Swimmer’s Shoulder Takes a Toll on Young Bodies
July 05, 2005
By: Jean Johnson for Shoulder1
The condition known as swimmer’s shoulder was first described in 1974 two years after Mark Spitz won seven gold medals in the 1972 Olympic Games and inspired thousands of Americans to head off to their nearest lap pool. Termed a painful repetitive use syndrome, swimmers shoulder wears most heavily on the young – children who often start swimming careers as early as age 7.
|Watch for these symptoms of swimmer’s shoulder:|
1. Pain during freestyle and butterfly strokes
2. Pain that is worse with backstroke and less intense with breaststroke
3. Increased sensitivity when sleeping on the aggravated side
4. Shoulder is tender to the touch
5. In advanced cases, pain that occurs when not swimming or using the shoulder
Scott M. Koehler M.D. and David C. Thorson M.D. note that “children naturally avoid activities that cause soreness and discomfort, but they are pushed beyond discomfort in competitive athletics when they have the motivation to succeed and pressure to please coaches and parents.” Further, the physicians note that adolescents’ relatively underdeveloped shoulder muscles often compounds problems.
“Swimming brings the shoulder through at least one impingement position with each stroke,” according to Koehler and Thorson. “A 10,000-yd. training session may include 4,000 or more strokes with each arm, probably the most overhead arm strokes used in any sport.”
Because the shoulder has a wide range of motion in both directions, it is of necessity a loosely constructed joint. Consequently, impingement in which the soft tissues in the joint are compressed between the upper arm bone or humerus and shoulder blade or scapula.
Rotator cuff tendonitis is the most common injury seen in swimmer’s shoulder according to associate professor of orthopedic surgery and rehabilitation at the University of Chicago, Sherwin S. W. Ho M.D. “As the shoulder is pushed to its limits in terms of strength and endurance, the rotator cuff muscles generally fatigue before the power muscles,” writes Ho. In addition to causing inflammation associated with swimmer’s shoulder, Ho points out the problem also “decreases stroke efficiency.”
That’s precisely what brings swimmers to their physicians. Pain is one thing, but poor performance come race time gets everyone’s attention. “That’s why Tracy finally said something to us,” said Dorian Fletcher of Portland, mother of 12-year-old Tracy. “She’d been doing everything her coach said including hours of training outside the pool – all the weights and cardio workouts. This went on for months, of course. She started in September just after school began and kept up the regime just like she was supposed to all winter long clear into March. Who knows how far she would have pushed her body if her race times hadn’t started slipping and we began asking questions.”
The best treatment for swimmer’s shoulder is rest, but physicians know that swimmers will only tolerate so much time off from their sport. Consequently, approaches try to supplement regular training that involves the shoulder with biking and kickboard pool workouts. Swimmers with shoulder problems are also tutored in both warm-up exercises that include careful stretching and the mechanics of stroke technique. These techniques combined with icing and massaging routines as well as in some cases physical therapy generally allow the shoulder to recover and often swimmers find they are able to increase their race times despite training with less overall yardage.
Last updated: 05-Jul-05