What’s Really Behind That Swimming Pain?

Swimming is widely recognised for its cardiovascular benefits and low-impact nature, making it a popular choice for people of all ages. However, despite its reputation as a joint friendly sport, swimming carries a distinct set of injury risks.

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Whether you’re a recreational swimmer or training competitively, understanding how to protect your body is essential to staying pain free and progressing efficiently.

Common Swimming Injuries

The repetitive overhead motion involved in most swim strokes places considerable stress on the shoulder joint. The most prevalent condition, “swimmer’s shoulder,” typically involves rotator cuff tendinopathy or subacromial impingement. This injury can significantly affect performance and may persist if not addressed early.

Other common issues include:

• Lower back strain due to sustained spinal extension, especially during freestyle and butterfly.

• Neck pain, often resulting from poor breathing mechanics and thoracic stiffness, leading to excessive cervical rotation.

• Breaststroker’s knee, caused by the whip kick action that places stress on the medial knee.

• Shoulder instability, particularly in younger or hypermobile swimmers.

These injuries tend to develop gradually and are invariably related to training volume, poor technique, or muscular imbalances.

What Makes Rehab for Swimmers Unique?

Swimming injuries are fascinating to physiotherapists because effective diagnosis and rehabilitation is truly individualised. While it’s often said that ‘everything is connected,’ in swimming, this really holds true, and injuries frequently stem from a mix of mechanical factors.

Shoulder pain is a perfect example of how complex swimming injuries can be. Here are some things an expert would consider in an assessment:

Breaking Down Shoulder Pain

Shoulder Muscle Imbalance - Swimmers with shoulder pain commonly exhibit increased stiffness in the posterior deltoid (rear of the shoulder). This can produce pain directly but also create a compressive, irritating force on the tendons of the rotator cuff.

Scapula Movement - The shoulder is complex due to its unique anatomy. It relies on the efficient gliding of the shoulder blade to achieve a full range of movement. This coordination (known as “scapulohumeral rhythm”) is fundamental to swimming, and dysfunction here often precipitates shoulder pain.

Spinal Mobility - Shoulder movement is not only constrained by the shoulder blade, but also by mobility of the thoracic spine. If you need convincing, try hunching forward and then reaching for the roof without changing your posture. Restrictions in thoracic extension or rotation inevitably result in overloading of the shoulder complex.

Lower Body Strength - You might expect the upper back and shoulder blade to play a role, but here’s where it gets interesting: Swimmers with shoulder pain frequently demonstrate greater strength in their opposite leg. This imbalance is

thought to produce altered trunk and upper limb mechanics, resulting in excessive shoulder strain.

Why Expertise Matters

As you can see, assessing and treating a swimming injury (or any complex condition) isn’t just about easing the pain. It’s about understanding why those symptoms developed in the first place. Failure to address underlying causes can result in poor long-term outcomes, often leading people to seek out injections or surgical interventions before they’re really needed.

Physiotherapists who understand the mechanics can connect the dots and, instead of chasing symptoms, target the source of the problem.

If you’re struggling with a swimming-related injury or want to stay ahead of potential issues, don’t go it alone. Partnering with a skilled physio gives you the best shot at staying in the water and moving pain-free into the future.

This article is for informational purposes only and does not constitute medical advice; always consult a qualified healthcare provider for personalised care.

For all your health and rehabilitation needs, check out Peak Physio in Newcastle, Rutherford and Budgewoi