavily on ligaments, muscles, and cartilage to help provide stability. 

The shoulder joint from the back (left picture).  Shoulder joint from the front (right picture). And looking at the glenoid fossa (where the upper arm bone joins with the shoulder blade)

The shoulder joint from the back (left picture).  Shoulder joint from the front (right picture). And looking at the glenoid fossa (where the upper arm bone joins with the shoulder blade)

Impingement Explained

Impingement is when the humerus glides upward and causes stress on structures that sit under your acromion (part of your shoulder blade). There are a lot of pain sensitive structures that lie under this subacromial space, namely your rotator cuff musculature and your bursa sac. The rotator cuff is the musculature that helps to perform certain movements of the arm and shoulder blade as well as what helps to provide stability to the joint. A bursa sac is a fluid filled sac that helps to dampen forces and helps the shoulder joint move more freely. During the recovery phase or above water portion of the swim stroke the arm is going into a flexed and internally rotated position. This position along with the force of the water during hand entry puts a lot of stress on the shoulder joint and its surrounding structures. 

The supraspinatus muscle (shown below) and its tendon are often affected in impingement of the shoulder. 

supraspinatus.png

This muscle plays a key role is stabilizing the head of the humerus to prevent it from migrating upward into the acromion. This muscle along with others are susceptible to fatigue as the swimmer's practice progresses. This is where performing specific dry land training exercises helps to strengthen and build the endurance of those muscles. 

Try this exercise: It has shown a large level of contraction in the supraspinatus muscle. Make sure you are using a weight that you can perform 2-3 sets of 15 to 20 repetitions. Don't raise your arms straight ahead, but angled out slightly. 

Scaption.jpg

If you can't seem to get a handle on your shoulder pain. Give me a call or shoot me an e-mail and I will be able to do a thorough assessment to find your impairments that are leading to the true cause of your pain. 

Click on Pinnacle Physical Therapy below to head to my website for more information about me and my practice. Please like my FB page 'Pinnacle Physical Therapy.' I will be posting some cool videos on there specifically to keep Central Arkansas Swimmers healthy!