Swimmer's Shoulder

Q: I'm a 34-year-old woman who took up swimming seven years ago after a severe back injury. Because of the type of injury and subsequent chronic pain, I am limited to doing the side stroke and the crawl with the aid of a snorkel and mask.

I move through the water depending almost entirely on my upper body. Consequently I've developed bursitis - "swimmer 's shoulders." After swimming for 30 minutes my shoulders feel like they are on fire! I periodically take aspirin to alleviate the inflammation, but I feel like I'm just putting a band-aid on the problem.

I've temporarily stopped swimming, but my spine feels worse for it. Can you give me some suggestions?

A: Shoulder problems are common overuse injuries in sports in which the arm is used in an overhead or throwing motion. Repetitive use of the shoulder causes friction in the tissues of the rotator cuff.

These structures run underneath a tight archway formed by the collarbone and scapula (coracoacromial arch). When the arm is raised, there's less room under the archway and the tendons can be pinched.

The repetitive motion can cause painful microscopic damage, bleeding, inflammation and swelling, which then further limits the room under the arch. Pain leads to weakness, which sets up a vicious cycle of dysfunction. Contributing factors are weak muscles, improper training technique, previous injuries and either inflexibility or laxity of the shoulder joint.

Stopping the pain and inflammation early in the cycle will give you the best chance for a full recovery. Listen to your body and stop swimming when the pain starts.

Begin by icing the shoulder with real (not chemical) ice or a package of frozen peas for 15 minutes after a workout and additionally every three to six hours during the day. Stretch both before and after your workout, and spend some time in the weight room strengthening your rotator cuff and shoulder muscles.

To assure proper technique and set up a routine, consult with your physical therapist. Other treatments by a physical therapist, such as ultrasound, can be very helpful in reducing inflammation.

If the pain in your shoulders is constant, you need to stop swimming or just do the side stroke for a few weeks. Review your freestyle technique with a coach.

Anti-inflammatory drugs may be of help. You'd need to take 10 to 20 aspirin tablets a day for several days to get the same anti-inflammatory effect present in most prescription drugs. You might want to try some different types of prescription drugs.

There is a wide variety of individual responses to anti-inflammatory drugs, so keep looking if you don't get any relief. A sports medicine doctor may also recommend a cortisone shot directly into the inflamed tissues. But this may not be necessary: The program of stretching, strengthening, ice, rest and anti-inflammatory medication should get you back on track in six to 12 weeks.

About the authors: Carol L. Otis, M.D., is Chief Medical Advisor to the Sanex WTA and a UCLA student health physician. Roger Goldingay is a former professional soccer player. They are married and the co-authors of The Athletic Woman's Survival Guide.

Order Now!

Table of Contents

Foreword: Billie Jean King

Comments by Barb Harris
Editor in Chief,
Shape Magazine

General Health
Nutrition
Exercise
Common Medical Problems
Dental Health
Emergency!
Infectious Disease
Sexual Health
Emotional Well-Being
Eating Disorders
Alcohol & Other Drugs
Environmental Health
Prevention