SWIMMERS: SHOULDER MOBILITY

 
 
 

In this program, we will cover some of the basic principles of maintaining healthy, strong shoulders in the water. This course is not medical advice and is meant for educational purposes.

 

WHO WE ARE

DR. PIERRE MEUNIER, PT

Dr. Pierre is a life long athlete who has competed in swimming and triathlon. He is interested in helping active individuals and athletes become more resilient and healthy in their endeavors through education, therapeutic care, and exercise prescription and training. When not in the clinic, you will likely find him in the mountains biking and running, or dropping nature facts that nobody really cares about.

DR. MATT SMITH, DC, CES

Dr. Matt enjoys nothing more than finding ways to connect with and help active, motivated people achieve success. Matt specializes in therapeutic care, rehabilitative exercise, and sport-specific strength training for elite and amateur athletes. When Matt is not in the clinic, he is most likely on a surfboard, on a trail, and/or searching for the perfect slice of pizza.

EVERATHLETE

EverAthlete is a team of sports chiropractors, physical therapists, and strength coaches who are committed to helping outdoor enthusiasts continue to do what they love at the highest level. Since 2015, we have helped thousands of athletes through sports injury rehabilitation, injury prevention, and performance training.

1-on-1: We offer in-person soft tissue therapy, injury rehabilitation, and performance training.

Online Membership: We offer online guided strength training and recovery resources through our membership at www.everathlete.fit

TRUSTED BY THE BEST

INTRODUCTION

Goals For Today:

  1. We will first discuss the anatomy and movement of the shoulder to give you a fundamental understanding of how your shoulder moves.

  2. Then we will teach you how to assess your own movement.

  3. Finally, we’ll show you how you can improve your movement at home to improve your performance and reduce your risk of injury in the pool

Shoulder Pain In Swimmers:

The prevalence of shoulder pain in swimmers can be as high as 91%. Research shows that 9/10 swimmers will be affected by shoulder pain at some point in their swimming career.

There are many potential causes of shoulder pain in swimmers including rotator cuff issues, impingement, labrum tears and long head of the biceps tendinopathy.

The risk of shoulder pain increases with age, years of training and level of competition.

What Makes The Demands of Swimming Unique?

Unlike most sports, in swimming, most of the propulsive power is generated by the shoulder complex. In freestyle swimming, about 80% of the power is generated by the shoulders and the rest by the legs.

Swimming Has Inherent Repetitive Stress In The Shoulder

During a 5000 yds practice, each shoulder will rotate about 850 times

Certain muscles are constantly active during swimming such as the serratus anterior and subscapularis (part of the rotator cuff). Any fatigue will lead to compensations elsewhere and potentially to injury.

Swimming Injuries Are Nearly All Chronic Overuse Injuries

These injuries occur over long periods of time due to overload in our muscles, connective tissues, and joints.

They are often caused by muscular imbalances and limitations in our mobility that create chronic stress and injury over time.

SHOULDER ANATOMY

SHOULDER COMPLEX
 
 

THE SHOULDER COMPLEX:

Gleno-humeral joint: it is mainly the ball (humerus) and the socket (scapula) joint but it also contains the labrum, the rotator cuff and the long head of the biceps. Proper function requires the ball to remain centered in the socket at all times.

Scapulo-thoracic joint: it is not a true joint but rather it is the movement of the scapula over the rib cage. It needs to be sufficient and stable via thoracic mobility and control of the supporting muscles so it can aid in maintaining the ball and socket centered during movement.

Thoracic spine: it is the region of the spine that we call the mid back. The rib cage attaches to it so a lack of motion will affect the ability of the rib cage to move which affects the capacity of the scapula to move well. In addition, several muscles crucial to the function of the scapula attach there.

Cervical spine: it is important to consider as issues in the neck commonly refer to the shoulder. Most of the nerves exiting from the neck need to travel through the shoulder girdle to reach your arm. Several muscles stabilizing the scapula also have attachment in the cervical spine. A shoulder pathology can also affect your neck.

SHOULDER MUSCLES
 
 

Latissimus Dorsi, Teres Major and Pectoralis Major

  1. They are the primary force generator in swimming during the pulling phase.

  2. They have a tendency to become tight and can restrict overhead motion.

Serratus anterior 

  1. This muscle helps move and maintain the scapula stable on the ribcage, and assist its upward rotation and protraction. This muscle is constantly active throughout the entire swim cycle. 

Rotator Cuff - Primarily The Subscapularis

  1.  It is part of the rotator cuff and helps stabilize the humerus into the glenoid cavity (keep the ball into the socket). It also performs internal rotation of the shoulder, so rotating your arm inward.

  2. There is a frequent loss of internal rotation in swimmers which not only alters the mechanics of the joint but also potentially makes the subscapularis’s job harder. 

Middle and Lower Trapezius

  1. They assist the stability of the scapula during the recovery phase of swimming (when the arm is out of the water in freestyle and butterfly).

  2. Indirectly supports the rotator cuff and other muscles attaching onto the scapula.

SHOULDER MOVEMENT

 
 

Shoulder Flexion

  1. It is the ability to reach your arm into the overhead position.

  2. Deficits in this motion are very common in swimmers and can be due to a variety of factors.

  3. If you lack this range of motion, it can lead to compensation, inefficiency in the swim stroke, and potential injuries over time.

Shoulder internal rotation

  1. It is the ability of rotating your arm/shoulder inward. If you place your bent elbow at your side with your fingers pointing straight ahead and then move to place your hand on your stomach, you achieve internal rotation. Of course, it can happen in all the positions that you place your shoulder in.

  2. Deficits are very common in swimmers with deficits usually greater on the dominant side.

  3. Varying levels of internal rotation are required during all phases of the stroke cycle from hand entry, to the pull through and hand exit, to the recovery.

  4. Limitations lead to inefficient stroke, compensations and potentially injuries.

Thoracic/mid back mobility

  1. Shoulder range of motion can only be complete and stable when the thoracic spine moves well so the scapula can move adequately.
    Poor mobility tends to increase stress on the shoulder joint.

ASSESS YOUR MOBILITY

MOBILITY ASSESSMENTS
In this section, we will use movement assessments to help you better understand your movement capabilities.
Equipment needed: Partner, floor space, phone with inclinometer app, chair or box

THORACIC ROTATION TEST

  1. < 45 degrees is a pass

  2. Note side to side difference

  3. Score of 0 if pain

SHOULDER FLEXION TEST

  1. 3/3: able to reach the wall in standing

  2. 2/3: able to reach the floor in supine

  3. 1/3: unable to reach the floor in supine

  4. Note side to side difference

  5. Score of 0 if pain

OVER / UNDER REACH TEST

  1. Less than 2 fist fits is a pass

  2. Note side to side to side difference

  3. Score of 0 if pain

IMPROVE YOUR MOVEMENT

OVERVIEW

In this section, we will focus on strategies to improve your overall shoulder health through light exercises to improve the mobility of your shoulders and thoracic spine.

The techniques we will use to improve your mobility are:

Self-Myofascial Release - 30-90 sec in each
This is a self-massage technique using a foam roller or ball to compress a specific area. This compression can provide temporary relaxation of the muscles, restore sliding and gliding capabilities of the connective tissue, and improve overall mobility of a given area. This is best performed pre-activity for 30-45 sec in each region or post-activity for 60-90 sec in each region

Long Hold Stretching - 45-90 sec hold
This is a technique used to lengthen muscle groups, provide improved joint positioning, and restore healthy balance to the relationship between muscles in a given area. This is best for a recovery session or following sport/gym activity.

Dynamic Stretching - 10-15 reps
This style of stretching is best for pre-activity and is to be performed in controlled brisk reps.

THORACIC MOBILITY

THORACIC FOAM ROLLING

CHILDS POSE REACH THROUGH

SIDE LYING THORACIC ROTATION

ACTIVE THORACIC ROTATIONS

SHOULDER MOBILITY

LAT + POSTERIOR SHOULDER FOAM ROLLING

PRONE LAT STRETCH

PEC SELF-MYOFASCIAL RELEASE

SHOULDER INTERNAL ROTATION STRETCH

SHOULDER FLEXION STRETCH WITH BAND ASSISTANCE