By John Vann, MD, Piedmont Orthopaedic Associates
If you’re training for a triathlon, you’re likely aware of
common injuries like runner’s knee or Achilles tendonitis. However, another
common injury that triathletes may not have heard about is a condition called
Although the swimming portion of the competition is low
impact, the repetitive overhead motion of swimming freestyle can cause injury
to the tiny vasculature in the rotator cuff. These microtraumas can happen
again and again during the weeks and months of training, causing inflammation
and pain. Ultimately, if not treated, it can lead to impingement of the rotator
cuff, and require more serious treatment.
Swimmer’s shoulder occurs due to the amount of training
(repetition) and intensity of your workout, often combined with poor technique.
The main symptom is pain in the shoulder that is most
commonly felt during the late recovery phase and early catch phase of your
stroke – when your arm is out of the water and reaching in front of you.
If the injury progresses to rotator cuff impingement, you
will feel irritation, stiffness and/or pain whenever you raise your arm to
shoulder height, not necessarily while swimming.
Give the shoulder a rest by reducing your swimming distances
for a while. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs)
like ibuprofen can treat the inflammation and pain. The classic RICE technique
(Rest, Ice, Compression and Elevation) for treating sports injuries will also
help swimmer’s shoulder. For a shoulder injury, elevation can be difficult, so
focus on resting, icing the area and using a compression wrap if needed.
As with any injury, if symptoms continue or worsen in any
way, it’s best to see a sports medicine physician for treatment and
recommendations. If you wait for it to just “go away,” you may end up
developing a more chronic condition that could hamper your training.
A sports medicine physician can prescribe physical therapy,
rehabilitation or administer a steroid injection to treat the injury. If
nonsurgical treatment does not relieve pain, your doctor may recommend a
minimally-invasive arthroscopic surgery. The goal of this type of surgery is to
create more space in the rotator cuff so that the structures in the shoulder do
not rub against or impinge on each other.
Once your symptoms have resolved, add stretching and
strengthening exercises to your regular training regimen to help prevent future
injury. Also consider consulting a swimming expert to determine if you can
improve your technique to reduce the chance of injury.