So I think I have what is called shoulder impingement. A pain/burning sensation on the side and back of my left shoulder that sometimes occurs in my upper arm as well (sorry, I’m not so good with the anatomy words). In searching past posts, it seems like there may be some technique flaws that exacerbate this, and that flexibility and strength exercises will help.
My questions for the gurus are (1) what technique flaws contribute to shoulder stress and impingement, (2) what flexibility exercises would help, and how can I tell if I’m flexibile, and (3) what strength exercises would be appropriate.
Thanks in advance. Maybe if I get brave enough I’ll post a swimming video…
There are lots of possible causes, but it essentially comes down to overstressing the very small rotator cuff muscles as compared to the much larger lats. This list is not exhaustive, there could be other issues that lead to this issue.
insufficient rotation of the shoulders
pulling too wide
crossing midline on entry / reach / pull
dropping elbow.
It’s less of a flexibility issue as opposed to technique. you want to do exercises aimed at strengthening the rotator cuff (your gym might have charts, or some of the physio types might chime in here, I don’t have time to give a lot more right now) and ice the area post workout. make sure you warm up well before swimming hard as well.
I’m not a swimming guru, but I went through the same RC problems/pains last winter after increasing my volume rapidly. My left shoulder still isn’t totally normal, but it’s functional and pain free now (Last Feb./March I was at the point where it was too weak/uncomfortable to lift over my head).
What I did was 1. take a couple weeks off. Impingement is caused by inflammation and the tendons rubbing against each other. As long as you keep swimming, they’ll keep rubbing and stay inflamed. 2. Go back to swimming gradually, starting with one a week and moving up to three within about 6 weeks. 3. Advil 4. Stretch. I now ALWAYS stretch for 5 minutes before warming up (yes, “cold”, it seems to work well for me), then for 5 minutes after warming up, then for 5 minutes at the conclusion of my swim. 5. Vary what strokes I do! Don’t just do all freestyle all the time. Also, learning to breathe bilaterally helps to keep shoulder use even if you aren’t already doing that.
The stretches I do are the typical triceps stretch (elbow above head, hand pointing down behind neck, tug on elbow with other hand), a yoga stretch called “eagle” (google it), and stretching each side (arm fully extended above head, bend at waist and reach), amongst others.
I can speak from a therapy perspective. Impingement can be exacerbated by imbalances in the muscles around the shoulder joint, although the traditional view that two bones compress together has actually been challenged in a lot of recent studies.
Common causes can include weakness of the posterior rotator cuff muscles on the back of the shoulder, tightness in the latissimus dorsi and pectoral muscles, weakness in some of the muscles that provide stability around the shoulder girdle as well as technique faults as you mentioned.
It is impossible for me or anyone here to give meaningfull advice over the internet. I would suggest that you look for a good sports PT for stretching/strengthening, I have also had good results personally with neuromuscular therapy.
Many shoulder problems i see are due to people starting their pull with a straight arm and then making it worse if using a pull buoy. For instance, it’s similar to trying to pull yourself out of a pool with your arms straight in front of you. That’s pretty tough on the shoulders. If you aren’t sure what you’re doing, and most people can’t be without seeing themselves on video, then have somebody check out your stroke. Good luck!
I would suggest having someone watch your stroke underwater. Have them look for this:
When your arm reachs full extention before you catch phase, your fingers should be more >> than 6 inchs below the surface of the water. If your fingers are at the surface of the water, you are putting your shoulder in a compromised position that can lead to impingment issues (much like if while standing if you put your arm straight up and attempt to push on a wall). As someone above mentioned, it is nearly impossible to pull from that kind of position without dropping your elbow.
I’ve seen many (including myself) cause impingment injuries through that kind of arm positioning/overextension.
If you have more questions feel free to PM me, there are other ways to impinge, but that is one of the most common.
Shoulder impingement is usually due to a decrease in the size of the subacromial space which maybe due to muscle imbalances rotating the scapula forward or weak rotator cuff muscles which are not controlling your humeral head. Most commonly tight pecs specifically the pec minor and weak inferior traps contribute to poor scapular stabilization. Also you may have a restrictive or lax joint capsule or a problem with how your scapula moves along your thoracic wall. Make an appointment with a sports doc or physio and they can do a complete assessment of your shoulder and let you know what specific exercises to do.
I’ve had two major insults to my shoulders – the first was a car accident at 60+mph that caused impingements in both RCs. The second happened 18 months later, when I tripped and broke my right collar bone and made the first injury worse. Both caused impingement.
Physical therapy helped me tremendously. The therapists were able to identify which muscles were weak, and had me go through exercises at each session that strengthened them. They also worked on the flexibility of the joints (particularly after the broken collarbone).
It’s important to know which muscles need the work, and that’s where their expertise was extremely valuable. There are a number of exercises that you can do, but I think you should get properly diagnosed so that you make sure to do the appropriate ones.
On a side note, I had gone back to PT after having back pain return 18 months after the car accident. I showed up to cancel my second appointment with my arm in a sling, and I think they were somewhat amused at my string of bad luck.
Shoulder impingement is usually due to a decrease in the size of the subacromial space which maybe due to muscle imbalances rotating the scapula forward or weak rotator cuff muscles which are not controlling your humeral head. Most commonly tight pecs specifically the pec minor and weak inferior traps contribute to poor scapular stabilization. Also you may have a restrictive or lax joint capsule or a problem with how your scapula moves along your thoracic wall. Make an appointment with a sports doc or physio and they can do a complete assessment of your shoulder and let you know what specific exercises to do.
Nice summary, matches my research from when my shoulder was a big problem.
I’m not sure the original poster has impingement. I thought that usually resulted in pain in the front of the shoulder.
As for the poster who said that you need to keep your fingers >6" below the surface… I dunno if that is right. The key would be to not do something stupid like start a straight arm pull from that position. A nice rotation of the upper arm with the forearm pointing vertically down before initiating the pull, Hackett-style, shouldn’t be a problem. Of course, who the heck can do that?
It is likely that you are not doing at least one of two things…
completing the stroke underwater with that arm, - lifting your hand out too early.
Not relaxing your recovery.
It mostly DOES NOT MATTER what your arm does when it is not in the water. Too many fast swimmers have crazy looking recoveries. But, very few fast swimmers don’t have relaxed recoveries…It’s true that you don’t want to enter the water crossing over your head to the other side. And, - it’s true that you don’t want to twist your shoulders and upper body, (and fishtail), if you happen to swing your arm around.
But even if you swing your arm around, are relaxed, and stop it before it crosses over, and keep your upper body still and streamline and not fish tail, - even a low swinging recovery is fine as long as its RELAXED.
Try flicking/snapping your wrist upon exiting the water at the completion of your stroke. This will help tremendously…
Concentrate on lifting from the elbow and just let your wrist dangle and swing side to side, - it should be so relaxed.
When your arm is in the air, - that is your rest. There is a WORK PHASE and there is a REST PHASE. When you’re arm is in the air, - you must be resting that arm.
Swimming is different from the other sports, - well I think that one should rest their up-pedals too on the bike, - in that you must spend HALF of your swimming time resting.
My suspicion is that you’re trying to hard to recover with a high elbow and your not finishing your pull before lifting your arm out of the water and you’re scrinching up your arm/elbow once it gets in the air and it’s tense. Complete the stroke, relax the exit and recovery, and don’t worry too much about a high elbow. I high elbow isn’t a bad idea, and not a bad way to learn, - but it should never be at the expense of relaxation.
So I think I have what is called shoulder impingement. A pain/burning sensation on the side and back of my left shoulder that sometimes occurs in my upper arm as well (sorry, I’m not so good with the anatomy words). In searching past posts, it seems like there may be some technique flaws that exacerbate this, and that flexibility and strength exercises will help.
My questions for the gurus are (1) what technique flaws contribute to shoulder stress and impingement, (2) what flexibility exercises would help, and how can I tell if I’m flexibile, and (3) what strength exercises would be appropriate.
Thanks in advance. Maybe if I get brave enough I’ll post a swimming video…
Take it from me from someone who saw a lot of this when I was practicing medicine. If you truly have impingment (some mechanical cause - usually a bone spur - impinging on the rotator cuff muscles causing inflammation from shoulder use) then you will probably need surgery if you really want to get better. If you have some muscle imbalances causing some pain that looks like impingement or the problem is not very bad, physical therapy can make a lot of difference. There are many other diagnoses that can look like impingement but isn’t. This disorder is commonly misdiagnosed.
There are a number of “incorrect” things that Doug says that get eaten up by inexperienced distance swimmers here. Doug steps outside some of the “norms” and accepted coaching techniques propagated by many current elite coaches.
One example is that overemphasis of the kick as propulsion that removes one from the streamline position.
The kick is important, it flows from the shoulder and hip rotation to assist in the proper balance when rolling and employing compensatory rolling.
But by all means, - pick up a kick board and kick for 3,000 yards, don’t work your upper body, and don’t keep your head down; and watch the real swimmers blow by you as you tire yourself out with kicking…
It is likely that you are not doing at least one of two things…
completing the stroke underwater with that arm, - lifting your hand out too early.
Not relaxing your recovery.
It mostly DOES NOT MATTER what your arm does when it is not in the water. Too many fast swimmers have crazy looking recoveries. But, very few fast swimmers don’t have relaxed recoveries…It’s true that you don’t want to enter the water crossing over your head to the other side. And, - it’s true that you don’t want to twist your shoulders and upper body, (and fishtail), if you happen to swing your arm around.
But even if you swing your arm around, are relaxed, and stop it before it crosses over, and keep your upper body still and streamline and not fish tail, - even a low swinging recovery is fine as long as its RELAXED.
Try flicking/snapping your wrist upon exiting the water at the completion of your stroke. This will help tremendously…
Concentrate on lifting from the elbow and just let your wrist dangle and swing side to side, - it should be so relaxed.
When your arm is in the air, - that is your rest. There is a WORK PHASE and there is a REST PHASE. When you’re arm is in the air, - you must be resting that arm.
Swimming is different from the other sports, - well I think that one should rest their up-pedals too on the bike, - in that you must spend HALF of your swimming time resting.
My suspicion is that you’re trying to hard to recover with a high elbow and your not finishing your pull before lifting your arm out of the water and you’re scrinching up your arm/elbow once it gets in the air and it’s tense. Complete the stroke, relax the exit and recovery, and don’t worry too much about a high elbow. I high elbow isn’t a bad idea, and not a bad way to learn, - but it should never be at the expense of relaxation.
Cheers,
one of the worst, most inaccurate posts i have ever seen. and that’s saying a lot around here.
It seems like most of the traditional cause and effect stuff has been discussed here already. The truth is, we have no idea what is really wrong with your shoulder or stroke because we haven’t seen/examined them, and even then it would still be very difficult. I suffered from a lot of shoulder problems throughout my swimming career and I will just add something that worked for me. 2 years after I graduated from college and stopped swimming non-stop, my shoulders still hurt all the time - in the morning, when I was lifting upper body, whatever. Even though I hadn’t swam much since I graduated in those two years they were still pretty bad. I started doing the arm bike at the gym to add some cardio and conditioning for my upper body. It is like a stationary bike for your arms and would probably be recommended as treatment if you went to PT. I would do a 20-30 minute interval type workout on this machine and I was really shocked at the results. I could feel all those little muscles in my shoulders being strengthened when I did the workout and my shoulders got better. I have since gotten more serious about swimming again as I picked up triathlon and I have had no problems so far - something that never happened before.
So if you have access to one, I would strongly recommend the arm bike. Try a workout or two a week on one and maybe you will have the great results that I did. You will work through this problem one way or another. Feel free to PM me if you have any questions about it. Good Luck.
I had a swim coach who worked with me and I still developed impingement. A lot of mine had to do with a poor computer set up at my job.
After suffering for 2 years, and trying ART and physical therapy, I’m having surgery in December. After an MRI, I have a bone sput and a little bit of a hook that’s rubbing on my rotator cuff. I also have some scapula issues.
If you have something to say, why not say it instead of attaching a label? How is it inaccurate?
Explain yourself, instead of just attaching a sound bite.
Wherein do my points not follow current, and well learned trainging and stroke techniques from the pundits in the sport? Quick, Jochums, and their ilk? Are you a swim coach?
There are a number of “incorrect” things that Doug says that get eaten up by inexperienced distance swimmers here. Doug steps outside some of the “norms” and accepted coaching techniques propagated by many current elite coaches.
One example is that overemphasis of the kick as propulsion that removes one from the streamline position.
The kick is important, it flows from the shoulder and hip rotation to assist in the proper balance when rolling and employing compensatory rolling.
But by all means, - pick up a kick board and kick for 3,000 yards, don’t work your upper body, and don’t keep your head down; and watch the real swimmers blow by you as you tire yourself out with kicking…
That’s a stretch. I’ve seen him swim. His kick is tight and moderate, and he encouraged the same in my swimming. I think many over-read what it is he is saying about the kick.
I would get it looked at by a doctor or therapist who has experience with athletes. If you have a connection or contact with a university, you could have one of the trainers or doctors point you in the right direction. It may be something that isn’t caused by swimming. If it is caused by swimming, you would probably need to have somebody watch you swim in order to determine what’s happening.
If you have something to say, why not say it instead of attaching a label? How is it inaccurate?
Explain yourself, instead of just attaching a sound bite.
Wherein do my points not follow current, and well learned trainging and stroke techniques from the pundits in the sport? Quick, Jochums, and their ilk? Are you a swim coach?
okay, your idea of finishing the stroke, flicking the wrist, etc. is flat out wrong. no propulsion is generated and it makes it more difficult to initiate the recovery. you’re more or less on track with the majority of the rest of your post, which is strange, because you are so wrong on this fundamental point. in fact, you essentially contradict yourself. in looking back, that stuck out at me and is such a common misconception, hence my response.
