Our shoulders are vulnerable to injuries during swimming as they bear most of the workload in the rotational movements of the arms. The most common cause of shoulder pain in those who swim intensively—whether amateur or professional—is the so-called “swimmer’s shoulder,” which is inflammation of the rotator cuff tendons or the impingement/friction of various structures within the shoulder.
The best way to prevent these injuries is to increase the strength of the muscles and tendons within the rotator cuff and/or improve swimming technique.
Swimmer’s Shoulder / Causes – Symptoms
The primary causes of swimmer’s shoulder are excessive stress on the joint (e.g., intensive training before a competition), subjecting untrained muscles to intense exercise, and incorrect swimming technique. It can also result from previous injuries causing anatomical damage such as a labral tear or rotator cuff tear.
The main symptom is pain. It is usually difficult to pinpoint exactly and is described as deep within the shoulder joint, but it can also radiate upwards to the back or neck, or downwards into the arm. If the swimmer ignores the symptoms and continues swimming, the pain may appear even at rest or during sleep.
Diagnosis – Treatment
Diagnosis is made by clinical examination and may require X-rays or MRI scans of the shoulder, which can accurately reveal any pathology.
Treatment is conservative in most cases. In the early stages of pain, it is recommended to:
- Rest the shoulder
- Apply ice therapy
- Take painkillers/anti-inflammatory medications to reduce inflammation
At the same time, a targeted physical therapy and muscle strengthening program can be started to improve range of motion and shoulder stabilization. Additionally, injections of biological agents (P.R.P.) can be administered with very good results.
In cases where conservative treatment fails after a maximum waiting period of 6 months, or if damage to the shoulder’s stabilizing tissues (labrum) or rotator cuff tear is diagnosed, swimmer’s shoulder is treated with the minimally invasive method of arthroscopy.
Shoulder Arthroscopy
Arthroscopy is a modern technique where the orthopedic surgeon can examine the inside of the shoulder joint without damaging it, precisely identify any lesions, and simultaneously repair them using specially designed, very thin instruments. For example, the surgeon can repair torn tendons, release adhesions, or fix injuries resulting from dislocation (e.g., labral repair).
During the procedure, the surgeon inserts an arthroscope through small incisions of only a few millimeters in the shoulder skin. The arthroscope carries a tiny camera connected to a monitor that provides a highly magnified, clear, and colored image of the inside of the joint.
In most cases, shoulder arthroscopy lasts no more than an hour, is performed under a combination of regional and light general anesthesia, and the patient is discharged home the same day.
Advantages of Arthroscopy
- More effective and faster therapeutic recovery
- Minimally traumatic method
- Significantly lower risk of complications
- Minimal postoperative pain
- Better cosmetic results due to very small incisions (no scars or deformities on the skin)
- No need for hospitalization
Recovery
After surgery and for the first few days, the use of a special shoulder sling is usually recommended, allowing the use of the arm for basic daily activities. Sutures are typically removed after a few days.
Successful recovery requires the patient to follow a specialized physiotherapy program afterward.