Can Shoulder Pain From Swimming Mean An Impingement?
Yes, shoulder pain from swimming can indicate an impingement. During swimming, repetitive overhead arm movements can irritate the rotator cuff muscle, leading to compression between the humeral head and the acromion (a part of the shoulder blade). This constant pressure inflames soft tissues around the joint, leading to shoulder impingement syndrome.
At Total Orthopedics & Sports Medicine, we help you manage swimmer’s shoulder pain. Our specialists assess your shoulder using imaging and a detailed physical examination to determine if impingement is causing your shoulder pain. Moreover, we design a treatment plan that includes a shoulder rehabilitation program and guided exercises to reduce inflammation. Call us at 855-321-6784 to book your appointment.
What Are the Signs of Shoulder Impingement in Swimmers?
If you experience sharp or aching pain in your shoulder while swimming, you may have shoulder impingement. This pain often appears during or after repetitive swimming strokes and may worsen when lifting your arm or reaching behind your back. Other than that, swimmers often notice tenderness around the shoulder joint, reduced range of motion, and constant discomfort.
As your shoulder condition worsens, even simple swimming strokes and daily activities can trigger severe pain, stiffness, and significant weakness. You may also feel discomfort when rotating your arm inward or during the pull-through phase of your freestyle stroke. These symptoms develop because the rotator cuff muscles and tendons get irritated from the constant friction between the humeral head and the shoulder blade. Moreover, according to OrthoInfo, you may experience severe pain at night, which can affect your ability to sleep.
Can Poor Swimming Technique Lead to Shoulder Impingement?
Yes, poor swimming technique can potentially lead to shoulder impingement. For instance, crossing your arm over the midline or applying excessive force during the stroke can change shoulder mechanics. Similarly, overreaching beyond your shoulder puts stress on the rotator cuff muscles, leading to shoulder impingement.
Additionally, improper form (low elbow position or weak body rotation) can further strain the shoulder joint and increase irritation. Besides that, an NCBI study of 31 collegiate swimmers found that biomechanical errors increase the risk of shoulder injury. The results revealed that the most common training errors were a “dropped elbow” during the pull-through phase (61.3% ) and the recovery phase (53.2%).
Other poor swimming techniques that contribute to shoulder impingement include:
- Over-rotating the torso during breathing
- Entering the water with a thumb-first hand position
- Using excessive internal rotation during strokes
- Performing repetitive motion training without enough rest
- Ignoring shoulder pain and resuming high-intensity physical activity
What’s the Difference Between Shoulder Impingement and Tendonitis?
Shoulder impingement occurs when the rotator cuff tendons are pinched, while tendonitis is the inflammation of those rotator cuff tendons. Beyond that, impingement is a mechanical problem that occurs when the humeral head presses against the shoulder bone. In contrast, tendonitis develops when constant strain causes the tendons to swell and become irritated.
Moreover, in shoulder impingement, you typically experience pain when lifting or reaching overhead, often linked to ligamentous laxity. However, in rotator cuff tendinitis, pain may persist even at rest, with tenderness and stiffness around the shoulder blade. While both conditions share similar symptoms, impingement typically develops first and often leads to tendonitis.
Here’s how shoulder impingement differs from rotator cuff tendonitis in key clinical aspects:
| Shoulder Impingement | Rotator Cuff Tendonitis |
|---|---|
| Pain typically occurs between 60 ° and 120° elevation (the painful arc). | Pain can extend down the arm and may feel dull or constant. |
| Usually, there is no visible swelling. | Mild swelling around the tendon. |
| Often identified through Neer’s impingement tests. | Confirmed by imaging showing tendon thickening. |
How Do Doctors Diagnose Shoulder Impingement?
To diagnose shoulder impingement, doctors perform a physical exam and conduct imaging tests to assess the shoulder structure and movement. For example, X-rays, MRI, or ultrasound can visualize bone spurs and tendon inflammation for a proper diagnosis. Other than that, your doctor may review your medical history to understand when the pain began and which movements worsen it.
In addition, during the physical examination, doctors may use tests such as Neer’s or Hawkins-Kennedy to diagnose impingement. Here’s how these physical tests work:
Neer’s Test
In this test, your doctor stabilizes your shoulder blade while raising your straightened arm forward and upward. This motion narrows the space between the acromion and rotator cuff tendons. If you experience pain during this movement, it may indicate subacromial impingement. According to a PubMed study, Neer’s test has a sensitivity of 79%. Moreover, it is more accurate for rotator cuff pathologies (81.6%) and highly sensitive (90%) for partial supraspinatus tear.
Hawkins-Kennedy Test
For this test, your doctor positions your arm at a 90° angle in front of your body and bends your elbow. Then, they gently rotate your arm inward. This motion compresses the rotator cuff tendons beneath the acromion. If you experience shoulder pain or discomfort during movement, it may indicate shoulder impingement or tendon irritation.
What Are the Best Exercises to Prevent Shoulder Impingement?
To prevent shoulder impingement, focus on exercises that strengthen the rotator cuff, stabilize the shoulder blade, and improve joint mobility. For example, targeted movements like external rotations, wall angels, and scapular squeezes enhance joint laxity, help prevent swimmer’s shoulder and impingement. Here are some additional rehabilitation exercises that support shoulder health:
- Doorway Stretch: Gently open the chest and stretch the anterior shoulder muscles.
- Thoracic Spine Extensions: Improve posture and reduce stress on the shoulder joint.
- Prone Y Raises: Strengthen the lower trapezius (a muscle in the upper back) and improve neuromuscular control.
- Push-Up Plus: Activate the serratus anterior (scapular stabilizers) to improve scapular positioning and avoid impingement.
Moreover, to ensure a safe and gradual return to training, our fellowship-trained orthopedic and sports medicine specialists have designed a Shoulder Exercise Recovery Guide. It includes detailed exercise instructions and practical recovery tips to help you rebuild strength and protect your shoulder throughout the rehabilitation process.
Can Shockwave Therapy Treat Chronic Shoulder Impingement?
Yes, shockwave therapy is an effective non-invasive treatment for chronic shoulder impingement. This therapy uses high-energy sound waves to enhance blood flow, reduce pain, and promote healing in the rotator cuff tendons. Shockwave therapy can also help improve joint mobility when other treatments, such as rest, injections, cold packs, or NSAIDs, fail to provide pain relief.
When Should You Consider Surgery for Shoulder Impingement?
You might need surgery for shoulder impingement if you experience persistent pain, limited range of motion, or shoulder weakness despite conservative treatments. These symptoms may indicate that the rotator cuff or surrounding shoulder structures are under constant stress or not healing properly. Similarly, constant discomfort during overhead movements may indicate that surgery is needed to repair the damaged shoulder structures.
Moreover, surgery may be necessary if imaging reveals structural damage in the shoulder joint. For example, bone spurs, rotator cuff tears, or subacromial narrowing can limit recovery and cause persistent pain. In such cases, you should consult our shoulder specialists, Dr. R Champ Dengenis. He will thoroughly examine your shoulder, review the imaging results, and determine if surgery is necessary to repair damaged tissues and restore the range of motion. You can call us at 855-321-6784 to book an appointment with Dr. Dengenis.
How Long Does It Take to Recover From Swimmers’ Shoulders?
It typically takes 3 to 6 months to recover from swimmer’s shoulder, depending on the severity of your injury. For example, mild rotator cuff tendinitis may improve within a few weeks with rest, applying ice, and targeted exercises. However, more severe tendon tears may require several months of structured rehabilitation to restore strength, flexibility, and shoulder function.
In addition, several other factors can affect a swimmer’s shoulder recovery time, such as:
- Your age and overall health
- Consistency with a rehabilitation program
- Frequency and intensity of swimming or overhead activity
- Presence of other shoulder conditions or previous injuries
- Muscle imbalances in the upper extremities (arms, shoulders, wrists, hand, and fingers)
- Use of hand paddles or improper equipment
Can Shoulder Impingement Return After Treatment?
Yes, shoulder impingement can return even after successful treatment. Impingement recurrence often happens if the shoulder is exposed to overuse injuries before it has healed completely. Besides that, factors such as persistent muscle imbalances or failure to maintain proper arm position during overhead movements can also contribute to the recurrence of impingement. In such cases, maintaining a consistent rehabilitation routine and proper technique can help reduce the risk of recurrence.
Total Orthopedics & Sports Medicine Diagnose and Treat Shoulder Impingement Before It Worsens — Visit Us Now!
When you have swimmer’s shoulder, every stroke, pull, and overhead movement can cause sharp pain and fatigue. You may struggle to complete laps or maintain your usual speed. Moreover, even simple movements, like lifting your arm or rotating it behind your back, can trigger pain. Over time, this ongoing discomfort can weaken your rotator cuff, which affects your swimming performance.
At Total Orthopedics & Sports Medicine, we help you manage and treat swimmer’s shoulder effectively. Our specialists assess your shoulder with physical exams and imaging to identify impingement or tendon irritation. Then, we provide surgical and non-surgical treatments to help you return to swimming safely. Call us at 855-321-6784 or visit 2103 Deer Park Avenue, Deer Park, NY 11729 to discuss your treatment options.
FAQs
Which Swim Strokes Trigger Shoulder Impingement?
The freestyle (front crawl) stroke can trigger shoulder impingement due to repetitive overhead arm movements. The butterfly stroke also increases the risk of shoulder impingement, because it requires overhead motion that stresses the shoulder. Moreover, backstroke can cause shoulder impingement if excessive arm rotation places too much pressure on the shoulder joint.
Is Shoulder Impingement the Same as Rotator Cuff Tendinitis?
No, shoulder impingement and rotator cuff tendinitis are related but not the same conditions. Shoulder impingement occurs when the tendons or bursae in the shoulder are pinched during movement, causing pain and limited motion. In contrast, rotator cuff tendinitis is inflammation of the rotator cuff tendons, often caused by overuse or repetitive overhead activity.
Can Shoulder Impingement Syndrome Heal Without Treatment?
No, shoulder impingement syndrome typically does not heal on its own and may worsen without treatment. Over time, this syndrome can lead to increased tendon irritation and inflammation, resulting in persistent pain and reduced shoulder mobility. Without proper care, the condition may progress to rotator cuff tears or chronic shoulder dysfunction.
Can Tight Chest or Pec Muscles Worsen Shoulder Pain?
Yes, tight chest or pectoral muscles can worsen shoulder pain by pulling the shoulders forward and changing normal joint alignment. This imbalance increases stress on the rotator cuff and shoulder tendons, making them more prone to irritation or overuse injuries. In such cases, stretching and releasing tight pec muscles can reduce swelling and strain on the shoulder, which helps relieve pain during movement.
Is Shoulder Cracking or Popping a Sign of Impingement?
Yes, shoulder cracking or popping can sometimes indicate impingement, especially when it occurs in conjunction with pain or limited movement. However, occasional popping without discomfort is often harmless and may result from normal tendon or joint movement. Moreover, if the popping sound becomes frequent and painful, you should consult our doctor immediately to identify the cause and prevent injury.
Can Poor Breathing Technique Cause Shoulder Stress?
Yes, poor breathing technique can lead to shoulder stress. Shallow or improper breathing can lead to overuse of the upper chest and shoulder muscles, resulting in tension and strain. Over time, this can worsen shoulder pain or increase the risk of injuries like impingement. That’s why it’s essential to practice proper breathing techniques and maintain good posture to protect your shoulders.
Can Dehydration or Fatigue Increase Shoulder Discomfort?
Yes, dehydration and fatigue can increase shoulder pain. When your body is dehydrated, muscles or tendons lose elasticity and become more prone to strain. Moreover, fatigue reduces muscle performance and coordination, which makes your shoulder more prone to overuse injuries. Therefore, maintaining proper hydration and getting sufficient rest are essential to support recovery.
