"Healing Swimmer's Shoulder by Staying in the Water"

"Healing Swimmer's Shoulder by Staying in the Water"
-- Bonnie Adair

Bonnie Adair is the head Coach of the LMU Women's swim team and co-founder of Southern California Aquatics. In just three years as head coach, Bonnie has turned the LMU program into a contender for the Pacific Coast Swimming Conference Championship. The LMU Lions finished a program-best third in the conference in 2005 and set 16 of 19 school records in a history-making season. LMU earned its first two conference event titles in 2005, winning both the 200 medley relay and the 100 backstroke. [LMU Swimming] 

During her own 13-year swimming career, she set 35 National Age Group records including a 50m freestyle record that stood for 29 years.

Many swimmers and triathletes of all levels have succombed to the pain of "swimmer's shoulder," an impingement syndrome caused by repetitive shoulder rotations. A typical Masters or fitness swimmer swimming three 1-hour workouts each week will do between 10,000-11,000 rotations compared to a professional tennis player who will do approximately 1,000 rotations.

The standard Rx: ice the involved area, take an anti-inflamitory medication and give the shoulder a rest. In short: stay out of the water! This may be good advice for that occasional flare up of shoulder pain caused by extra activity or heavy lifting, but it is not the desired treatment plan for those with chronic shoulder pain who do not wish to interrupt their training regimen by skipping workouts each time that nagging shoulder ache returns. Thus, we designed this workout to allow you to continue your training while correcting poor stroke mechanics and building strength in the vulnerable area.

In our program at SCAQ, we train over 1,500 swimmers each year and are confronted almost daily with complaints of shoulder pain from swimmers of every level - ranging from new fitness swimmers and first time triathletes to aging competitive swimmers still seeking that personal best.

We employ a 3-step approach to eliminating shoulder problems:
(1) Correct technique: If you have chronic shoulder problems, chances are you have a flawed stroke which causes excess pressure to be placed on your shoulder structures. By making a few simple stroke adjustments, we find that we can quickly eliminate shoulder pain in 90% of our swimmers that are having repeated "flare-ups. If you are one of these, ask your coach to look at your stroke or, better yet, sign up for a video clinic if one is available to you.

(2) Strengthen: We strongly recommend that all swimmers, not just those with shoulder problems, incorporate a series of dryland shoulder strengthening exercises into their weekly training schedule (3-4 times/week).

(3) Relax: learn to relax while swimming.
However by staying in the water and slightly modifying your standard workout, you also can strengthen this vulnerable area, something not being done when you are continuously "giving it a rest" by skipping weeks of workouts waiting for the pain to subside. And the good news is that the modified workout we recommend actually accelerates your heart rate and provides a great conditioning workout. So here it is!

Warm-up: Easy 400 - Alternate breathe to even out stroke. Relax.
Warm-up #2: 4 X 100 freestyle increasing effort each 100 but only to 80% on 4th 100.
Warm-up #3: 4 X 50 - 3 on a short rest interval providing 5-10 sec. rest, the 4th 50 is easy. Repeat set 3 more times with 30 seconds rest in between each set for a total of 12 X 50. Stay between 80-85% effort. These are not sprints! [Total 1200 yards]

Main Set: 6 X 200. If you are having a "bad shoulder day" we recommend that you use a short fin on this set and follow this pattern. #1: Do the first 150 yards using a "catch-up" or "touch-stroke" to stretch out and relax the arm cycle. Put your kick into overdrive, which will increase your cardiovascular output. The last 50 is in your regular stroke cycle. #2: The first 100 is "catch-up" stroke, the second 100 regular cycle.#3: The first 50 is "catch-up," the remaining 150 regular cycle#4: Same as #1; #5: Same as #2; #6: Same as # 6
[1200 Total]

Kick set: 25 - 50 - 75 - 100 - 75 - 50 - 25. Repeat. [Total 600] Do not use kickboard as this will cause extra stress on your shoulders. Instead try kick on your side, alternating between right and left.

Sprint set:4 X 25 @ 30 sec. 2 breaths maximum each 25, loosen 25 4 X 25 @ 35 sec. 1 breath maximum each 25, loosen 25 4 X 24 @ 40 sec. no breath Until you are asymptomatic for 3 months, we recommend that you substitute breath control for "sprints." Stay below 90% effort but put your kick in overdrive to create.

Warm-down: 200 "catch-up" stretch out and relax.

ADDITIONAL TIPS:
Extend your warm up: At least 1/3 of your swimming workout should be in the "warm-up" phase. Gradually increase the effort, never exceeding 80% until you are well into the middle of your workout. You are still getting a good cardiovascular workout at 80% and are strengthening your upper body structures without tearing down the shoulder area by sprinting too soon. Save the 100% effort for another day when you have rehabilitated your shoulder to a point that it is pain free.

About pulling: we recommend that you don't pull in workout until you have been pain free for at least 3-months. Instead substitute "catch-up" stroke with a short fin when your coach gives pulling sets. Most importantly - stay away from paddles! If you must, use an undersized paddle which will still satisfy your "paddle addiction" without breaking down your vulnerable shoulder structures. Again, it is better to put the paddles away and use a short fin until you are asymptomatic for a minimum of 3 months.