Swimming Injuries - Solutions?

I have been doing competitive swimming since I was 9 (I am now 37). About 5 yrs ago I suffered a major shoulder injury during workout. After about a 1 1/2 yrs of trying different things, I ended up having surgery. I am finally able to swim without pain, but it's been a major learning experience. The key here is maintaining strong rotator cuff muscles so that your shoulder joints remain in their correct position to a fraction of a mm. So here's what I would do: 1. You should, under no circumstances, swim through the pain. This will only excacerbate your injury, causing chronic and perhaps permanent damage. You should lay off for at least 6-8 weeks. This will allow a possible tear to heal. You should not get back in until you can swim without pain! You may have to be out of the water for as long as 3-6 months, or even a year. 2. At the same time, you should try to strengthen your shoulder rotator cuff. For me it really works to do external rotation and straight arm exercises (standing up) with surgical tubing. Start out easy, maybe 3 sets of 10 with little resistance. Do the excercises slowly. Eventually you should build up to 3 sets of 18. Stop if it hurts. Not strengthening your shoulder will cause your shoulder problems to continue. You should go to a physical therapist to get more excercises. You can also look at the USA swimming web site (www.usa-swimming.org), which at least until recently had really good articles on shoulder strengthening excercises. 3. Take ibuprofin for your pain when you are out of the water. The swelling causes further damage with shoulder movement and should be treated. 4. If you can not get rid of the shoulder pain through rest, physical therapy, and ibuprofin, you should definitely see a doctor! You may at first get a steriod shot in your shoulder, which may succeed in reducing swelling and pain, and allow you to heal. In my case this did not work (the pain did not subside for more than a day!) and I had to have orthroscopic shoulder surgery. It is not the end of the world. Eventually I was able to get back in the water and now I can do regular workouts. I still do my shoulder excercises every day before I swim, and this keeps my shoulder feeling great. I also don't use paddles (and you shouldn't either). Hope this helps.

I am new to this board, and definitely a newbie to swimming for exercise. However, I grew up almost swimming before walking (recreationally) and really love the exercise I get from swimming now. But that is beside the point. I am a family practice physican with a bit of sports medicine training (I am NOT board certified for sports medicine, however). I have also had more than my fair share of sports related, chronic injuries from various activities. I do have a few recommendations, but take them with a grain of salt since I have not had the chance to examine you, and mostly these are general recommendations. 1. You should, under no circumstances, swim through the pain. This will only excacerbate your injury, causing chronic and perhaps permanent damage Very very true. Sad, and bad news if you think about it, but things WILL get worse with any chronic tendonitis (which it sounds like you have) You should lay off for at least 6-8 weeks Hard to say for sure, but if this has been persistent or even intermittent for 6 years, 6-8 weeks is not long enough to rest your shoulder. 2. At the same time, you should try to strengthen your shoulder rotator cuff. Also true. Many chronic sports related injuries are at least in part caused by muscle imbalances across a large joint (examples: knees, shoulders, the low back). Here is the difficult part: it is nearly impossible to recover on your own. The shoulder muscles and its motion is perhaps the most intricate and complicated joint in the human body. I would say that you need either an awesome trainer or physical therapist to work with your shoulders to evaluate its motion and relative strengths of the rotator cuff muscles. If you continue on the path now, you will probably have chronic pain and/or instability of that shoulder. It's all about balance of strengths and mechanical forces. I don't see an easy answer to this one. A physical therapist well versed in sports medicine combined with avoidance of re injury, and knowing you are in for a long (but not impossible, I suspect) recovery are key. And now that my first post to this board is so preachy, please forgive me when I ask some questions that may sound dumb in the future

Duncan I am a college coach and we get many damaged goods that come to our team. Ahh, the benefits of years of hard work! We have found (mostly our trainers have found) that shoulder problems stem from lack of stabilizing muscles in and under your scapula.. maybe the reason we are all slouching as we read this. 1st solution: Sit and stand up straight. Our mothers were right, posture affects everything and you can begin strengthening those stabilizing muscles just by standing tall. Try it for five minutes to see what I am talking about. 2nd solution: talk to a sports trainer or somebody in the rehab industry and find a way to start a rehab/prevention program. A good program should require no more than 15 minutes a day, but here is the trick. You have to stick to it for the rest of your life if you want to keep swimming, better yet, pick up your kids. 3rd solution: try to start a lifting program, preferebly with someone who knows what you are trying to do. Many shoulder problems also stem from too much flexilbility. Yes, too much can cause other related problems. Yes, lifting is hard and takes time, but 30 minutes maybe two days a week could make an improvement. 4th; like everyone else has said, listen to your body. if it hurts then stop. try kicking the rest of practice or put fins on. Technique change is difficult especially if you are trying to change an already weak area, plus you are ignoring the prblem by placing blame on technique. Fix the shoulder not the form. Good luck Kipp

Thanks for all of your replies. I'm going to make it my New Year's Resolution to act on your suggestions. Thanks!

Those are great points. Six months ago I began a rehab program intended to strengthen the muscles which support the scapula. This has made a significant difference. I read somewhere that we should think of it as staying fit to swim, rather than swimming to stay fit.

I have had many sports related injuries over the years as well as some pretty severe damage from a car accident. I workout daily including a swim session at least 4 times a week. I have found that a combination of medical professionals seems to provide the best maintenance for my lifestyle. I do visit a Chiropractor once a month for lower back and shoulder/neck/arm adjustments. I also go to a certified massage therapist every 3 weeks. This is essential for me and has also been a great help to may daughter who is a collegiate swimmer. Additionally I consult an MD and Physical Therapists when I have a new injury. I would say that the Massage Therapist is the most indespensible. He is able to keep my muscles and entire body in balance and pain-free. Look for one who is certified for deep muscle massage and/or neuromuscular therapy. Not the type of massage you get on a cruise ship or a tanning spa.

I would definitely focus on proper stroke. I have taken a few Total Immersion clinics, and my previously "problematic" shoulder is giving me no trouble at all. I do not use paddles and limit my pull buoy use. I also have mastered the art of bi-lateral breathing, therefore destressing my left shoulder. I focus more on my body roll and making my body longer to swim faster, as opposed to pulling harder with my arms. I really do suggest checking out Total Immersion, it has done away with shoulder pain and has made me much more efficient. TI focuses more on the core of your body doing the work (torso) instead of the small muscles of your arms.