I have searched the forum but haven’t found a good answer to my question.
I am a 43 yr old ex bike racer, and new swimmer and runner in the last yr and a half.
My swim is bad (1:14 at IMAZ this yr). Prior to IMAZ my swim training had been mostly steady swims, peaking at 6k per wk.
I am trying to qualify for Kona at IMCDA as I was 10 minutes away in IMAZ and the swim is obviously the weak link.
I am a physician and single father with 2 young boys and time is very hard to come by and increasing the days in the pool is not realistic so I have ramped up the intensity alot. My swim mainsets are now basically 20 X 100’s and then about 10 X 50’s, and the main set has been brutal and at maximal intensity. I only use paddles for up to 250meters per session.
I have made alot of progress but now my left shoulder is sore anteriorly and has been aching throughout the night. I breathe on the left. In the past ignoring nagging aches and pains has worked well for me and I want to ignore this too. My swim coach told me my technique had no glaring flaws that would predispose to injury. Since my swim volume and intensity are far less than what a competitive swimmer and most competent triathletes do, can I swim through the pain or am I asking for trouble? Any chance it will just go away on its own like so many annoying aches and pains do with cycling and running? Backing off is highly undesireable as my swim finally feels as though it’s making progress. Any thoughts during swimming that may take stress off the shoulder, such as waiting longer in the pull to apply the most effort?
I’ve got a cranky left shoulder that gets even crankier if I swim at a higher intensity than usual or quickly add volume. Interestingly, bike fitter identified part of the issue as bicep tendon inflammation at the shoulder end (couldn’t get comfortable in aero bars). In terms of my swim form, I think the things that exacerbate the pain are using solely my shoulder to pull, instead of core/back/lats. I think this happens because I initiate the pull too early, when my left arm is still stretched out and before I have adequately rotated.
Anyhow, here are the things that have helped:
–PT exercises, these need to be specific to your issue; US Swimming has a good section on shoulder injury prevention
http://www.usaswimming.org/ViewMiscArticle.aspx?TabId=1645&Alias=Rainbow&Lang=en&mid=702&ItemId=700
–backing off intensity and/or volume when the shoulder gets cranky; training through it makes it worse
–doing the 12 week Finding Freestyle program; you’ll quickly identify the areas in your swim form that need work
Good luck
Strengthen your rotator cuff muscles.
Since you’re an MD, can you be more specific? Where anteriorly does it hurt? Bicepital tendon? Acromioclavicular joint area?
Read this…
Thanks for the links, much appreciated.
I bet it is the subscapularis tendon at its insertion to the humeral head. Don’t think it is the biceps tendon.
I have been working on my catch and think I may be pulling too early also.
subscap tendon is common. Strengthen rotator cuffs, serratus anterior, and posterior shoulder muscles. Backstroke is excellent to work on rhomboids.
Hey there, i’ve been battling this myself recently and a little bit of pain (to let me know when I’m tweaking it) plus my masters coach has helped identify what was happening with me, although your pain and cause may be different. I have pain towards the back of my left shoulder (right side breather) and as I used to start the catch, my arm and elbow were being pulled in from the back side of my body i.e.the elbow-left shoulder-right shoulder angle was putting my arm slightly behind me rather than being a straight line - a 180o angle pull relative to the elbow-shoulder-shoulder angle. This was occuring because I was rotating more that direction because of my breathing and I was trying to pull relative to the bottom of the pool rather than relative to my body and keep the pull straight.
probably described that terribly…
This must be a first. A physician coming to Slowtwitch for medical advice…
I’d recommend erring way on the side of caution. It’s January, you’ve got a lot of time between now and CdA. There’s no reason to push this now and risk seriously fucking yourself up. Just focus on the run for a few weeks and give your shoulder some rest.
I’m fighting this exact same issue right now. Swam 20k+ weeks all through October/November, pounded out a 6k workout on Thanksgiving morning like a boss and felt great afterward. Six hours later that afternoon I couldn’t lift my left arm above my head without considerable shoulder pain and it’s been hurting in some capacity ever since. I tried to hit a few masters workouts in December and it sucked. I was slow, miserable, and came out of every swim with the shoulder feeling much worse than going in. Fast forward 3-4 days and I’d convince myself the shoulder was feeling “better” and go do another swim only to see the exact same results.
I’m finally starting to make some progress. I took two weeks completely out of the pool, iced the shoulder 3-4 times daily, and started doing some very light resistance band work targeting the rotator cuff. I had my first pain free swim since Thanksgiving this morning. I only did 1200m, took it very easy and was slow as fuck, but that’s a whole other issue.
Let me guess - The shoulder opposite your breathing side is sore, and you have just recently figured out how to improve your catch and are now pulling harder?
It that is mostly true you are not rotating correctly on your sore side. There is a description on ST somewhere of the “ultimate swim drill” or something close to that. It involves a hand on a kickboard, kicking, and pulling with one arm while looking forward. The next time you swim stop when you start to strain your shoulder and do that drill with the sore arm, only allow your head to roll as you pull (instead of looking straight ahead), which will force an exageration of the roll on that side. If the pain in the shoulder goes away or is much less you are not rollling correctly on that side. Next time in the pool do that drill correctly before you start your set and watch what happens after a few weeks.
Do you have full range of motion, can you lay on your back and lay your arms flat on the floor above your head?
What does your posture look like, rounded shoulders?
Do you do a lot of computer work or prolonged surgeries?
It sounds like impingement syndrome and since your swim volume is not too much you should be able to add high reps of tendon gliding to get the suprascapularis tendon healthy. But if you have the other issues then you may need to correct those also. Refer yourself to PT.
I figured all the fish on slowtwitch with previous years of 20hrs per week in the pool would have some sort of shoulder pain at some point and hoped they all went on with the daily routine. It’s easy for a doctor or therapist to say take time off because most have never trained a day in their life and don’t realized how fast fitness is lost. I am highly irritated that my “huge” 6k swimming weeks have resulted in shoulder pain.
In my experience a physician seeking advice is not that unusual and usually the sign of a good physician. Ears and eyes open. Gathering evidence and listening to previous experience would seem a far better course than simply relying on memory of the books they read some years ago.
I had a similar issue. Mine was caused mainly by weaker back muscles, scapula amongst others, causing me to be a little round shouldered leading to impingement on recovery stroke. It was also a symptom of not rotating enough on that side, meaning I had to swing my arm out straighter rather than have a nice, less force on the shoulder, bent elbow.
Also, chest muscle strength / tightness should be looked at. A stong chest and weak back causes the rounding too. As does a tight chest. Look up the Triger Point Therapy ball chest exercise (basically stand against a wall, ball between pec and wall and move in a circular motion - look up the trigger points in pec twards shoulder joint)
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A mix of back strengthening, chest stretch and better rotation helped me. The rotation was by far the biggest help.
I figured all the fish on slowtwitch with previous years of 20hrs per week in the pool would have some sort of shoulder pain at some point and hoped they all went on with the daily routine.
Back in the day when I was a swimmer ~12-16 hrs week and never shoulder pain. But when I returned to swimming in my 40’s I did have some shoulder issues on ~3-5 hrs/wk. I did swim though it, but modified my stroke by exaggerating the roll and starting my catch deeper. I think the pain came from decreased shoulder flexibility with age and the deeper catch + greater roll requires less shoulder flex. For me it was ez to modify technique to find a more comfortable stroke in order to keep swimming until it cleared up.
Also, the pre-swim shoulder exercises that I learned from the H2ouston swim club helped quite a bit for prevention (
http://h2oustonswims.org/articles/hops_whirlpools_shoulder_thangs_stretches.html)
Stop all paddle use till it clears up.
Thanks very much for all the advice. I appreciate it. I am going to try that deeper catch and exaggerated roll. I don’t have to focus as much on the back and core strength stuff because I am already super strong 
What nobody has bothered to mention that this is a common overuse/training injury. I have experienced this and through PT and shoulder, back exercises, and core (high rep low weights) I have been much better. The best way to avoid this injury though is by mixing up your strokes. Learn to swim backstroke as this helps prevent this overuse injury by using different arm muscles and motion. Also, a 20x100 in your main set is too much if they are a high intensity swim. Here is an example of a workout that incorporates strength and speed work (ditch those paddles). Also, add some drill work in there periodically.
Warm up (1000)
500 alternating 100 swim 100 pull
Kick 10 x 50 :10 RI w/ flippers (alternate free/back)
Main set (2500)
5 x 200 pull at 3:30 (really stretch it out and work on form)
10 X 100 3@2:00, 3@1:50, 4@1:40 (adjust times accordingly)
10 x 50 sprint free 1st 3 on 1:00; 2nd 3 on :50; last 4 on :40
300 cool down
That’s a good solid 3800 yard swim.
Good luck and rest and stretch that shoulder first!
Do you do flip turns or just reach for the rail with your arm and turnaround?
I think the repetitve motion of reaching to the pool rail and pulling yourself to the wall to turnaround is hard on the shoulders. It is on mine anyway.
I would like to stress that you shouldn’t swim through the pain if the changes to your stroke don’t help the shoulder improve. The people I knew who tried to swim through the pain without modifying either the work out (by doing more breast, kicking etc.) or intensity ended up with much worse shoulder injuries. I swam through mine because I found the cause (I think) and mitigated that so I wasn’t swimming with pain.
Those H2Ouston pre-swim drills really helped, I feel.
I reach for the wall. Flipturns not yet learned. But I reach for the wall with the right hand and the left shoulder is the problem. I am thinking the catch up drill may help me. I may be able to pull while rotating in a more coordinated fashion this way instead of pulling when I am flatter.
If you are racing M40-44 at CDA this year…I think you should just hang it up and give up triathlon.
That is the plan. But I am hoping to spend as little time in that cold water as possible.