Recreational and professional swimmers and surfers experience shoulder pain from time to time, and this condition is commonly referred to as swimmers/surfer’s shoulder. The typical symptoms are very similar to rotator cuff and impingement injuries. It is a condition caused by overuse.
Swimmers and surfers are required to use freestyle and ‘front crawl’ strokes, and these repetitive actions can lead to over-activation of the pectoralis muscles and overdevelopment of the internal rotators (subscapularis) located within each shoulder.
The pectoralis muscles may become much tighter than normal, and repetitive stress may lead to irritation of the soft tissues found around the shoulder, causing pain.
People with swimmers/surfers’ shoulder will have a reduced subacromial space, and the scapula (shoulder bone) will take a protracted abducted position. Left untreated, swelling will continue and subacromial space will continue to reduce. This is a debilitating condition, and without treatment individuals place themselves at risk of developing supraspinatus tendinosis.
Diagnosing Swimmers/Surfers Shoulder
This is a straightforward condition which can be diagnosed through a physical examination. The first sign is the presence of anterior shoulder pain, which is most acute either during physical activity or immediately after a swimming or surfing session.
The condition can make it difficult to maintain an even freestyle stroke, with individuals instead displaying a wide, flattened stroke. This is commonly referred to as the “dropped elbow” and can usually be seen when you first start swimming. In some cases, it may become more pronounced after you have warmed up and the scapula stabilizers start to suffer from fatigue.
During a physical examination, individuals may display bilateral abnormal scapula mispositioning which causes them to take on a round shouldered appearance. Impingement tests will be performed to confirm the diagnosis.
Treatment of Swimmers Shoulder
Treatment of swimmers/surfer’s shoulder at Sydney Shoulder Clinic is tailored to each individual, with the aim of addressing any muscle imbalance and improving shoulder strength and flexibility.
In the early stages, resistance band programs are typically used to assist with external rotation strengthening and helping to stabilize the scapular. This may then be followed by weight machines, free weights and stretching as advised by your physiotherapist.
Most individuals respond well to treatment, and within a few weeks you should be able to resume normal activity and gradually return to swimming as your rehabilitation progresses. Occasionally, subacromial corticosteroids used to supplement physical therapy.