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News Letter

Shoulder injuries in swimmers and surfers Print E-mail

Peter Reynolds, M.D.

Despite the year round popularity of water sports in Santa Cruz, shoulder problems increase in the summer months as more people surf and swim.  The repetitive nature of swimming and paddling out in surfing requires an overhead motion of the shoulder with power and force being applied when the shoulder is the most vulnerable.

The medical term is impingement syndrome, formerly known as bursitis or tendonitis. When the arm is overhead and a force is applied, the bursa and rotator cuff tendon push against a portion of the shoulder blade called the acromion. Studies have shown two factors come into play:  a wringing out of the blood vessels in the tendon and a mechanical pinching of the tendon against the bone.

With overuse, these movements can result in inflammation of both the bursa that cushions and lubricates the tendon and the tendon itself. Overuse is usually doing too much, too fast for the joint, but can even occur with a period of rest and a quick return to the sport.

Symptoms include pain and occasional popping and clicking in and around the shoulder, usually worse when moving the arm overhead. Early treatment consists of rest, which is avoiding overhead use of the arm and ice after any offending activity. Gentle pendulum swinging of the arm can keep the shoulder mobile. Anti-inflamatory medications such as Advil or Aleve can alleviate pain and actually treat the inflammation. Shoulder exercises are available from most physicians and physical therapists.    

Shoulder impingement syndrome is the most common shoulder problem we see in our office and usually responds to conservative treatment. Occasionally the problem progresses and arthroscopic surgery is needed to trim the bone pinching the rotator cuff. This is an outpatient procedure with predictably very good results in the 85-90% success range.

Obviously, preventing these problems altogether is the best option by paying attention early to pain and stiffness, keeping the shoulder mobile and strong, and resuming swimming and surfing when comfortable.

Competitive swimmers and surfers who are focusing on increasing their speed do well to heed advice that goes beyond basic swimming technique. Commonly agreed upon recommendations from exercise physiologists and kinesiologists – swimming with the “lats” rather than shoulders, stabilizing the scapula, balancing rotator cuff strength and increasing leverage with the forearm paddle – can help avoid injury and increase performance.

More detailed information is outlined in “How to Swim Faster,” an excellent primer by author and musculoskeletal disorder expert Fred Drennan.


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