Three Simple Ways To Prevent Shoulder Pain When Swimming

When it comes to preventing shoulder injuries, it’s important to nail the basics first.

As a physical therapist who specializes in working with swimmers, one of the most frequent questions I encounter is, "What can I do to prevent a shoulder injury?" Often, swimmers seek specific exercises or a quick fix to ward off shoulder injuries. When I share insights from the latest research on injury prevention, my patients are often surprised by its simplicity.

Simple, however, doesn't always equate to easy, and many swimmers overlook these straightforward methods to prevent injuries. Here are three simple yet impactful ways to prevent discomfort that might hinder your performance in the pool. These three simple things support good technique, which is a significant factor in preventing injury.

Well-Rounded Strength Training Routine 

For good reason, strength training has increased in popularity over the years.

In addition to injury prevention, strength training has other tremendous health benefits including increased bone density, improvements in strength, increased muscle mass, and improved metabolism. 

Not all strength training is equal. To prevent shoulder injuries and fully realize the benefits of strength training, you must have a well-rounded routine that covers all the major muscle groups. If you complete five exercises for your shoulders, but all five target the same muscles, you’ll find some muscles remain underdeveloped. This could cause trouble in the future. 

Here's an example of a well-rounded upper body strength training routine: 

• Three-Way Banded Pull-Apart—3 x 6 reps
• Push-Up Plus or Countertop Push-Up Plus—3 x 8-12 reps
• TRX Row—3 x 12 reps
• Dumbbell Scaption—3 x 8 reps
• High Plank—3 x 30–45 seconds

Adequate Sleep

Juggling work and family, staying healthy, and maintaining a social life isn’t easy. 

As a result, many Masters swimmers sleep less than they should. Over time, lack of sleep can have a major impact on your health, including on your risk of injury. According to a 2021 study published in Current Sports Medicine by physician Kevin Huang, sleeping less than seven hours a night consistently is associated with 1.7 times increase in injury risk.

Lack of sleep results in decreased muscular strength and endurance, slower reaction times, and diminished coordination in the water. Less strength and endurance results in faster muscle fatigue. Slower reaction times and decreased coordination in the pool leads to suboptimal swimming techniques. Poor technique and increased muscular fatigue in the pool will lead to increased stress on the shoulder, increasing your risk of injury.

My patients report significant improvements in their pain when they improve their sleep quality and quantity. This is supported by a 2019 study published in PLOS One done by physician Alexander Staff, a faculty member at Aalborg University Hospital in Denmark, in which researchers assessed the effect of sleep deprivation on pain thresholds. By the end of the study, many of the participants reported significantly lower pain thresholds when they were well rested. Sleep has a significant impact on not only preventing injuries but can also help alleviate existing aches and pains.

Consistent Training 

Inconsistent training is one of the top reasons why swimmers find themselves under my care. 

 A common example is someone who’s been away from swimming for years and jumps back into swimming with a team a few times a week. They enjoy their new Masters team so much they decide to do five practices a week. After a few weeks of increasing the yardage, they develop a dull ache in the front of their shoulder. While other factors may contribute, the excited-to-be-back-in-the-pool spike in swimming frequency plays a major role in the onset of shoulder pain in this scenario.

Rather than suddenly increasing the number of swims you do each week, gradually increase the number and duration of your workouts. Start with three swims a week for a couple of weeks. If your team swims a lot of yardage, limit what you do until you’ve built up strength and endurance. When you have, go to four swims a week and more yardage. Once your body has adapted, advance to five swims a week.

Likewise, insufficient training often fails to provide the necessary stimulus for muscle strength and endurance. A common scenario is a swimmer attempting a longer open-water race with minimal training. Without building sufficient muscular strength and endurance, the muscles and tendons around the shoulder break down, resulting in irritation.

Consistency reigns supreme, particularly in swimming. Regular, gradual increases in intensity or volume contribute significantly to preventing painful shoulder issues.

Although injuries can be complex, preventing them need not be complex. Adding a well-rounded strength training routine to your exercise regimen, getting at least seven hours of sleep each night, and swimming consistently will go a long way in preventing shoulder injuries.