Go see an Ortho. They can help and hopefully get you back in the water pretty soon!

As the OP suggested, go see an ortho doc.

I've been having shoulder pain over the last month. Shut down the swim for ~10 days, hoping the pain would be better but it didn’t. Today saw the ortho and after doing some manipulations and looking at X-ray, he thinks I merely have rotator cuff inflammation and gave me a cortisone shot and can resume swimming in 2 days. It’s still TBD if this is the solution, but I’m very encouraged with the initial prognosis.

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Tad

It took awhile, but I finally discovered that its not the destination that's important, but rather the journey.

This may be unpopular but just giving some tough love here.

I strongly recommend you do some band work, rotator cuff strengthening activities. 100-200 each arm before swimming. Personally I would not get an injection before I had exhausted those other measures. I would and am deeply suspicious of any expert who had to do an xray to confirm whether I had inflamed the tendons around my rotator cuff.

Good luck with it. The band work really strengthens your arms, shoulders and forearms, if you can build up to doing 200 on each arm at a time. External rotation rotator cuff exercises.

I agree 100%! I neglected to mention that he did give me a whole packet of exercises to do along with bands of varying resistance.

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Tad

It took awhile, but I finally discovered that its not the destination that's important, but rather the journey.

This - I would skip the ortho, who will tell you it is tendonitis and send you to PT, and find a PT. PM me for the name of a swim specific PT online.
I had rotator cuff tendinitis develop three or four weeks ago and have eliminated it, or close to it, with PT and stroke technique changes
The key is you want a PT who is a swim specialist

Here are the exercises I do:
Lay on side, external rotations w 1 or 2 lb wt
External rotation step out: anchor resistance band to something. Hold in R hand. Step to the right and don’t let shoulder rotate inward
Serratus push ups (google)
Face pulls (google)
Supraspinatus thing - hold two lb wt in both hand, raise arms w elbows in a diamond position. Elbows to shoulder height

There is an excellent chance the pain can be relieved w strength… and better technique

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

To the OP, sorry this happened at this time. You can still have a good race that you are proud of!

honestly there is just about no other diagnosis other than something serious that cannot be healed in time. If this was a month earlier, I'd say there is enough time to fix a tear, but with only a month, nah.

And I'll say it anyhow: You should still go to the pool and KICK. The entire workout. Anyone who says that won't help you swim faster or is will "tire" your legs for the other disciplines doesn't know what they are talking about. Feel free to add fins at times too.

This is reason # 2 (maybe #1) as to why you shouldn't do long straight swims very often. I am NOT in the "never do them" camp. But maybe twice a month tops.

he said it is tendonitis, not a tear

tear is different story!

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

no I am agreeing with you. What I am saying is if its a tear, well, he's out of luck.

ah, got it

and yes kicking is a good ROI

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Longtime swimmer here and I developed some pretty gnarly impingement in left shoulder and tendonitis in right shoulder prohibiting me from swimming in 2020 after a few years of masters swimming competitions. I went to ortho and got MRI to confirm no tears, cortisone shot made it worse, and PT over a few months doing the resistance band exercises started helping a lot, but the only thing that finally cured it was the hanging method described by Dr. Kirsch orthopedic surgeon who discovered this method to heal his own shoulder and avoid surgery himself. I read the book and ordered some deadlifting wrist straps from amazon and began hanging a few mins a day from my pull-up bar and within weeks I was cured, and to this day anytime I feel a twinge, its back to a few mins of hanging with the straps, although I recommend allowing some weight to be supported with your feet, especially when first starting the regiment. Dr. Kirsch shows x-ray evidence in his book of how the shoulder joint can be permanently enlarged with this regiment allowing more room for rotator cuff tendons to move freely and that is how the problems are cured. Honestly, I would not be still swimming and improving to this day without the hanging regiment and of course I still do resistance band exercises to strengthen the shoulder tendons. Here's the book:


Shoulder Pain? The Solution & Prevention, Revised & Expanded: Kirsch M D, John M: 9781589096424: Amazon.com: Books

Amazon.com: DMoose Weight Lifting Hooks (Pair), Hand Grip Support Wrist Straps for Men and Women, 8 mm Thick Padded Neoprene, Deadlift, Powerlifting, Pull up bar, Liftups, Shrugs : Sports & Outdoors

I've heard of that and read Kirsh's book. I think it definitely works for some people.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

lifelong swimmer, have literally had all the shoulder injuries (including shoulder surgery).

Immediate thoughts - you probably have something in your form that's causing an overuse injury (or did something to make your shoulder angry). Work with someone on swim form to get some correction.

After every swim (and probably a few times per day) - ICE. Seriously.

Go see a sports PT or a sports chiro that does dry needling. Skip the ortho. Orthos will just send you for imaging, inject you with cortisone and tell you to stop doing what you're doing. A sports PT will give you some corrective exercises and also do some work (dry needling, graston) to loosen things up and restore motion. Then follow their instructions to the letter.

How will that help? It got inflamed, you rested a bit, that didn't help (but if it was inflamed, you wouldn't really have expected it to be sorted in 10 days). You get a cortisone shot, which will help with the inflammation, and the pain it's causing, but won't help with why the inflammation started in the first place. And the inflammation won't be away in 2 days, it will merely be suppressed by the cortisone shot. If you have a race this weekend or next weekend, than it will get you through, but if you want it to be sorted in the long run, you probably need to look at why it got inflammed in the first place, and give it more rest to heal.

That's a fair response and I agree the cortisone injection is treating the effect, and not the cause.

Given that this is the first time I've had a shoulder issue like this in the 40 years I've been doing tri's and being a swimmer since I was a kid, I'm willing to take this approach to start to see how it plays out.

If the pain continues 4+ weeks from now, I'll get an MRI and see what that reveals to determine next course of action.

The dialogue on this thread has been helpful! Some good options to look into!!

No races on the calendar, just trying to keep in top shape. My training changes very little whether training for an IM, climbing 14ers, doing some open water swims, long hikes, rides or runs. I just enjoy the training and being active. Total privilege that I appreciate more and more with every passing year.

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Tad

It took awhile, but I finally discovered that its not the destination that's important, but rather the journey.

Your user name is great

Glad you had some improvement and recovery on the hangs. It sounds like such a fringe, unorthodox treatment. But it is working for many people. I had heard about it from a masters swimmer kelly Parker palace on her podcast and she swears by it. My limiter to completing hangs is grip strength so the straps are a good idea for me. I can manage 5x30 seconds on and 30 seconds off but it’s very painful to my hands.

Kelly is an accomplished masters swimmer and a life long distance swimmer.

I don’t always like her podcasting style but that may be a cultural difference

Gratuitous observations aside hanging does feel very good and the feeling of taking deep breaths when hanging is doing something remedial as far as I can feel. Kelly describes it as having blood pump through and flush out the shoulder, which correlates nicely to what I can visualise in my head

I had the same thing
Here is what solved it for me

Run the heat in your vehicle while driving to the pool. You want to be WARM

Rotator cuff warmup with surgical tubing for 10 minutes EVERY time before swimming. Look on YouTube

EASY extended warmup before your main set

Substitute fist swimming for your normal stroke. This takes the stress off your shoulder. Look on YouTube for Swimming fist drill

Ice immediately after your swim

RELAX your arm on the recovery. Believe it or not this could be the cause

I would definitely NOT suddenly start kicking a lot

I did that based upon advice here ended up causing soreness in my knee. Bad enough I had to stop biking and running for 2 weeks

That after just increasing kicking 400 yards per day for 2 weeks

Did a search for shoulder injuries, everything else was quite old. good luck Paddyb. I'll need to post a new thread.

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2024 Races: USAT State of CT Age Group Championship/State of CT HS Champs/ CT Club Championship - Sat June 15th (Oly/Du/Sprint) Hopkins Vineyard Tri at Lake Waramaug Saturday July 13th http://www.HopkinsVineyardTri.com

This would've been my advice too but it sounds like you answered that OP & are doing a lot of strength work. I'm still a little skeptical of a serious injury on 2-3 swims/week without a ton of intensity. On the surface, it sounds like something where PT & strength could help you continue your normal routine. As suggested, maybe have someone take a look at your form. & maybe think about some coaching if you self coach. It sounds like you just get in the pool & go most days. Lots of ez but continuous swimming. It's ok to use different pool aids. You can isolate your upper & lower body. You can use paddles to try to build some strength. You can be doing some kick sets while you let your shoulder calm down some. Maybe some more balanced training allows you to be able to find some consistency.

Totally agree. First time I've ever seen anyone say this. I'm not sure how a sports doctor or physio is going to fix a swimming injury without understanding the fundamentals of the freestyle stroke. The issue would be an ineffective stroke, which is overloading the shoulder causing tendonitis. How is a PT who isn't a swim specialist going to diagnose this? As Dr T says, they'll just say it's tendonitis, give you a cortisone shot and a bunch of useless strengthening exercises with a band. There is nothing wrong with the shoulder joint or the rotator cuff, it doesn't need to be stronger, it needs to be not overloaded! And that's done with stroke correction, something a doctor or PT (with no swim knowledge) is not going to be able to fix.

This is a great suggestion.


I'm sorry to hear that. Kicking has technique too. IDK if that was an issue for you. Adding that much kick - which isn't a lot - and getting hurt from it is somewhat strange.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

This.

The cortisone shot reduces the inflammation, but doesn't fix the problem.

  


General PTs are usually okay at what I'd call the basics of rotator cuff strengthening - which typically involves strengthening the serratus anterior and infraspinatus (the former helps with scapular control and the latter helps w external rotation). That can help. But form corrections are KEY.

The biggest contributor, IMO, to my resolving my tendonitis was videoing my stroke and making form corrections. The strength I am doing supports that, but the strength alone (which I did pre-video) wasn't enough to override the strain of less-than-perfect mechanics.

I don't think general PTs are useless, I just think it's better to work with a swim specialist one, and there are people who do that online now which is awesome

Cortisone may calm pain and get one over the hump such that one can DO some strength training. I don't think it's entirely useless. But expecting it to solve something on its own, without adding the strength and addressing the stroke, isn't a smart choice IMO

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

I'm sorry to hear about your shoulder issue before IMTX. I know that can be frustrating. I'll give you my advice for how best to get to the race in the best shape possible. The biggest thing will be to get the inflammation under control and then figure out what is causing it. As long as a medical professional hasn't said don't swim, you can do the following:

Kick - Do it with fins, without fins, try it with short fins and long fins. Do sets of longer repeats and shorter repeats. You can treat it just like you are training for the swim and it will keep your fitness up and feel for the water.

Wear fins - If you are up for a regular swim, wear fins. The fins will take pressure off your shoulders and allow you to work on your technique.

Video - Take a look at your stroke. Your movement incorrectly over and over again is what is causing the tendinitis. The most common reason I see is an athlete pulls on the outside their body frame. Literally, while they are pulling the hand is 8-12 inches outside their body instead of inline with their shoulder or underneath their body when they pull. There are a bunch of causes for it to happen, but the result is usually a "bicep tendinitis."

Training - There are types of training that are more prone to generating tendinitis. The one you mentioned from your training is the continuous, straight swim. It is an absolute recipe for injuring your shoulder and re-enforcing crappy technique. The other would be as a new or inexperienced swimmer working on tempo.

Again, sorry to hear about your shoulder and if you have any other questions, please let me know.

Tim

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Checking in, how are you?

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD