3 Myths About Swimmer’s Shoulder (and the Truths Behind Them)

If you’ve ever had shoulder pain when swimming, going online to look up information is not your best bet.

Every website will give you a different diagnosis and set of exercises to do. Very few articles are written by a physical therapist or other professional who has extensive experience working with swimmers. Much of the information you’ll find online isn’t up to date on the latest research or isn’t helpful, making it impossible to know what to do about your shoulder pain.

This article will help dispel some of the most common myths on the internet about swimmer’s shoulder and give you some other ways to think about the causes and treatments for it.

Myth #1: Swimmer’s Shoulder is Always a Result of Shoulder Impingement 

Historically, it’s been thought that swimmer’s shoulder is caused by shoulder impingement. Shoulder impingement refers to a pinching of the rotator cuff muscles by one of the bones in your shoulder when you lift your arm overhead. Because swimming involves lifting your arms overhead hundreds of times a workout, it was long thought that this repetitive pinching would eventually lead to shoulder pain.

This theory has been disproved by a 2019 study published by Rebekah Lawrence, an assistant professor within Washington University’s School of Medicine, in the Journal of Orthopaedic & Sports Physical Therapy. It turns out, your rotator cuff is more likely to be pinched when your arms are below shoulder height and less likely to be pinched when your arms are all the way overhead. Considering that many swimmers with shoulder pain have their pain when they lift their arms above shoulder height, it becomes less likely that your shoulder pain is from shoulder impingement. Instead, your pain may be a result of something else. 

Shoulder impingement can be a cause of a swimmer's shoulder, but it’s not the singular cause of all swimmers' pain. Other common shoulder conditions swimmers may face include rotator cuff tendinitis, labral tears, biceps tendinitis, or shoulder instability.

Although it’s tempting to search online and guess while self-diagnosing your shoulder pain, it’s more important to understand why your shoulder pain developed in the first place. It might be decreased strength of the muscles around your shoulder blade, decreased shoulder mobility, or tightness in the muscles around your neck.

Myth #2: Swimmer’s Shoulder is Only and Overuse Issue

An overuse injury is pain that is caused by repetitive motions over time. Considering how much you use your shoulders in the pool, it is easy to think that is the cause of the discomfort. 

However, both of your shoulders take the same number of strokes in the pool. If your pain was simply caused by how much you used your shoulders when swimming, both shoulders would hurt equally. This is rarely the case. Most swimmers only have pain in one shoulder so there are other factors that are leading to your pain. 

Swimmer’s shoulder is too complex to simply be labeled an overuse injury—there’s more to it. Your pain could be from weakness in one shoulder, a lack of mobility of one shoulder, or a technique error made because of an imbalance. 

Myth #3: You Must Stretch Your Shoulders if You Have Swimmer’s Shoulder

For many swimmers, a lack of flexibility isn’t the root cause of their pain. In fact, too much stretching can aggravate your shoulder pain. 

Many swimmers are quick to add stretching to their routine because their shoulders feel tight or because they think it will help get rid of their shoulder pain. However, many swimmers don’t think about why their shoulders are tightening up in the first place.

When certain muscles around your shoulder blade are weak, other shoulder muscles compensate by working harder. This leads to quick fatigue and tightness in those overworked muscles. You can do all of the stretching in the world but unless you address the weakness, your tightness will not go away.

What swimmers need to do instead of stretching is strengthening. Here are two shoulder-strengthening exercises to address weakness around the shoulder blade: the push-up plus and the 3-way banded pull-apart. Try three sets of 8-12 reps for each exercise.

How to do the push-up plus:

• Begin in a high plank position.
• Lower your body toward the ground by bending your elbows.
• Stop when your chest is 2–4 inches from the ground.
• As you push back up, round your upper back and push it toward the ceiling.
• Hold the protracted position briefly, then return to the starting position.
• Start with three sets of eight to 12 reps.

How to do the 3-way banded pull-apart:

• Stand with your feet shoulder-width apart and hold a resistance band in front of you with a shoulder-width grip.
• Keep your arms extended and begin by pulling the band apart horizontally, squeezing your shoulder blades together.
• Return to the starting position and then repeat the motion by pulling the band apart diagonally, upward, and downward.
• Repeat again with the opposite arm up, pulling diagonally, upward, and downward.
• Start with three sets of five reps, where each rep you complete has all three movements.