Competitive swimmers often face a unique set of challenges, with shoulder injuries being one of the most common issues. Due to the repetitive motions involved in swimming strokes like freestyle, butterfly, and backstroke, swimmers are prone to developing shoulder instability and overuse injuries. These injuries, if not properly managed, can lead to long-term issues, potentially sidelining an athlete's career.

In this post, Dr. William Sterett, a distinguished orthopedic surgeon at Vail-Summit Orthopaedics & Neurosurgery, delves into the causes of shoulder instability in swimmers and offers practical advice on how to prevent overuse injuries, with a focus on strengthening exercises to keep the shoulders healthy.

What is Shoulder Instability?

Shoulder instability occurs when the structures that hold the shoulder joint together—muscles, tendons, and ligaments—are weakened or damaged. In swimmers, this typically happens due to the repetitive overhead motions involved in their strokes. Over time, these motions place stress on the shoulder joint, potentially causing it to become loose or even dislocate. Instability can result in pain, weakness, and limited range of motion, all of which can affect a swimmer’s performance.

Dr. Sterett explains, “Swimmers rely heavily on the shoulder joint for propulsion in the water. With every stroke, they put their shoulder muscles and tendons under tremendous strain. Without proper conditioning and care, this strain can lead to instability or even dislocation.”

Overuse Injuries in Swimmers

In addition to instability, overuse injuries are prevalent among swimmers. These occur when the muscles and tendons in the shoulder are repeatedly overworked, leading to inflammation and pain. Common overuse injuries in swimmers include:

• Swimmer’s Shoulder (Rotator Cuff Tendinitis): Inflammation of the tendons in the shoulder, particularly the rotator cuff, is often caused by repetitive overhead strokes.

• Labral Tears: The labrum, a piece of cartilage that stabilizes the shoulder joint, can tear due to repeated strain.

• Biceps Tendinitis: The tendon connecting the biceps muscle to the shoulder can become irritated from overuse, causing pain in the front of the shoulder.

Dr. Sterett emphasizes, “Overuse injuries develop gradually and can be difficult to detect early on. It’s essential for swimmers to listen to their bodies and seek medical attention if they experience persistent pain or discomfort.”

The Importance of Consulting a Professional

Before incorporating any new exercises or routines, it's essential to consult a healthcare provider, especially if you have any pre-existing conditions or concerns about your shoulder health. A medical professional can guide you on appropriate exercises for your body and ensure that you're training safely to avoid injury. Dr. Sterett advises, “Every athlete is unique. Getting personalized advice can help prevent injuries and optimize performance.”

Strengthening Exercises to Prevent Shoulder Injuries

To prevent shoulder instability and overuse injuries, swimmers should focus on strengthening the muscles around the shoulder, particularly the rotator cuff and scapular stabilizers. A strong, well-balanced shoulder can handle the repetitive motions of swimming more effectively and reduce the risk of injury. Below are a few recommended exercises:

External Rotation with Resistance Bands

• This exercise targets the rotator cuff muscles and helps to stabilize the shoulder joint.

• Secure a resistance band to a sturdy object at elbow height.

• Hold the band with your elbow bent at 90 degrees, keeping your elbow close to your side.

• Rotate your forearm outward, then slowly return to the starting position.

• Repeat for 2–3 sets of 10–15 reps on each arm.

Scapular Push-Ups

Scapular push-ups strengthen the muscles around the shoulder blades, which play a critical role in shoulder stability.

• Start in a high plank position with your hands directly under your shoulders.

• Without bending your elbows, squeeze your shoulder blades together, then push them apart.

• Perform 2–3 sets of 10–12 reps.

Prone Y-T-W Lifts

This exercise works the scapular stabilizers and helps improve shoulder strength and mobility.

• Lie face down on a bench or the floor with your arms extended overhead in a Y position.

• Lift your arms off the ground, squeezing your shoulder blades together. Lower them and repeat.

• After 10 reps, move your arms to a T position and repeat. Finish with a W position.

• Complete 2–3 sets of each position.

Internal Rotation with Resistance Bands

This exercise complements external rotations by working the opposite muscles in the shoulder.

• Secure a resistance band to a sturdy object at elbow height.

• Hold the band with your elbow bent at 90 degrees, keeping your elbow close to your side.

• Rotate your forearm inward, then slowly return to the starting position.

• Repeat for 2–3 sets of 10–15 reps on each arm.

Shoulder Flexion Isometrics

This exercise strengthens the shoulder muscles without excessive movement, reducing strain on the joint.

• Stand facing a wall with your arm extended in front of you.

• Press your hand against the wall as hard as possible without moving your arm.

• Hold for 10–15 seconds, then relax. Repeat 2–3 times per arm.

Proper Technique and Recovery

In addition to strengthening exercises, swimmers should ensure they are using proper technique to reduce unnecessary strain on their shoulders. Coaches and trainers can provide feedback on stroke mechanics, ensuring that swimmers maintain proper alignment and avoid excessive internal rotation of the shoulder.

Recovery is also key to preventing overuse injuries. Incorporating rest days into the training schedule, using ice therapy after intense sessions, and prioritizing flexibility through stretching can all aid in keeping the shoulders healthy.

Dr. Sterett advises, “Preventing shoulder injuries in swimmers is all about balance—between training intensity, technique, and recovery. By paying attention to all three, swimmers can avoid the common pitfalls that lead to shoulder instability and overuse injuries.”

Conclusion

Shoulder instability and overuse injuries are common in competitive swimmers, but they don’t have to be career-ending. By focusing on strengthening exercises, proper technique, and recovery, swimmers can keep their shoulders healthy and strong. If you’re experiencing shoulder pain or instability, don’t wait—schedule a consultation with Dr. Sterett at Vail-Summit Orthopaedics & Neurosurgery today.

For more information or to schedule a consultation with Dr. Sterett, contact our office. Your health and mobility are our top priorities.