Swimmers shoulder causes symptoms treatment and prevention

If you’re experiencing shoulder pain after swimming, or you feel that your arm movement has become heavy or unnatural, you might be dealing with a condition called Swimmer’s Shoulder.This problem doesn’t only affect professional athletes, but can also happen to anyone who repeatedly uses their shoulder—whether during swimming or even daily workouts.Swimmer’s shoulder usually starts as mild pain, but if ignored, it can develop into a more annoying condition that affects your daily life and your ability to move normally. That’s why it’s very important to understand its causes, recognize the symptoms early, and learn how to treat it properly. Most importantly, you should know how to prevent it in the first place.In this Dalili Medical article, we will cover everything you need to know about swimmer’s shoulder—from its causes and symptoms to effective treatment methods and the best prevention tips—so you can get back to moving and swimming without pain.

What is Swimmer’s Shoulder?

Swimmer’s Shoulder is a term used to describe shoulder pain caused by inflammation of the rotator cuff tendons due to repeated stress and continuous movements during swimming. It is often associated with a condition called shoulder impingement, where the tendons get compressed under the shoulder blade, leading to irritation and inflammation.

Treatment usually includes rest, cold compresses, and physical therapy exercises. Recovery time may range from a few weeks to several months, and in some cases it can take up to a year.

❓ Is Swimmer’s Shoulder dangerous?

In most cases, Swimmer’s Shoulder is not considered dangerous. However, it can become chronic if not treated properly. It may also lead to muscle weakness or partial tendon tears if ignored.

❓ Can you continue swimming with the injury?

It is recommended to stop or significantly reduce swimming during the injury. Continuing the activity may worsen inflammation and delay recovery.

❓ How long does treatment take?

The duration depends on severity:

Mild cases: 2 to 4 weeks
Moderate cases: 4 to 8 weeks
Severe cases: longer periods, especially if there is a tendon tear

❓ Can Swimmer’s Shoulder come back?

Yes, it can recur, especially if the swimmer returns to incorrect techniques or does not strengthen shoulder muscles and take proper rest.

❓ Does it appear suddenly?

Usually, it does not appear suddenly. It starts gradually as mild pain after training and worsens over time with continued stress.

❓ Can children or teenagers get it?

Yes, children and teenagers can develop it, especially if they train intensively without rest or use improper swimming techniques.

❓ Is rest alone enough for recovery?

Rest is important but usually not enough on its own. It should be combined with physical therapy and strengthening exercises to prevent recurrence.

❓ Does it affect daily life?

In moderate or severe cases, it can affect daily activities such as:

Wearing clothes
Lifting objects
Sleeping on the affected side

❓ Is swimming the only cause?

No. Other causes include:

Improper weightlifting techniques
Repetitive overhead movements
Poor posture for long periods

❓ Is imaging necessary?

Not always. However, if pain persists or is severe, doctors may request:

X-rays
MRI scans to evaluate tendons and soft tissues

❓ Can you return to swimming after recovery?

Yes, but gradually and carefully, while:

Warming up properly
Strengthening shoulder muscles regularly
Improving swimming technique

❓ Do painkillers treat Swimmer’s Shoulder?

No. Painkillers only reduce pain but do not treat the root cause. Full treatment includes rest, physiotherapy, and rehabilitation exercises.

Types of Swimmer’s Shoulder

1. Rotator Cuff Tendinitis

The most common type. It is inflammation of the shoulder tendons due to repetitive movement, causing pain when lifting the arm or swimming overhead.

2. Shoulder Impingement Syndrome

Occurs when shoulder tendons are compressed under the shoulder bones, causing sharp pain, especially when lifting the arm upward.

3. Bursitis

Inflammation of a small fluid-filled sac (bursa) that reduces friction in the joint. It causes pain, swelling, and limited movement.

4. Partial Rotator Cuff Tear

Results from continuous overuse or heavy training. It causes stronger pain and noticeable weakness in the arm and may require intensive physiotherapy.

5. Labral Injury

The labrum is a cartilage structure that stabilizes the shoulder joint. Injury leads to deep joint pain and a feeling of instability. It is less common but can occur with repetitive or forceful movements.

Causes of Swimmer’s Shoulder

Swimmer’s Shoulder is usually caused by repetitive stress on the shoulder joint and surrounding tendons.

Main causes:

1. Repetitive shoulder movements

Swimming requires repeating the same arm motion hundreds of times, which stresses the tendons.

2. Overtraining

Training for long periods without adequate rest prevents proper muscle and tendon recovery.

3. Weak or imbalanced shoulder muscles

Muscle imbalance increases stress on certain tendons.

4. Incorrect swimming technique

Poor form increases friction and strain on the shoulder.

5. Lack of warm-up

Starting training without warming up makes tendons more vulnerable to injury.

6. Excess shoulder flexibility

Some individuals have overly flexible joints, which reduces stability during movement.

Symptoms of Swimmer’s Shoulder

Swimmer’s Shoulder symptoms usually develop gradually and become worse with continued activity or stress on the shoulder.

1. Shoulder pain

This is the main symptom. It appears during or after swimming and may worsen when lifting the arm upward or backward.

2. Weakness in the arm

Difficulty lifting the arm or carrying heavy objects, with a feeling that the shoulder is weaker than usual.

3. Joint stiffness

Reduced flexibility in the shoulder, making it difficult to move freely, especially during wide movements like dressing.

4. Clicking or grinding sensation

A feeling or sound of popping or friction inside the shoulder joint, sometimes accompanied by pain.

5. Pain during sleep

Pain becomes more noticeable when lying on the affected side, often disturbing sleep.

6. Swelling or inflammation

A mild feeling of warmth or slight swelling around the joint, even if it is not clearly visible.

Complications of Swimmer’s Shoulder

Complications usually occur when the condition is ignored or not properly treated, allowing a mild inflammation to become a chronic shoulder problem.

1. Chronic pain

Pain may persist even at rest or during sleep and can significantly affect daily activities.

2. Shoulder muscle weakness

Over time, shoulder muscles may weaken due to reduced use and ongoing pain, leading to decreased arm strength and function.

3. Frozen shoulder (stiff joint)

The shoulder becomes significantly restricted in movement, making it difficult to lift or rotate the arm. This condition may last for a long time if untreated.

4. Rotator cuff tear

Persistent inflammation may weaken the tendons, leading to partial or complete tears, which may require intensive physiotherapy or even surgery in severe cases.

5. Recurrence of injury

Even after recovery, the injury may return, especially if swimming is resumed with poor technique or without proper training adjustments.

6. Reduced athletic performance

Shoulder inflammation reduces strength and endurance during swimming, making it harder to perform movements efficiently.

Diagnosis of Swimmer’s Shoulder

Diagnosis involves several steps to determine whether shoulder pain is due to overuse or another shoulder condition.

1. Medical history

The doctor asks questions such as:

Type of physical activity (swimming or repetitive shoulder use)
When the pain started
Whether pain increases with swimming or arm movement
Previous shoulder injuries

2. Physical examination

Includes:

Checking shoulder range of motion
Testing muscle strength
Pressing specific areas to locate pain
Observing clicking or stiffness in the joint

3. Special shoulder tests

Such as:

Shoulder impingement tests
Rotator cuff strength tests
Joint stability evaluation

These help identify the exact type of injury.

4. Imaging tests

If pain persists or diagnosis is unclear, the doctor may request:

X-ray: to rule out bone problems
MRI (Magnetic Resonance Imaging): shows tendons, inflammation, and possible partial or full tears
Ultrasound: sometimes used to quickly assess tendons and muscles

Drug Treatment for Swimmer’s Shoulder

Swimmer’s Shoulder treatment with medication mainly focuses on relieving pain and reducing inflammation, while supporting healing through rest and physical therapy. All medications should be taken under medical supervision, especially in moderate or severe cases.

1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

These are usually the first line of treatment, such as:

Ibuprofen
Diclofenac
Naproxen

Benefits:

Reduce inflammation in the shoulder tendons
Relieve pain
Improve joint movement

⚠️ Note: It is recommended to take them after food to reduce stomach irritation, and they should not be used for long periods without medical advice.

2. Simple Pain Relievers

Such as:

Paracetamol (Acetaminophen)

Benefits:

Relieves mild to moderate pain
Does not treat inflammation itself, but improves comfort

3. Topical Creams and Ointments

Such as:

Diclofenac gel

Benefits:

Applied directly to the painful area
Reduces local pain and inflammation
Fewer side effects compared to oral medications

4. Muscle Relaxants

Used in some cases when muscle tightness is present:

Benefits:

Relieve muscle spasms
Improve relaxation of shoulder muscles

⚠️ Usually used for a short period and under medical supervision.

5. Cortisone Injections

Used in moderate to severe cases:

Benefits:

Injected into or around the shoulder joint
Quickly reduces inflammation and pain

⚠️ Important: Repeated injections are not recommended due to possible long-term side effects.

Important Notes

Medication alone is not enough for full recovery from Swimmer’s Shoulder.

It should be combined with:

Relative rest from swimming
Physical therapy
Shoulder strengthening exercises

Continuing activity despite pain may worsen the condition.

When to see a doctor immediately?

Severe pain that does not improve after a few days
Noticeable weakness in the arm
Difficulty lifting or moving the shoulder normally

Exercises for Swimmer’s Shoulder Treatment

Exercise therapy is one of the most important and safest treatments for Swimmer’s Shoulder because it strengthens shoulder muscles and improves flexibility, addressing the root cause rather than just symptoms. Exercises should be done gently and stopped if pain increases.

1. Stretching Exercises

Cross-body arm stretch

Bring the affected arm across your chest
Pull it gently with the other arm
Hold for 15–30 seconds
Repeat 3 times

Benefit: Improves shoulder flexibility and reduces stiffness.

Behind-the-back stretch

Place the affected arm behind your back
Gently pull it upward or sideways
Hold for 20 seconds

Benefit: Improves joint mobility.

2. Strengthening Exercises

External rotation with resistance band

Keep elbow close to your body
Rotate the arm outward against a resistance band
Return slowly
10–15 reps × 3 sets

Benefit: Strengthens rotator cuff muscles.

Internal rotation with resistance band

Same position
Pull the band toward your stomach
10–15 reps × 3 sets

Benefit: Balances shoulder muscle strength.

Light lateral arm raise

Raise the arm sideways up to shoulder level
Use very light or no weight
10 reps × 2–3 sets

Benefit: Gradually improves shoulder strength and function.

3. Stability Exercises

Shoulder blade squeeze

Stand upright
Pull shoulder blades together gently
Hold for 5 seconds, then relax
10–15 reps

Benefit: Improves shoulder stability and reduces joint stress.

Important Exercise Guidelines

Stop immediately if sharp pain occurs
Perform movements slowly and gently
Avoid heavy exercises at the beginning
Include rest days between sessions

Prevention of Swimmer’s Shoulder

Preventing Swimmer’s Shoulder is very important, especially for regular swimmers or those performing repetitive shoulder movements. Prevention focuses on reducing joint stress and maintaining muscle balance.