What You Can Do to Keep Shoulder Injuries at Bay

As Masters swimmers, we know the basic, telltale signs of shoulder injury: pain, pinching, and those dreaded clicking sounds. But what do they mean—and when is it time to get your shoulders checked out by a doctor?

Sharp pains in your shoulder, especially felt at mid-catch when swimming freestyle, can be an indication of internal shoulder impingement—pinching—and tearing of the labrum, the ring of cartilage that reinforces the shoulder’s ball-and-socket joint, says Dr. Emilie Cheung, associate professor of orthopaedic surgery at the Stanford University Medical Center.

Pinching felt in the shoulder when the arm is extended out front can mean impingement of the rotator cuff—the muscles and tendons that cover the top of the upper arm bone and attach it to the shoulder blade, she adds.

And the clicking noises? Those are mechanical symptoms, often associated with pain, that can indicate tearing of the labrum or rotator cuff, Cheung says.

Only a doctor can diagnose a shoulder injury—and that’s done typically though the combination of a physical examination and an MRI—so sharp pains and clicking sounds should generally be followed by a trip to the doctor, Cheung says, to determine the exact injury.

But how do we keep those pains and clicks from ever happening in the first place?

Don’t Overdo It

Overuse of the shoulders is a common cause of shoulder injuries in swimmers, Cheung has found. That’s particularly the case for swimmers who swim a lot of freestyle—which is most of us—because with freestyle, the shoulders are in almost constant motion, going in the same direction.

That can lead to overused muscles in the front of the shoulder and underused muscles in the back—an imbalance that, in turn, can lead to labral tearing and rotator cuff and internal shoulder impingement, Cheung says.

Developing a good symmetrical body rotation is very important in avoiding muscle imbalance, Cheung says. When you begin the recovery part of your stroke, be sure your elbow is leading your arm out of the water, and, if you’re not already doing it, try bilateral breathing to make your body rotation more symmetrical.

Another tip: Make sure your thumb is not hitting the water first when your hand enters the water. If it is, your arm may be crossing your mid-line, putting your shoulder at a mechanical disadvantage, Cheung says. Instead, your fingertips should enter the water first at the end of the recovery, says Cathy Gainor, a coach for the Montgomery Ancient Mariners in Montgomery County, Md.

In fact, good technique is essential to avoiding shoulder injuries. “If someone has the kind of technique that will lead to injury, we [as coaches] try to get ahead of it,” says Jean Paul Gowdy, who coaches the swim teams at Pomona and Pitzer Colleges.

Mixing up your strokes can also help keep front and back shoulder and upper torso muscles from becoming imbalanced, Cheung adds. Backstroke is good reverse motion to complement a freestyle-heavy set. Or try reverse freestyle, which Gowdy frequently works into his teams’ workouts.

And swimming breaststroke “takes the pressure off of the arms and shoulders and puts it in other places,” adds Gainor, who always starts and ends her practices with a good warm-up and cool-down and advises following tough sets with an easy lap. “That breaks up what you’re doing to your shoulders,” she says.

Do Dryland

There are things swimmers can do out of the water, too, to preserve shoulder health. Cheung advises regularly stretching the main core muscles, the lower and upper back muscles, the hamstrings, and the quads to encourage proper shoulder rolling when swimming freestyle.

Sleeper stretches are a good way to stretch the shoulder, Cheung says, as are the strengthening exercises often referred to as the “I’s, Y’s, and T’s,” Gowdy adds. The former is a simple shoulder stretch that can be done while lying on your side, and the latter is a series of shoulder-strengthening exercises that can be done while lying face-down on a physioball or standing.

And, good posture, building up your core, and sitting upright—especially when spending the day behind a computer—are critical, Gainor adds.

“No matter what you do, always do some core exercises,” advises Mel McLaughlin, who was the head coach at Middlebury College from 1986 to 1997 and at MIT from 1997 to 2003. Using a resistance band is a great way to get in a few minutes of shoulder and core strengthening exercises—just be sure to put a rolled-up towel under your elbow when using the band, since the elbow and shoulder naturally curve toward the waist, she says.

But perhaps one of the best ways Masters swimmers can keep their shoulders healthy is not to try too hard to replicate the yardage of their youth, Gowdy says. Instead, focus on stroke quality.

When Masters swimmers let go of the idea that they need to keep swimming the same yardage they swam when they were 17 or 22, their risk for injury decreases—“and they actually do swim fast,” Gowdy says, “even when they’re only training for an hour, four days a week.”