OR Secondary Impingement?
The most common cause of time lost in the pool for swimmers is shoulder pain. You may have heard this referred to as “swimmers shoulder,” but this really does not give an accurate description of what is actually occurring.
More often than not “swimmers shoulder” is actually a “subacromial impingement,” which roughly translates into “pinching under the acromion.”
If you look at the diagram below you can see the bony process attached to the shoulder blade (scapula) called the acromion. This bone is essentially the “roof” that houses a portion of the rotator cuff (supraspinatus muscle). Many times when a rotator cuff tear occurs it began as an impingement syndrome. Coincidentally the supraspinatus muscle is the most commonly injured/torn muscle of the rotator cuff.
There are two types of shoulder impingement that can occur. The first type, known as “primary impingement,” describes impingement as caused by the actual structure and shape of the acromion. Whereas “secondary impingement” describes impingement caused by combination of excessive joint movement, ligament laxity and muscular weakness around the shoulder joint causing pinching under the acromion mainly as a result of excessive and repetitive overhead movement.
Secondary impingement is what swimmers encounter the majority of the time. This is, again, generally the byproduct of too much overhead movement combined with a lack of shoulder stability.
Now that you understand the source of a lot of shoulder pain in swimmers, you need to understand how to treat it yourself.
This is where a consistent prehab program and a post exercise recovery routine will be the ultimate determinant of injury prevention.
Scheduling an appointment with a physical therapist is a great way to treat an existing injury, but did you know that you can see a physical therapist for preventative measures too? They can do an examination and determine what you need to strengthen. From there they can give you a personalized program to prevent injury and improve performance.
If you are interested in learning more and seeing practical solutions for swimming specific injuries follow me on Instagram:@theswimmingphysio (click link to follow)Thanks for reading!
Dr. Jacob Reynolds PT, DPT, OCS – Physical Therapist Board Certified Specialist in Orthopedic Physical Therapy
Wanivenhaus F, Fox AJ, Chaudhury S, Rodeo SA. Epidemiology of injuries and prevention strategies in competitive swimmers. Sports Health. 2012;4(3):246-51.Picture: ://eggzack.s3.amazonaws.com/cg4-vyzv3leeyf9uyZgUJXmm3GJExQi229pUm.bmp