Swimmer’s shoulder

Swimmer’s shoulder, also known as shoulder impingement syndrome, is shoulder pain and stiffness that happens when the soft tissues in the shoulder joint become swollen or compressed.  

Swimmer’s shoulder happens when the shoulder bone rubs or pinches the rotator cuff. The rotator cuff, made up of muscles and tendons, sits below the bony structure of the shoulder and allows you to raise and rotate your arm. Swimmer’s shoulder symptoms are common in people who regularly do activities that involve raising an arm above their shoulder, such as swimming or throwing. A rotator cuff injury that can happen from swimming is a type of shoulder impingement. 

Swimmer’s shoulder makes it hard to move your arm without pain, but treatment can help you get back to your usual activities. Our team at Penn Medicine Orthopaedics evaluates your shoulder pain and creates a unique treatment plan based on your lifestyle. 

People with swimmer’s shoulder usually feel pain in the front or side of the shoulder or down the arm. You may feel pain and stiffness when you lift your arm, such as when you reach for something. You may also feel pain when you lower your arm.  

Swimmer’s shoulder pain tends to be worse at night. Mild symptoms of swimmer’s shoulder may include: 

• Pain that spreads from the front of the shoulder to the side of the arm 
• Sudden pain when lifting or reaching 
• Pain at rest or when lying on the shoulder 
• Pain when you twist to reach into a back pocket 
• Needing to take longer to warm up when playing sports and having pain when throwing or serving a ball 
• Stiffness and swelling 
• Changes in skin color 
• Feeling or hearing a crack when you move your shoulder 

Symptoms may get worse over time. If shoulder impingement becomes more serious, you may have symptoms that include: 

• Tenderness when you touch your shoulder 
• Pain that prevents you from sleeping at night 
• Weakness in the shoulder 
• Having trouble moving the shoulder 
• Trouble getting dressed, washing your hair, or fastening your seatbelt in the car 

There are a few reasons why bone in the shoulder may rub against tissues and cause swimmer’s shoulder.

• Tendinitis: Tendons connect muscles and bones. If any of the four tendons in your rotator cuff become inflamed and irritated, known as tendinitis, it can lead to shoulder impingement.
• Bursitis: Bursitis develops when a fluid-filled sac known as a bursa becomes inflamed. When this happens in your shoulder, the swelling can cause a bone to pinch tissues in the rotator cuff.
• A shoulder bone that is shaped differently: An acromion is a bony structure at the top of the shoulder blade. It’s usually flat, but some people are born with a curved acromion. This curved bone can press against the rotator cuff and cause swelling and irritation.

Swimmer’s shoulder usually happens from an overuse injury. When you do an activity that involves using the shoulder over and over, it puts stress on the shoulder joint and can cause swelling.

Sports commonly cause overuse injuries. But swimming isn’t the only sport that can cause swimmer’s shoulder. Other sports that can lead to shoulder impingement include:

• Tennis and pickleball
• Golf
• Gymnastics
• Volleyball
• Baseball
• Weightlifting

Physical jobs that require lifting or raising one or both arms above the head also can cause swimmer’s shoulder. These types of jobs include:

• Construction
• Painting or hanging wallpaper
• Hanging drywall
• Washing windows
• Stocking shelves

Although overuse injury is a common cause, swimmer’s shoulder doesn’t always happen from movements you do over and over. It can also be caused by a one-time injury from a fall, auto accident, or a sports collision.

Swimmer’s shoulder treatments include taking steps at home to heal your shoulder. These can help you regain function in your shoulder. 

• Rest: You may need to take a break from your sport or from work to help your shoulder heal. Follow your provider’s recommendations about when to go back to your usual activities. This is important because you could reinjure your shoulder if you don’t give it time to heal. 
• Ice: Applying ice or a cold pack wrapped in a towel can help relieve shoulder pain. 
• Physical therapy: Stretches and exercises can improve strength and movement in your shoulder. Specific exercises can also target the rotator cuff. 
• Pain medications: Taking over-the-counter pain relievers called nonsteroidal anti-inflammatory drugs for a short period can reduce swelling and help with pain. 

If your shoulder impingement needs further treatment, your provider may recommend: 

• Corticosteroids: This prescription medication lowers inflammation. Sometimes this medication is given as a cortisone shot into your shoulder joint. 
• Shoulder impingement surgery: If other treatments don’t relieve your pain, you may need shoulder surgery to remove part of the bone that’s rubbing against your rotator cuff. 

Getting treatment for swimmer’s shoulder can help you feel better within a few weeks, although recovery may take months for some people. Getting treated for swimmer’s shoulder early can lead to a full recovery. 

You can take steps to prevent overusing your shoulder to avoid swimmer’s shoulder. 

• Take time to warm up and cool down before and after physical activity. 
• Wear proper equipment when playing sports or doing physical work. 
• Don’t continue doing an activity if it’s causing you shoulder pain. 
• Don’t delay seeing a health care provider if you have shoulder pain, stiffness, or swelling. 

Penn Medicine specialists offer surgical and nonsurgical treatments for shoulder conditions, including the latest minimally invasive techniques. Our providers at Penn Orthopaedics work with you to create a treatment plan to help you reach your recovery goals. When you come here, a team of shoulder and elbow experts work together to provide you with complete and compassionate care.