How to spot a shoulder injury and how you can prevent one

Tennis elbow. Runner’s knee. And now swimmer’s shoulder. It’s nice that the world of physiotherapy tries to soften the blow of an injury by linking it with a sport. However, these issues are not exclusive to the particular sport, but more to the motion of the movement done in that sport which leads to them.

The swimmer’s shoulder is particularly tough to identify due to the range of muscles when you injure the most mobile joint in the body. “Swimmer’s shoulder is a term that can represent numerous shoulder pathologies. These include impingement syndrome, rotator cuff tendinitis, labral injuries, ligamentous laxity or muscle imbalance causing instability, muscular dysfunction, and neuropathy from nerve entrapment,” states a study titled Swimmer’s Shoulder, published in the National Library of Medicine.

But there are ways to figure out whether you have it or not, with some basic movements. This is not to encourage self-diagnosis, but having a sense of where exactly the pain is, can help you communicate with your physiotherapist when you go for a professional consultation.

A video posted by YouTube channel Ocean Fit explains how there are two types of pain, one during the overhead motion of a swimming stroke and one when you pull the water under you. The video demonstrates a couple of stretches and angles which you can carefully try going through with another person helping you.

The most common sign of this issue is radiating pain which travels along the back of the shoulder; it seems like a deeper pain than a one which is merely irregular or uncomfortable only at some angles.

“Due to the nature of swimming, all swimmers can develop imbalances in the muscle where the internal rotators and adductors of the arm over-develop. This can leave a weakness of the scapular stabilisers and external rotators, unfortunately, because they’re not being used as much,” states a Coastal Orthopedics article titled,Swimmer’s Shoulder: Signs, Symptoms, Stretches, And Treatment.

Swimmer’s shoulder is not limited just to swimmers, but in case you are a regular swimmer, there are lots of resources online to make sure you fix your stroke to avoid injuries. The video below, posted by YouTube channel Effortless Swimming, is a great starting point to understand the different mechanics associated with the stroke you are using the most.

A detailed study, titled Prevention And Treatment Of Swimmer’s Shoulder makes for some interesting reading; especially where it discusses how people with this injury try to adjust around it, especially when swimming. The change happens to avoid the feeling of impingement.

“With painful shoulders, the hand enters further away from the midline with the elbow dropped closer to the surface of the water. This change is usually made to avoid an impingement position of full elevation with internal rotation and horizontal adduction. Another adjustment occurs at the end of the pull-through phase, when the hand should be close to the thigh with internal rotation of the shoulder. In swimmers with painful shoulders, the shoulder was externally rotated and the pull-through phase was shortened to avoid impingement,” the article states.

Which brings us to treatments for this condition, and the exercises that could strengthen your shoulder, and also some stretches. Using the phone in a hunched position, not having an ergonomic desk to work on, and sleeping awkwardly are all reasons for developing this condition. I felt a deep set pain on the left side of my shoulder, possibly due to using a curved pull-up bar for a few workouts which has led to an imbalance, but when I watched the video below, I knew it was because of the way I was stretching both arms out while sleeping on the side. That has resulted in a tight pec, and I felt it on chest day. Regularly doing a couple of basic stretches and an anti-inflammatory later, the pain is nearly gone.

While researching for this piece, I came across Fares Ksebati, who is a three-time U.S. Masters Swimming individual National Champion, and the CEO of MySwimPro. His YouTube video on Swimmer’s Shoulder is so well made, it is worth a watch, even if you skip to the last part, where he speaks about the drills to get stronger and avoid having this issue.

The drills are the basic shoulder strengthening workouts, like Y-W-Ts, scapular pushups, external rotations and rotator cuff exercises. These are all useful exercises, but ones that we tend to forget once the issue is gone (until it reappears in some other form). You can read about these in detail in a story I wrote for Lounge titled How To Make Your Shoulders Injury-Free.So whether you are on dry land or in water, strengthen the shoulders, understand your injury, and work beforehand to avoid it.

Pulasta Dhar is a football commentator, podcaster and writer.