Sore Shoulders

I'm going through something similar. Age 41, no arthritis, swim 5k a week. The cause of shoulder pain in my case is probably a combination of my decidedly unschooled technique and my need to build up some musculature (I just started swimming several months ago). See previous posts under "Shoulder Pain". I've since gotten a bit of coaching, but am pursuing more. Also got some videos. 5x per week I do a routine with dumbbells that strengthen the rotator cuffs. (If you search the net under rotator cuff exercise, you should run across some free sites with illustrations.) This combination of things seems to be working in my case.

I posted a while back on shoulder and neck pain. I found out that my problem was that I tend to only use my upper trapezius when lifting my arms and not my lower and middle trapezius (all three should be used). There is an article in Swim on maximinzing your core strength ( November December 2002) that states that the trunk muscles of swimmers are generally weaker in relationship to the extremities and that most dryland exercises focus on the rotator cuff, shoulder and anterior muscles which are rarely week in swimmers. It suggests exercises that focus on the core and gives many exercises for the lower and middle trapezius muscles. It also talks about poor posture in swimmers. The article refers to shoulder problem articles in May/June and July/August 2001 of SWIM. These might be worth checking out. I would love to hear more information from anyone else with more knowledge on this topic.

If there is a professional, semi-pro, college, or even junior college athletic program in your area, call up the athletic trainer and ask who he/she recommends for sports medicine physical therapy. If you can find a top level SWIM program, the recommendation from a trainer here would be particularly applicable to your situation. Odds are high you can overcome your injury with the right tailored program of exercises, but you will need someone skilled to show you specifically which exercises you need. For what it's worth, one of the top shoulder doctors in the world thinks that "impingement" is something of a myth. His view is that most shoulder problems seen in overuse situations, like in swimming, stem from an overly stretched and thus loverly lax ligamentous capsule (the sheathe that keeps your humeral head attached in its socket); the warble and woof caused by this laxity, in turn, causes chafing of the tissues with resultant imflammation. Impingement--which is chafing against one of the bony arches in your shoulder--is not a primary problem but rather a secondary consequence of this capsular laxity. Fix the laxity and the "impingement" goes away. (Surgeons would rather carve away part of the bony arch and leave the shoulder capsule loose--which, in my mind, is a backwards solution at best.) Exercises to strengthen the rotator cuffs can stabilize the joint, reduce the warble, stem the inflammation, and make you feel better. One more note: contrary to popular belief, stretching can sometimes make things worse, since the root cause is often too much looseness to begin with. Strengthening counterbalancing muscles -- which more or less tightens your shoulder up a bit -- will likely help more. But you need an expert to tell you how to do this strengthening.

You need to go see a good orthopedic doc to find out exactly what is the problem. There are numerous possibilities, but several of the most common are: impingement, rotator cuff problems, osteoarthritis of the A/C joint. Impingement usually requires some combo of rest, technique change, anti-inflammatories and surgery. Rotator cuff problems require surgery if they are severe (tear, etc) , but often can be improved with rest and rehab exercises if not too bad. Highly recommended book: The Seven Minute Rotator Cuff Solution. I went for a year with symptoms that had everyone convinced that I had impingement, but an MRI revealed little of that. turns out it's osteoarthritis of the A/C joint and it feels alot like it's in the shoulder, but it's not. The good news there is that the doc said I could use it as long as I could stand the pain and then the surgery would likely be quite successful. Bottom line is that it's be 3 years and 1300+ miles of swimming and I still haven't had to get cut and it hasn't really progressed. Go to an "A" team doctor and get the diagnosis. (Two recommendations, although they are way out of your way: Brian Sennett at Univ of PA in Philly and Leigh(anne) Curl in the University of Maryland system.) -LBJ

Hi, let me throw in another thought for consideration. A month or so ago my right shoulder started getting sore. I rested it, cut back on the yards I was swimming, paid close attention to my technique, etc. but nothing seemed to help and I was beginning to get worried. Then one day at work, I realized that at about the time my shoulder started hurting was about the same time I rearranged my desk and moved my mouse to another position... further up on my desk, more of a reach. ?????????? I moved it back to its original position and poof by the end of the day I could tell a difference and, my shoulder was better in about 2 days! My point it may, or may not be the swimming, look for other things that might be causing your shoulder pain too. Lainey

I had an impingement problem in my left shoulder after trying to increase my fly distance. For three days I could hardly lift my arm, much less think about swimming. When I got back in the pool, I was expecting a problem with freestyle, but it never happened. I took a few easy practices with just freestyle, then tried fly again. Wham! Sore shoulder. Not as bad as before, but still pretty uncomfortable. Looking around the web for some answers, I came across an article about hand position on entry for freestyle and its effect on shoulder pain. The author said that the middle finger should enter the water first, and that a thumb/forefinger entry would put the shoulder in an awkward position and contribute to impingement problems. I realized almost immediately that, when I swim fly, I rotate both hands so that the thumbs enter first. I think I'm trying to grab as much of the water as I can. I was actually taught this way in my youth. I tend to have a similar entry in freestyle, but it isn't as exaggerated and I don't catch quite the same way. I surmised it was the exaggeration in fly that gave me the problem. I started making a conscious effort to reach forward instead of inward on entry, and the shoulder problem seems to have abated. I have yet to try to increase my fly distance again, but happily my stroke seems a little more powerful this way and less tiring. So I guess I should thank my traitorous shoulder. That's my story, and I can only speak for me... But maybe it's worth taking a look at your hand entry position?