This winter, after taking another stroke clinic, I've really made some real progress with my swimming. In December a dull ache started in my right shoulder. It has now progressed to a much sharper pain that is deep inside the shoulder joint and it feels like my right arm is getting weaker. I have made an appointment with a hightly regarded ortho but he can't see me until March. It feels like the tendenitus I had in my elbow which swimming cured a few years ago. Does anyone have any idea what could be wrong and what I should do until I see the doc?
We would ned to know a little more about your swimming background and what other activities you are doing as well as some more infor about what seems to make the pain better or worse. I don’t know why you have the sensation that your arm is WEAKER on the side of the pain but I would worry about nerve compression. Certainly stroke errors can produce elbow pain and it is usually related to an improper hand entry I think e.g entering too close to the midline or I guess also from an “old school” type pull where you scull out after entry rather than coming straight back.
Are you lifting now?? Is your pain aggravated by aero bars?? Tell us more.
Chip
You’re likely to be suffering from impingement syndrome. The nerve gets pinched as it passes form the spine through the shoulder into the arm.
It is very likely casued by your swim technique.
Three areas are likely to be the problem examine them first. You’ll need a video camera and an interested investigator to see if you exhibit these things.
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Thumb first entry in freestyle, made worse by a straight arm recovery.
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Thumb first exit at the end o the pull also made worse by straight arm.
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Upper arm breaks frontal plane during recovery; also can be ade worse by straight arm recovery.
These thee things are the first place to look in your self examination. If you exhibit them, please stop doing them.
You’ll also need to strengthen the muscles, a physical therapist is the place to go.
Others on here will point you to shoulder exercises for those muscles including i think the 8 minute shoulder plan or something. Those exercises are good no doubt; they strengthen the shoulder capsule. But don’t overlook the mid and lower traps, they are the muscles that hold the scapula-shoulder system to the ribcage. They are overlooked but are very important to keep swimmers healthy.
The physical therapist will recommend exercises for them.
The first one is cable rows. But no tin the manner you’ve done them previously probably. Your shoulder girdle needs to be perfectly still while you do hem as does your back. The only motion sahould be in the arms and your low traps and mid traps should be burning.
The 50 cent explanation is that you put maybe 20 pounds on the cable machine, very light. Then you “SET” the shoulders. You set by first hunching your shoulders up, then bringing them back, then down. Now your shoulders are set and you can begin very slowly. You won’t be bale to move the cable more than 5 or 6 inches without your shoulders moving or hunching. If they do you aren’t doing it right; reset the shoulders and do a couple more. When you first start you’ll need to reset several times during the set of 12 or so.
If you can see a physical therapist before a few months then do so; if you need a referral from a GP then get one. March is too long to wait if your shoulder is losing strength.
Since you are losing strength try to get in with a neurologist; the whole point is that you need to see a sports physical therapist to get your rehab oing. If you can go directly, then do so; if you can get a referral from a GP then do that, ortho, neurologist; whatever you need to do to get to a PT do it.
Enjoy these links that cover the issue of shoulder health pretty well.
http://www.education.ed.ac.uk/swim/papers4/ad.html
First off you likely don’t need an orthopaedic surgeon for this. Likely all an ortho will tell you is that you don’t need surgery and refer you to physiotherapy for ultrasound. What I suggest to do is save yourself waiting until March and find a good physio or chiropractor in your area so treatments can begin sooner.
I had a shoulder problem when I first started tri. A swim coach told me I was dragging my arm too much across the water instead of lifting it and developed what he called “swimmer’s shoulder”, a fairly common problem. He showed me how to change my stroke and the problem went away, along with some self administered ultra-sound treatments(I’m a chiropractor). Don’t know if this is your problem as you’ve been to a swim clinic. Ask them to video tape you in the pool and analyze your stroke. That’s what they did at our swim clinic.
I had this exact same problem with my shoulder. Your problem is probably exacerbated by poor swimming technique. In my case part of the problem was pushing straight down with my fully extended arm while I was breathing. I am sure some of the other technique problems above would have similar results. Poor technique put a big strain on a shoulder that already had an impingment. In my case I needed surgery, but the large majority of times that is not necessary.
You can do a couple of tests with someone to help. Hold your arms straight out in front of you and have someone push down while you resist. Do the same with your arms rotated 1/3 of the way to the side. Do the same with your arms straight out from the side. Do the tests with both your thumb up and your thumb down. I am betting you will find one or two of these tests show the affected arm much weaker. In my case, with my thumb down and my arm rotated 1/3 of the way to the side, my arm went straight down with almost no resistance.
If you have a substantial weakness, I would suggest you stop swimming until you see the orthopedist. He will probably send you straight to the physical therapist. Barring a significant joint problem like a bone deposit or arthritis, the PT will fix you up if you work hard in therapy.
I highly recommend that you check out the posts at the discussion forum at the Julstro website. They wrote “The Pain-Free Triathlete” and “The Pain-Free Swimmer”. There are several threads on shoulder pain there. www.julstro.com/18.html.
I was having some sharp pain right in the joint, and found the problem to be spasms in the muscles in my back. Julie Donnelly (author of the ebooks) had me lie on my back with a tennis ball under my shoulder blade. I slowly rolled around on the tennis ball and found several spots that were VERY painful. One right in the middle of the shoulder blade, one between the inner edge of the blade and my spine, and one down in my Lat muscle. I kept pressure on those places for 60 seconds at a time. I began to feel a little relief right away. After a few days of doing this several times a day, the pain in my shoulder left. She really got my attention. I’ve been huge fan ever since.
Thanks for all your help.
Here’s the story right now. I started swimming in 1998 at 48 years old. Made it through IMLP in '99 then took TI cinic but really swam bad the next year. Got some help and I’ve been getting better ever since. As I said I took another stroke clinic in November. Worked hard with lots of drills and started to feel really good in the water. Just got my workout pace to 1 min or 50 meters. The dull pain started around Christmas. I thought I was just overusing, but I cut way back on swimming as I got ready for Miami Marathon and the pain just got worse. My stroke is: reach, bend the elbow, goood body rotation, pull straight back with the hand exiting the water straight. I only just now strated to enter thumb first, now that the shoulder hurts. I breath to the right, every stroke. Tried bilateral breathing but felt like I was not getting enough air. I’m a heavy construction carpenter forman in NYC. I work my body hard every day; sledge hammers, shovels, big wrenches, scaffold, heavy timbers. I’m not ready to retire so I have to solve this problem. Again thanks for your help.