Swimmer's shoulder?

allanl16allanl16 Miami, FloridaMember

I finished swim around key west a few months ago but I'm still having this odd, sharp pain in my left shoulder. It began right after I finished so I assumed it was a strain and decided to take a break from swimming and continue the other tri legs. I've swam maybe 2-3 times since then with each swim being a catastrophic failure due to the pain.

I breathed on my right side only during the race and believe that overstretching my left arm stroke while taking longer breaths for 6 hours did some damage. If I had alternated my breathing I don't think I'd be in this mess!

I'm going to visit my doctor this week but would love some input. Thanks!

Comments

  • wendyv34wendyv34 Vashon, WASenior Member

    Can you identify the specific origin of the pain or is it more generalized?

    It's always a bad hair day when you work at a pool.

  • allanl16allanl16 Miami, FloridaMember

    wendyv34 said: Can you identify the specific origin of the pain or is it more generalized?

    Hey Wendy, it's rather specific. I circled where I believe the pain is coming from here. Theres almost like a pinching/pulling feeling during my pull. Thanks for the reply

  • flystormsflystorms Memphis, TNMember

    Get with the doc, but it may be a winged scapula. It feels as if you've torn a lat or something and can be painful. I had this during some distance training (and a coach that wasn't great with detail) for Key West. Once I did some PT and went to a different coach, I got it worked out and haven't had issues since then. https://www.swimmingworldmagazine.com/news/how-swimmers-can-strengthen-the-serratus-anterior-muscle/
    http://www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/winged-scapula

    wendyv34
  • swimmer25kswimmer25k Charter Member

    If your pain is on the backside of your shoulder all the way into your armpit, you may be looking at a strained/torn subscapularis, supra/infraspinatus, and/or teres minor. You'll generally feel pain soon after the catch and all the way to your release. Do you have any trouble buckling a seatbelt? Try doing this with the affected side reaching across your body to grab the buckle. Pull the buckle across your body and plug it in. This will have your shoulder internally rotate. If it hurts, then one or all of those muscles could be jacked. Ask me how I know. Look into getting an MRI. MRI will show any tears in the muscles as well as the joint capsule.

    Another typical ache and pain is from a swollen biceps tendon. You can see and feel it jumping out of the groove. I had good luck with PT and taking it easy. The only therapeutic success I had was getting myofacial release and applied kinesiology on my right shoulder that ended up getting cut into about a year after symptoms arrived.

    Therapy is key to getting yourself back into the game. You might have something going on in your stroke that s really long swim exposes. Maybe have someone look into your stroke to see if you have a weird hitch in it.

    Chris

    wendyv34allanl16
  • allanl16allanl16 Miami, FloridaMember
    edited October 22

    swimmer25k said: If your pain is on the backside of your shoulder all the way into your armpit, you may be looking at a strained/torn subscapularis, supra/infraspinatus, and/or teres minor. You'll generally feel pain soon after the catch and all the way to your release. Do you have any trouble buckling a seatbelt? Try doing this with the affected side reaching across your body to grab the buckle. Pull the buckle across your body and plug it in. This will have your shoulder internally rotate. If it hurts, then one or all of those muscles could be jacked. Ask me how I know. Look into getting an MRI. MRI will show any tears in the muscles as well as the joint capsule.

    Another typical ache and pain is from a swollen biceps tendon. You can see and feel it jumping out of the groove. I had good luck with PT and taking it easy. The only therapeutic success I had was getting myofacial release and applied kinesiology on my right shoulder that ended up getting cut into about a year after symptoms arrived.

    Therapy is key to getting yourself back into the game. You might have something going on in your stroke that s really long swim exposes. Maybe have someone look into your stroke to see if you have a weird hitch in it.

    Chris

    Hey Chris, I've been resting since August thinking that was all I needed but I'm afraid that's not the case. I don't have pain when I try doing the seatbelt buckle movement. I think I've narrowed down the pain to the teres minor and I can replicate the worst pain by pointing my elbow to the sky. Oddly enough I've been raising my elbow for the past few minutes in order to pinpoint the troubled area and the stretching seems to have made the pain disappear.

    A doctors visit is in order but I'm terrified the MRI results will show something requiring surgery. I'm okay with putting training aside for my health but I can't afford to take off work until I heal. I'm driving myself mad but has anyone else had this issue? Thanks!

    Edit: Scratch that I don't know exactly where it's coming from. Looks like it could be coming from any of the locations you listed. This is the worst.

  • BridgetBridget New York StateMember

    I can't speak to your specific issue, but I dealt with a year of sciatic pain (and most of my adult life with back pain) with PT, figuring it was worth a shot and I could always revisit option as needed. I actually do understand that there are times when medical/surgical interventions are needed, but it is good to know the general philosophy of your doctor- so as you gather information about your situation, keep in mind that some practitioners are more open to less intrusive measures, at least initially, than others. Too many practitioners still don't consider the seemingly extraneous issues like missed work, etc. Good luck as you explore options.

    Your elbow to the sky incident brings to mind a slogan from a rheumatologist- motion is lotion. Hopefully, you will find something that offers relief and recovery, so you can resume the things you enjoy.

    allanl16
  • allanl16allanl16 Miami, FloridaMember

    Bridget said: I can't speak to your specific issue, but I dealt with a year of sciatic pain (and most of my adult life with back pain) with PT, figuring it was worth a shot and I could always revisit option as needed. I actually do understand that there are times when medical/surgical interventions are needed, but it is good to know the general philosophy of your doctor- so as you gather information about your situation, keep in mind that some practitioners are more open to less intrusive measures, at least initially, than others. Too many practitioners still don't consider the seemingly extraneous issues like missed work, etc. Good luck as you explore options.

    Your elbow to the sky incident brings to mind a slogan from a rheumatologist- motion is lotion. Hopefully, you will find something that offers relief and recovery, so you can resume the things you enjoy.

    Thanks for replying Bridget. I too am hoping for a solution that will not require surgery but will understand if it's necessary. As soon as this issue is resolved I'm going straight to a video analysis and stroke correction clinic.

    Motion is lotion! :D

  • MoCoMoCo Worcester, MAMember
    edited October 23

    allanl16 said: A doctors visit is in order but I'm terrified the MRI results will show something requiring surgery. I'm okay with putting training aside for my health but I can't afford to take off work until I heal. I'm driving myself mad but has anyone else had this issue? Thanks!

    A doctor's visit and MRI won't change what's going on with your body, they'll just change the knowledge you have. Even if they recommend surgery, doesn't mean you have to have it, or have to have it right away. Go get it looked at so you know all your options. Don't make any big decisions in the doctor's office.

    rosemarymintallanl16Bridget
  • allanl16allanl16 Miami, FloridaMember

    MoCo said:

    allanl16 said: A doctors visit is in order but I'm terrified the MRI results will show something requiring surgery. I'm okay with putting training aside for my health but I can't afford to take off work until I heal. I'm driving myself mad but has anyone else had this issue? Thanks!

    A doctor's visit and MRI won't change what's going on with your body, they'll just change the knowledge you have. Even if they recommend surgery, doesn't mean you have to have it, or have to have it right away. Go get it looked at so you know all your options. Don't make any big decisions in the doctor's office.

    You're right. I would just like to know what is going on so I can take the best course of action. I'm fairly young (22) however if I can avoid going under and stick to PT in order to return to 100%, that's the preferred route. Thank you for the replies guys, it honestly means a lot.

    Bridget
  • evmoevmo San FranciscoAdmin

    @swimmer25k alluded to this, but it may be worth considering how your swim technique may be contributing to shoulder strain.

    In order of importance, (1) dropped elbow on the catch, (2) crossing over the midline on hand entry, and (3) thumb-first entry are three common issues that can lead to shoulder injury, especially when combined with increased training volume.

    allanl16wendyv34curly
  • allanl16allanl16 Miami, FloridaMember

    evmo said: @swimmer25k alluded to this, but it may be worth considering how your swim technique may be contributing to shoulder strain.

    In order of importance, (1) dropped elbow on the catch, (2) crossing over the midline on hand entry, and (3) thumb-first entry are three common issues that can lead to shoulder injury, especially when combined with increased training volume.

    I'm almost certain it's from my swim technique, particularly my left arm. Hopefully this can all get resolved soon so I can get my stroke fixed. Thank you evmo.

  • curlycurly Issaquah, WAMember

    evmo said: @swimmer25k alluded to this, but it may be worth considering how your swim technique may be contributing to shoulder strain.

    In order of importance, (1) dropped elbow on the catch, (2) crossing over the midline on hand entry, and (3) thumb-first entry are three common issues that can lead to shoulder injury, especially when combined with increased training volume.

    All of those actions sneak into your stroke if you aren't careful. And then they feel perfectly normal. If you watch other people swim, you will notice all sorts of glitches in their strokes. I'm sure they feel like they are swimming as smooth as possible. A few years ago, I became convinced that something had gone askew in my stroke. I was sure I was swimming with good technique, but I wasn't feeling like I was moving through the water correctly. I had one of the lifeguards shoot some video of me swimming a length. Good Lord! It was mind boggling how awful my stroke had become. One hand was entering the water almost upside down, for example.

    Since that time, I have taken a month or two each year to re-teach myself how to swim. Probably the best place to start is to get someone to shoot some video of you swimming. If you get a shot of head on and also along side, it will probably show you almost everything you need to know. Then watch a couple of videos of the Olympic swimmers doing their thing and compare what they do to your video.

    The last part of the exercise is to feel like you are exaggerating the correction. For example if your arm is crossing over your midline at entry, make it feel like you are reaching too far outside your body, away from the midline. Chances are, you will be putting your arm in just the right place. Swimming is one of those skills that needs constant effort to keep in good form. I have a friend who I'm teaching to swim. I always tell her that she is halfway to having a perfect stroke. And she always will be halfway there...

    allanl16wendyv34
  • jendutjendut Charter Member

    evmo said: @swimmer25k alluded to this, but it may be worth considering how your swim technique may be contributing to shoulder strain.

    In order of importance, (1) dropped elbow on the catch, (2) crossing over the midline on hand entry, and (3) thumb-first entry are three common issues that can lead to shoulder injury, especially when combined with increased training volume.

    If I could "like" this 1000x I would. Thumb first entry (especially paired with internally rotated shoulder at recovery) are direct contributors to the biceps tendon pain (front of the shoulder). Also there is no downward push at the front of the stroke OR at the end prior to the recovery of the arm - those two "pushes" (not to mention the bouncing and the timing issues which accompany them) are very bad for the poor shoulder joint which is not meant to move that way.

    Oh right, now that I am ranting, I will mention that once you are not slicing into the water thumb-first, you likely will be helping correct a "crossover" problem; it's pretty difficult (though admittedly not impossible) for the hand to exit and enter the water with the correct pitch and an externally rotated shoulder and then cross over in front of the body. Sorry, I just can not resist a technique conversation.

    :D

    allanl16evmogregoc
  • If you breathe to just one side it is quite often the opposite shoulder that can start playing up. Most commonly due to an overly flat arm position and pushing down. Spear those arms in angled down, and breathe bilaterally. Or, if like me you can't seem to do this properly then breathe to the opposite side every lap. Even in ows I breathe 50 strokes left, then 50 to the right, rinse and repeat.

    gw

    allanl16
  • BridgetBridget New York StateMember

    The mention of thumbs down hand entry/shoulder rotation as a potential contributor made me think of turns. If you are doing a fierce turn to boost speed, and you press palms down before tucking your chin to start your summersault, you may also be turning your shoulder in a way that is contributing-- possibly.

    I do a modified turn-- I press down with the backs of my hands, not my palms, so that my arms pull through the water (or rather, my body moves through the water as my arms remain still) with a very simple motion that brings my arms from my thighs to the streamline glide with no rotation, and ready to go. With the number of turns I was doing last spring, I think it helped a lot.

    I also keep my "tuck" fairly open to avoid lower back stress, and minimize my push off, because after a few hours, my legs and feet were cramping up. And there are no flip turns in open water ;-) .

    allanl16
  • curlycurly Issaquah, WAMember

    Bridget said: And there are no flip turns in open water ;-) .

    Well except for those nuts banging flip turns off the Cliffs of Dover...

    NiekSoloallanl16Bridget
  • allanl16allanl16 Miami, FloridaMember

    Update: Just met with my physician and he thinks it’s a tear. Prescribed me an anti-inflammatory (meloxican) for 3 weeks and told me to rest my arm (even though that’s what I’ve been doing since June).

    Asked if he would suggest a scan if nothing changes after 3 weeks and he said nope, no point. Going to follow orders and assess then.

  • swimmer25kswimmer25k Charter Member

    Allan,

    Where's the tear? If you need a second opinion check out Dr Keith Heckman at UM. He's a great shoulder guy. I ripped mine up pretty good back in 1996 and needed surgery. I swam World 25K trials five months later and (almost) made the team. The therapy was key to my recovery.

    My injury was from over-use from swimming 100K/week. Lots of it with paddles. Never wear paddles again. Try adding more fins in your future workouts to give your shoulders a rest. However, keep your stroke balanced. If you begin to favor the other shoulder, that one might start to fight you.

    Heal up!

    allanl16
  • allanl16allanl16 Miami, FloridaMember
    edited November 13

    swimmer25k said: Allan,

    Where's the tear? If you need a second opinion check out Dr Keith Heckman at UM. He's a great shoulder guy. I ripped mine up pretty good back in 1996 and needed surgery. I swam World 25K trials five months later and (almost) made the team. The therapy was key to my recovery.

    My injury was from over-use from swimming 100K/week. Lots of it with paddles. Never wear paddles again. Try adding more fins in your future workouts to give your shoulders a rest. However, keep your stroke balanced. If you begin to favor the other shoulder, that one might start to fight you.

    Heal up!

    My physician didn't even try to pinpoint a rough location. Told me it was a tear, prescribed me an anti-inflammatory for 3 weeks, and sent me off. In hindsight I should have been more firm but I trusted his judgement and gave him the benefit of the doubt. I'm going to finish up his orders of rest + pills but I think I'll be visiting your Dr. Heckman. Thank you for your recommendation, Chris!

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