The shoulder is so mobile because it’s efficient, smooth-working mechanism of muscles, tendons, ligaments, bone, and cartilage. On the flip side, that’s a lot of moving parts to injure while swimming competitively. How your swimmers train, both in the pool and on dry land, will go a long way to preventing or causing swimmer’s shoulder. Indeed, poor strength and flexibility training is a significant risk factor for developing swimmer’s shoulder.
However, once a swimmer is suffering from an injured rotator cuff or another shoulder injury that makes training impossible, the focus needs to shift to workouts that promote shoulder recovery. Icing the shoulder, taking anti-inflammatories, and wearing a shoulder sling or tape are all a part of recovering from swimmer’s shoulder. Your swimmers can speed up their recovery time and help themselves prevent future swimmer’s shoulder with the proper exercises.
Simple shoulder squeezes and shrugs are gentle exercises to start or to use as a warm-up before doing some of the other practices.
Stretch out the backs of the shoulders — have the swimmer stand in an open doorway with a hand on either side. Holding on to both sides of the doorjamb, the swimmer should slowly lean through the doorway. Start with the arms lower in the doorjamb. The higher the arms, the more stress the move puts on the shoulders. An upper progression should come over time.
The swimmer should use a therapy tube or band to do a controlled external rotation. The swimmer should wrap the tube or band around a doorknob or have someone hold it, while the swimmer holds an end in each hand. The upper arm should hang straight down along the upper body. The lower arm should be bent at 90 degrees. Keeping the elbow touching the body, have the swimmer slowly pull the lower arm out to the side. The arm should stay at a right angle, with only the lower arm moving, for the entire movement. Start the swimmer with 10 to 15 pulls per side to assess how that feels. You can find a video example of this and other exercises described in this post here.
Using the same set-up, the swimmer can increase scapular strength by pulling both ends of the therapy band or tube straight back, pushing their shoulders back and down. To do it effectively, the swimmer should be pulling their shoulder blades together so their chest pushes out, not the other way around.
Plank exercises can strengthen the rotator cuff. There’s a wide range of height in plank exercises, which makes them a good benchmark and step therapy as the shoulder gets stronger. From simple, stationary plank to hand-stepping on and off a step or raised surface, select the plank exercise that meets the swimmer where they are and move up from there. Here’s an explanation of how to do plank hand step-ups, along with a couple more exercise recommendations for swimmer’s shoulder.
If the plank is too much in the beginning, a gentler option is to use the back of a chair or some sturdy surface that the swimmer can lean on without bending too far forward. With both hands secure, the swimmer should push down on the surface while slowing walking away. They will end up in almost a tabletop position but needn’t walk back that far before starting to walk forward again. The key is to keep pushing down through the shoulder to the hand while stepping back and forward. This video will show you how this exercise works.
When it feels like the swimmer is making progress, they can move on to exercises that come close to mimicking a swim stroke. The swimmer should lay on a trainer’s table or over an exercise ball, anything sturdy enough and high enough for the swimmer to extend their arm downwards and around. Again, securing a therapy tub on a doorknob or other apparatus, the swimmer can take the other end. With the therapy tube shoulder level, the swimmer should pull the tube down and back. They shouldn’t rotate the arm around — all the work here is done “below water level.” Pull back with the shoulder and elbow, straightening the arm so it extends towards the knee.
Personalized rehabilitation plan is best option to get back in the pool quickly
These exercises are general suggestions. Any swimmer’s specific injury requires specific diagnosis and treatment plan. Work with the swimmer’s orthopedist and physical therapist to develop a rehabilitation plan will be most effective for that specific athlete.