Hannah Diaz is a professional soccer player, currently with the Houston Dash. Hannah’s expertise expands to sports nutrition, general fitness, and running. She has coached soccer and conditioning sessions for athletes at many levels. She is a regular contributing writer for Complete Tri.
Swimming is a notoriously good sport when it comes to preventing injuries. Compared to running, and the impact that it places on your joints, swimming is a low-impact, high-cardio sport that generally allows an athlete to not worry much about injury. With that said, there is at least one overuse injury that we hear from swimmers: Rotator Cuff Injury. A rotator cuff injury can be painful, affect swimming, and have extended impacts in other areas of life, so it is worth taking very seriously.
First, what is the rotator cuff? It is the group of muscles and tendons that cluster around your shoulder and connect your upper arm to your shoulder blade. Because they are a very integrated group of muscles, having a strain in one or an imbalance in the strength or stretch of them can create issues for you. That is what happens when a rotator cuff injury stems from overuse. Like the domino effect that can happen to your knees and ankles if you get a hip injury, a strained muscle in the rotator cuff can spread to other areas as your body tried to compensate.
Rotator Cuff Injury Symptoms
A rotator cuff injury involves pain when moving the shoulder, especially when trying to lift the arm overhead. A common test for rotator cuff injury is to stick your arm directly out in front of you, ask someone to apply light pressure with their hand on the top of your wrist, and then attempt to lift the arm upward (pushing their hand up). If this type of activity presents pain or, in difficult cases, such weakness that you can’t even lift the arm up, there is a good chance you are suffering from rotator cuff injury.
Other symptoms include stiffness in the shoulder, pain when trying to do household errands such as reach up for a high shelf, or soreness and reaching forward while doing a freestyle swim.
How to Treat Rotator Cuff Injuries
If you find yourself with a sore or weak rotator cuff, some self-treatment can often solve the problem. In more severe cases, surgery may be necessary, but that is a definite last resort. Here are a few things you can do to treat your injury and aid in the healing process.
- Rest. Your pain will help you do this, but it can be good to have a period of rest where you are not swimming, doing any heavy weightlifting, or engaging in work or household activities that require you to lift above your head.
- Ice. Icing your shoulder can help the rehab process. For best results, try to ice daily for several minutes. Taking anti-inflammatory medications (NSAIDs) can also help as long as you have no health issues in taking them. You might also want to consider a regular cold plunge, if you have access to one.
- Stretching. Very careful stretching can help you regain range of motion in the affected shoulder, and should be considered. They key is to keep it light and not aggravate the injury. Most stretches involve extending your arm and using that as a lever to very slightly stretch your rotator cuff area, never to the extend that you are putting your arm or shoulder in an unnatural position. One common stretch is to stand in a doorway, extend your arm to rest on the door jamb (if straight out to the side is 3 o’clock, put your arm down at about 4 o’clock) and move your body until you give the shoulder a very slight stretch. Repeat.
- Strength training. Again, this should only be done after a rest period and with very light weight, but trainers can often recommend a lift that can strengthen and balance your shoulder muscles. Most of these lifts involve very light dumbells or cables, nothing that will exert much pressure on the shoulder. The goal is to rehab, not to add bulk.
Once you have rested and rehabbed the shoulder, consider how you can prevent the injury in the future. Doing regular stretching will help, and if your injury was caused by swimming, you may want to consult a swim coach to be sure your stroke is smooth, balanced, and not placing unwarranted pressure on your shoulder muscles.
Is a Rotator Cuff Injury Painful?
Yes. Rotator cuff injuries can range from a dull ache, to an acute, sharp pain when you do things like lift an item overhead or find yourself sleeping on the side of the injury. It is usually some combination of pain and weakness that causes people to seek treatment. For swimmers, the pain often is most pronounced when the shoulder is stiff, at the outset of a swim. If the injury is more serious, swimming may become impossible until the cuff heals.
When Should I Consider Rotator Cuff Surgery?
If your shoulder pain is preventing you from resuming normal activities, and you do not seem to be getting any better, you may want to talk to a shoulder specialist. Look for someone who deals with shoulders on a daily basis, and is experienced in the recovery from the procedure as well as the surgery itself. Don’t take it lightly, though. While some rotator cuff surgeries can be done with arthroscopic techniques, others require a more substantial surgery which could result in a 6-month recovery.
Be sure you have tried stretching, ice, and rest before getting serious about surgery, but there is a time and a place for it.