Strength training to prevent swimmer’s shoulder

Strength training to prevent swimmer’s shoulder

Weil, Wendy W

The emphasis of the exercises demonstrated in this article are the scapular stabilizers and posterior shoulder muscles.

This is the second in a two-part series on preventing swimmer’s shoulder by Wendy Weil.

The specific rotator cuff exercises with theraband or tubing should not be done until approximately age 12 or 13 as it is too hard to control the resistance.

Unless otherwise indicated, do three to four sets of 10 repetitions, once a day, four to five days per week. Decrease the amount of resistance and/or the number of repetitions if you are experiencing any discomfort during or after the exercises.

You should never experience pain! Pain is your body’s warning sign that you are pushing it too far. The exercises should be done exactly as illustrated.

Existing Shoulder Problems

If you already have existing shoulder problems, schedule a visit to see an orthopedist or physical therapist to determine the precise cause of your problems. If you already have tendinitis and/or an impingement, you will need physical therapy treatment to help resolve the problem.

Try to locate a physical therapist who has experience working with swimmers. The physical therapist will work on all the areas addressed in this article, but will not include strengthening of the rotator cuff until you are pain-free. Massage across the shoulder tendons can be extremely effective in breaking up the tendinitis.

Usually it is not necessary to stop practicing if the problem is caught in the early stages. Instead, the yardage at each workout should be reduced, or if you are swimming twice a day, drop to once a day until the problem is resolved.

Any strokes that are painful should be assessed by your coach for mechanical errors and should be corrected. If you still have pain, eliminate those strokes from your workout temporarily.

If you are kicking because it is painful to swim, do not use a kickboard because the outstretched position of the arms can aggravate tendinitis and an impingement! Keep your arms at your sides.

Review all the areas covered in this article and see which ones fit you, and then work on changing them!

Beyond Physical Therapy

If physical therapy fails and you have been diagnosed with multidirectional instability from too many years of over-stretching combined with weak posterior muscles, there is some new hope.

Traditional treatment has been open orthopedic surgery, which often takes a long time to heal and rehabilitate. It also sometimes limits the range of motion of the shoulder and any future swimming.

Instability has not been treated effectively with arthroscopic surgery until recently. However, a new arthroscopic technique is being done on swimmers by a few orthopedists around the country.

This surgery uses lasers to actually shrink the capsule and fill in the pockets of instability in the capsule with your own capsular tissue. The patients regain full range of motion in their shoulders afterward and can generally return to swimming.

This new surgery is called LACS (Laser Assisted Capsular Shift). It is my hope that no one reading and following through with the exercises in this article will ever need to undergo shoulder surgery!

This information is presented in an educational manner. Swimming World recommends that its readers first consult with their primary care physician before changing their lifestyle. None of this information is to be taken against the advice of the reader’s regular physician.

Photo 1

Scapular Stabilization:

Muliple Muscles Sitting Press- up

Sitting on chair with palms flat on seat, slump forward a bit. Push up so that bottom comes off chair. Do 25 repetitions.

Photo 2

Postural Alignment/Scapular Stabilization:

Standing Arm Slide

Lean against a wall wilh heels 4 inches away. Press head, back and hips into the wall Start with your arms straight out and elbows bent up in a 90-degree position. Slowly slide your arms overhead as you straighten your elbows. Be sure to keep your arms, shoulder blades and hips in touch with the wall as you slide your arms. When your arms are straight overhead, pull your stomach in and flatten your back more. Slide your arms down and repeat 5-10 times. You can add 1- to 3-pound weights.

Photo 3

Scapular Stabilization:

Lower Trapezius

Stand facing a wall about 6 inches away. Your arms are overhead and slightly out to the side. Hands rest on the wall with thumbs pointing away from the wall. With good posture, pull your shoulder blades back and together, then pull your arms backward, keeping your elbows straight. Hold for 3 seconds and repeat 25 times. You may add 1- to 3-pound weights.

Photo 4

Scapular Stabilization:

Middle Trapezius/ Rhomboids

Lie on a bench or the floor with your forehead resting down on a towel roll. With no weight or 1- to 3-pound weights, lift arms up, keeping elbows straight. Rotate your thumbs up toward the ceiling slightly as you lift. Lower slowly. You should be pulling your shoulder blades together as you lift. Repeat 3 sets of 10 repetitions.

Exercises 5 through 9 use light-weight tubing, Theraband or Stretch Cords. Do 30 to 50 repetitions of each, but stop before then if the muscles fatigue, or if you experience pain.

Photo 5

Middle Trapezius/ Rhomboids Rows

Wrap tubing around both fists. Pull arms back while bringing shoulder blades together as if rowing a boat.

Photo 6

Shoulder/Rotator Cuff Strengthening

Latissimus/Posterior Deltoid

(You can do both arms at the same time.) Using tubing, pull arm back. Be sure to keep elbow straight.

Photo 7

Shoulder/Rotator Cuff Strengthening

External Rotation

Multiple Muscles

Using tubing and keeping elbow in at side, rotate arm outward away fron body. Be sure to keep forearm parallel to floor.

Photo 8

Shoulder/Rotator Cuff Strengthening

Internal Rotation

Subscapularis

Using tubing and keeping elbow in at side, rotate arm inward across body. Be sure to keep forearm parallel to floor.

Photo 9

Shoulder/Rotator Cuff Strengthening

Supraspinatus

Sit or stand with arm down by your side. Bring away from your side slightly and turn hand so that thumb is pointing down and palm is facing away. Using 1- to 3-pound barbell, raise arm straight up, keeping arm in this position and elbow straight. Try to stop at 80 degrees, and don’t go beyond 90 degrees, as this movement will impinge the shoulder at higher angles. Lower slowly. Repeat 3 to 4 set of 10 rpetitions.

By Wendy W. Weil

Photos by James Kegley

Exercises demonstrated by

Caitlin Blandford and Jake Gregory

About the Author

Wendy Weinberg Weil, PT, ATC, OCS, won a bronze medal in the 800 meter freestyle at the 1976 Olympics and a gold at the Pan American Games in 1975 in the same event. Shoulder injuries severely hampered her last two years of competitive swimming in college (20 years ago when swimmer’s shoulder was not well understood or treated). She has been a physical therapist and athletic trainer for 18 years, and currently has her own practice in McLean, Va. She also coaches part-time with the FISH swim team, has three children ages 7-11 who swim and began swimming Masters this year.

Copyright Sports Publications, Inc. Aug 1999

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