Dryland Training for Swimmers’ Shoulder

潜水员

As a physiotherapist, I see clients in the clinic with varying degrees of swimming related shoulder pain. If you’ve been swimming for years to maintain fitness or are just picking up the sport as a new hobby or training for a triathlon, shoulder injury can really put a wrench in your plans.

It is important to see a physiotherapist if you are having shoulder issues for proper treatment to address the root cause of the injury, and to provide proper treatment including useful prevention strategies. A physiotherapist can also offer insight into training methods and stroke mechanics to keep you injury free.

Exercises for Prevention of Shoulder Injury in Swimmers

The majority of the forward propulsion force involved in swimming comes from the upper extremities, which explains why the shoulders are extremely vulnerable to injury in most swimmers. Much like athletes who throw, a swimmer’s shoulder is at increased risk to injury when muscles surrounding the shoulder joint start to fatigue.

It is common for the latissimus dorsi and pectoralis major muscles to become overdeveloped in relation to the stabilizer muscles of the shoulder blade (middle and lower trapezius, rhomboids).The highly repetitive nature of swimming is what contributes to these muscle imbalances, which can be a factor in postural imbalances, predisposing a swimmer to injury.

Shoulder blade stability exercises, thoracic mobility, rotator cuff and core strengthening should form the foundation of a swimmer’s training program in order to decrease the likelihood of shoulder injury.

1. Self-massage of the latissimus dorsi, pectorals, and deltoids.

Thoracic spine (mid-back) extension is crucial in protecting the shoulder joint from injury. Shortening of the latissimus dorsi and pectorals is common in swimmers, which leads to a loss of extension through the thoracic spine – predisposing to shoulder impingement.

Self-massage of the latissimus dorsi, pectorals and deltoid can be done by rolling a ball against the wall (1-2 minutes for each muscle group). Muscles should be stretched a minimum of 3 repetitions for 30 seconds.

2. Shoulder Stabilization Exercises

Stabilization of the shoulder blade is essential in achieving optimum function of the shoulder joint. The shoulder blade needs to serve as a strong base of support for the rotator cuff muscles to dictate movements of the arm. Rhomboid muscles have been found to be overused in the propulsive stage of the swim stroke for swimmers with shoulder pain.

Training rhomboids should reduce the forward position of the arm, which can help decrease the chance of impingement. Training of the lower trapezius is also beneficial as it balances the upward pull of the upper trapezius during the entire freestyle stroke.

Rotator cuff and serratus anterior muscles are active during the entire freestyle stroke and thus must be trained to not succumb to fatigue.

Exercise: Middle Trapezius

• Lying on stomach, arms hanging over the edge with elbows bent.
• Raise elbows upward by squeezing shoulder blades together.
• Return to start position.
  

Exercise: Rhomboids

• Lying on stomach, with elbows bent and hands at shoulder level ‘in a ‘W’ position’.
• Pull the shoulder blades together and downward towards tailbone.
• Return to start position
  

Exercise: Lower Trapezius

• Lying on stomach with arm stretched out overhead, thumb facing the ceiling,
• Squeeze the shoulder blade down towards the opposite back pocket.
• Return to start position
  

Exercise: External Rotation

• Holding a resistance band in one hand, keep the shoulder at 90 degrees to the body and elbow bent at 90 degrees.
• Externally rotate forearm while maintaining 90 degree bent elbow.
• Return to start position.
  

Exercise: Internal Rotation

• Holding a resistance band in one hand, keep the shoulder at 90 degrees to the body and elbow bent at 90 degrees.
• Internally rotation forearm while maintaining 90 degree bent elbow.
• Return to start position.
  

Exercise: Serratus Punch

• Hold on to resistance band with arm forward at shoulder height (resistance behind you at shoulder level).
• Push your arm forward against the resistance band, rounding the shoulder blade around the rib cage. Keep elbow straight.
• Return to start position.
  

Complete 2 sets of 15 repetitions for each of the exercises above.

3. Core Strengthening

The most effective and efficient use of your muscles to propel you forward in the water is to generate a significant amount of power from core musculature during the body roll instead of relying on the shoulder girdle muscles. Not only do core muscles have increased strength but they also have a greater resistance to fatigue, which is why it is imperative to include core strengthening in a training program. Work up to holding your plank for 60 seconds, repeating this 3 times.

Modifications to or alternate strengthening and stretching components of the suggested exercises may be more beneficial but should be prescribed on an individual basis, as each swimmers body is unique. If shoulder aches and pains occur, first speak with your swim coach to review stroke mechanics. Proper monitoring of training volume, intensity and duration can minimize overuse shoulder injuries in swimmers. Should pain persist in the shoulder(s), consult a physiotherapist who is trained in recognizing muscular imbalances and range of motion restrictions, which will aid in preventing further injury.

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Carrie Viola is a Registered Physiotherapist practicing in Vancouver, BC who is passionate about injury rehabilitation and prevention. Since obtaining a Masters in Physiotherapy from McMaster University in 2006 she has been working in private practice helping both active individuals and athletes restore function, minimize re-injury and get back to the things they love to do safely and effectively.