Many triathletes and high level swimmers suffer from shoulder pain so we asked Rachel Whittaker, clinical director at Six Physio, how to avoid and rehabilitate this common injury.

swimmer elbow

How to diagnose it:

Swimming predominately uses the upper body muscles (back, chest, shoulders and arms) to generate power and speed. Shoulder and neck issues are the main areas of concern for swimmers, often as a result of poor technique, which is frequently compounded by inappropriate training.

The shoulder is a very mobile joint and therefore it needs to be well controlled by the muscles and ligaments that surround it.

Over-training, fatigue, hypermobility, poor stroke technique, weakness, tightness, previous shoulder injury or the use of hand paddles can lead to your muscles and ligaments being overworked.

If this goes on, injuries such as rotator cuff impingement and tendonitis, rotator cuff tears, bursitis, capsule and ligament damage or cartilage damage can occur.

Getting the correct diagnosis is important in order to get the best treatment and to get you back in the pool quicker.

Swimmer’s shoulder is an umbrella term covering a range of painful shoulder overuse injuries that can occur in swimmers. Various parts of your shoulder can be injured from your swimming stroke, therefore the pain can be anything from a local ache near the shoulder joint to a radiating pain that travels up your shoulder and neck or down into your arm.

It is an overuse injury that is caused by repeated trauma rather than a specific incident. Over one third of top swimmers experience shoulder pain that prevents them from normal training.

Once you experience the onset of pain it is important you consult an orthopaedic specialist or a physiotherapist to assess your shoulder in order to seek the appropriate management of your pain.

Your physiotherapist will run through tests on the structures of the shoulder to determine what part of the shoulder is causing your pain.

They will also look at what has caused your shoulder to become painful in the first place and correct this.

How to fix it:

To prevent swimmer’s shoulder, work on lengthening tight muscles in the shoulder complex, strengthening the upper limbs and shoulder blade area and improving your thoracic(upper back) mobility.

Beneficial exercises include use of a foam roller to roll the upper back muscles, foam roller thoracic extensions, seated thoracic rotations and arm openings.

For strengthening, focus on scapula setting, rotator cuff strengthening using weights and resistance bands, pull ups, push ups and bicep/tricep strengthening.

Stretches for the pectoral muscles, latissimus dorsi, and tricep muscles are also beneficial. Maintaining strength and mobility increases speed through the water, but also delays the onset of fatigue and helps reduce levels of lactic acid accumulation.

Six Physio will be at Castle Triathlon Series events throughout the summer offering post-race massage to participants, or you can visit any of the Six Physio clinics in London and the South East. sixphysio.com/services/triathlon

See more training tips on our dedicated training page

Check out our injuries section for more solutions to niggling problems.