Identifying and Managing Shoulder Pain in Competitive Swimmers How to Minimize Training Flaws and Other Risks

For CME accreditation information, instructions and learning objectives, click here. In Brief: Shoulder pain resulting from glenohumeral instability is common among competitive swimmers. The biomechanics inherent to swimming promote muscular imbalances that stress the capsuloligamentous structures and contribute to shoulder instability. Most swimmers respond favorably to conservative treatment of rest and rehabilitation, while a small percentage may ultimately require surgical intervention. Swimmers who respond well to rehabilitation have a better prognosis for a successful return to swimming than those who require surgery. Overall, education in proper stroke and training techniques can minimize the likelihood that a competitive swimmer will experience disabling shoulder pain. Swimming is a rigorous sport that has been included in the modern Olympics since 1896.20 Because of its popularity, it is common for children to start competitive swimming at 5 or 6 years of age. In a typical 2-hour pool session, an elite-level competitive swimmer may swim between 6,000 and 7,000 yd, or about 3.5 to 4 miles. This amounts to swimming an average of 20 to 40 miles per week, which is the aerobic equivalent of running 80 to 160 miles.2 This high yardage means that competitive swimmers perform between 1,500 and 4,000 strok