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Shoulder Injuries from Swimming

Swimmers generate the majority of their propulsion through their upper limbs.  Training often involves many thousands of revolutions of your shoulders a day.  Overuse and microtrauma injuries are therefore a common problem. Indeed in some studies, two thirds of swimmers reported suffering with shoulder problems. For most swimmers with pain, the early pull-through phase or the early arm recovery phase of your stroke will be the most painful points.  You or your coach may have noticed a change in your stroke (low arm recovery, early entry) and slower times.  Early identification of the problem will help prevent progressive damage and blunting of your symptoms: this should help both a more accurate diagnosis and faster recovery.

Muscles around the shoulder are all working during your swimming.  From electrical muscle studies in swimmers with and without pain, it has been shown that two muscles (Serratus anterior and Subscapularis) are particularly prone to fatigue in swimming and this fatigue then causes poor patterning of the shoulder and makes it vulnerable to injury.  Your serratus anterior is responsible for stabilising your shoulder blade, while your subscapularis muscle acts to rotate your shoulder inwards as you catch and pull through.

Many competitive swimmers begin rigorous training at an age when their joints, and especially their shoulders, are relatively lax.  Shoulder instability can therefore be a problem in some swimmers, although frequently no trauma is recalled. Micro-instability, which may not even be noticeable during normal activities, may be causing pinching of your shoulder tendons within your joint, or inflammation in your subacromial bursa.  When your shoulder is subjected to thousands of revolutions a day, even minor mal-patterning can lead to pain and time off swimming.

It is important to get an accurate diagnosis for your shoulder.  Swimmers’ shoulder is not always subacromial impingement.  You and your surgeon, with the help of your therapist and swim coach should work out what is the underlying problem and then develop a strategy to address this.  For many, this will not require surgery, as therapy and technique modification can improve your symptoms.  Some of you will however require surgery to address structural problems and improve your function. 

If you have injured your shoulder that is interfering with your swimming, or if you have concerns about returning to training, do get in touch via the contact section, or book an appointment.