Swimmer’s Shoulder

Release it to improve performance

Swimmers, including triathletes, commonly suffer from shoulder pains.  This pain is usually felt either at the rotator cuff or between the shoulder blades.

Stresses in these areas affect the athlete’s performance long before they are even aware that they are having a problem.

Competitive swimmers must swim thousands of meters each day in order to achieve the fitness level required for competition. The front crawl is not kind to the shoulder joint, especially when executed incorrectly.

The majority of injuries suffered by such swimmers is related to the stress involved in the repetitive actions of their limbs while swimming, as many as 20,000 to 30,000 strokes per week for competitive training. In a typical workout of 4000 meters, each arm will rotate 1280 times. Any biomechanical problems at the start of the swim will only get worse with this many repetitions!

The most common injury is Swimmer’s Shoulder – a term commonly used to describe pain in the shoulder, and is almost always caused by the repetitive actions of the front crawl. This injury is also known as rotator cuff tendonitis or shoulder impingement syndrome.

Effects of Repetitive Motion and Shoulder InjuriesBack to the Top

The soft tissue stresses caused by the repetitive motions of freestyle swimming is often compounded in triathletes by the constant stress of holding the torso in a fixed position upon the bicycle’s aero-bars.

Pain between the shoulder blades is caused by the constant neck extension and the back position required to support the weight of the cyclist’s torso while bent over in the aero-bar position. This pain is often an indication of several problems in the body’s kinetic chain rather than the usually diagnosis of tight Rhomboid muscles or a Rotator Cuff Tear.

Repetitive motion, constant tension, and pressure often result in inflammation and swelling of soft tissue. The body responds to this inflammation by laying down scar tissue (cross fibers across the tissue) in an attempt to stabilize the affected area. This scar tissue:

  • Restricts motion.
  • Reduces circulation.
  • Inhibits nerve function.
  • Causes ongoing friction and pressure. This results in the production of yet more cross fibers and adhesions across inflamed soft tissues.

Training Techniques and Shoulder InjuriesBack to the Top

Poor swim technique, over-training, unilateral breathing, too large a swim paddle, or improper elbow-to-shoulder angle on the bike can easily cause shoulder problems.


Each of these physical factors can result in the creation of biomechanical restrictions within the shoulder muscles.

Start of the Arbor Lake Triathlon Swim (Calgary, Alberta)

Even though these training factors can be modified, the biomechanical restrictions that have been created in the triathlete’s body are seldomaddressed or resolved by just exercise and massage.

These biomechanical stresses lead to future injuries and inhibit the triathlete and swimmer from reaching his or her full performance potential. It is necessary to correct these biomechanical problems at the source (by removing restrictions between the shoulder’s tissue layers) if the swimmer is ever to achieve their full potential.

Muscles Affected by Shoulder InjuriesBack to the Top

Equally important, different athletes may present with identical pain patterns, but each athlete may have completely different soft-tissue structures that are impaired or injured.

Before treatment takes place, an extremely specific examination, biomechanical analysis, and diagnosis must be performed. It is important for the practitioner to look past the initial point of pain to identify other structures that are involved in the kinetic chain.

* For example, triatheletes using aero-bars commonly have restrictions at the Serratus Posterior Superior and at a very deep muscle called the Transversospinalis. Both these muscles affect the swimmer!

People suffering from rotator cuff injuries (swimmer’s shoulder or impingement syndrome) will often receive treatment for the Infraspinatus, Teres Minor, Supraspinatus, and Subscapularis muscles.

However, this limited focus ignores numerous associated soft-tissue structures (ligaments, muscles, blood vessels, fascia and nerves), which either caused the injury or whose restrictions greatly reduce an athlete’s performance level.  For example, swimmers often suffer from biomechanical restrictions in these primary swimming muscles:

* Latissimus Dorsi – A muscle that inserts into the Scapula and Humerus.
* Triceps – Mostly commonly the outer head.
* Deltoids – Medial, posterior and anterior sections.
* Psoas – Hip flexor that attaches to same general area as Latissimus Dorsi. A tight Psoas can cause a tight shoulder when you follow the kinetic chain of those structures.  The Psoas is also the most common muscle affected during the cycling portion of the race.
* Pectoralis Major/Minor – Flexes, adducts and medially rotates the arm.

It is essential to release the restrictions in these kinetic chain structures in order to fully resolve the problem.

ART Treatment of Shoulder InjuriesBack to the Top

ART Practitioners at the Hawaiian Ironman World Triathlon Championship.

Effective treatment of shoulder problems, or of any soft-tissue injury (ligaments, muscles, blood vessels, fascia and nerves), requires an alteration in tissue structure to break up the restrictive cross-fiber adhesions and to restore normal function to the affected soft-tissue areas.

When executed properly, this process:

  • Substantially decreases healing time.
  • Treats the root cause of the injury.
  • Improves athletic performance.

Active Release Technique (ART®) is very successful at treating this type of shoulder injury since it is able to remove the restrictive adhesions between both the superficial and deep tissue areas.  In fact ART has been shown to be over 90% effective for treating a broad range of soft-tissue injuries.

ART® finds the specific tissues that are restricted and physically works them back to its normal texture, tension, and length by using various hand positions and soft-tissue manipulation methods.

While breaking up the adhesions can be uncomfortable at times, it is a good sign if we reproduce the pain symptoms during the treatment, since this often indicates that the correct soft-tissue structures are being addressed.

Once the soft-tissue (ligaments, muscles, blood vessels, fascia and nerves) has returned to its normal state, specific exercises are prescribed.

Unlike most therapies, ART® does not require extended periods of rest before you notice results. You usually see significant improvements to the injured area after only two to three sessions.  It is also not uncommon, after only a few sessions, to see a considerable improvement in the athlete’s best personal performance.

Download More Information!

Swimmer’s Shoulder

The cause of swimmer’s shoulder, and how ART can quickly resolve long-standing problems, and increase swimming performance.

Improve Your Athletic  Performance with  Active Release Technique

How ART was used to at the Ironman Triathlon Championships in Penticton, BC and Kona, Hawaii to help resolve athletic injuries, improve performance, and assist athletes in completing these tremendously difficult events.

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Kinetic Health
Soft Tissue Mgt. Systems
10–34 Edgedale Drive NW
Calgary, AB T3A 2R4, Canada
p | 403-241–3772
f | 403-241–3846
e | reception@kinetichealth.ca


Kinetic Health
Soft Tissue Mgt. Systems
10–34 Edgedale Drive NW
Calgary, AB T3A 2R4, Canada
p | 403-241–3772
f | 403-241–3846
e | reception@kinetichealth.ca


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