Swimmers Shoulder

Being a keen swimmer myself I suffer a little with tight shoulders due to my training and the hands on treatments I do at Range of Motion Physical Therapy, Lucan. Swimmers shoulder is the term used to describe the problem of shoulder pain in a swimmer. Below is an overview of the injury but it is more of an issue with rotator cuff tendonitis and shoulder pain impingement which we can all suffer from due to posture and our work.

Swimming is an unusual sport in that the shoulders and upper extremities are used for locomotion, while at the same time requiring above average shoulder flexibility and range of motion (ROM) for maximal efficiency. This is often associated with an undesirable increase in joint laxity. Furthermore, it is performed in a fluid medium, which offers more resistance to movement than air. This combination of unnatural demands can lead to a spectrum of overuse injuries seen in the swimmer’s shoulder, the most common of which is rotator cuff tendinitis.

Rotator Cuff: the key muscle group of the shoulder is the rotator cuff, made up of the subscapularis, supraspinatus, infraspinatus, and teres minor. The primary role of the rotator cuff is to function as the dynamic and functional stabiliser of the glenohumeral joint. These muscles and their tendons can be overused and injured in shoulder dominant activities such as swimming, with the most commonly injured portion of the cuff being the supraspinatus.

Rotator cuff tendinitis, or impingement syndrome, may be due to:

  • Keeping the arm in the same position for long periods of time, such as doing computer work or hairstyling
  • Sleeping on the same arm each night
  • Playing sports requiring the arm to be moved over the head repeatedly as in tennis, swimming, and lifting weights over the head
  • Working with the arm overhead for many hours or days (such as in painting and carpentry)
  • Poor control or coordination of your shoulder and shoulder blade muscles
  • Poor posture over many years and the usual fraying of the tendons that occurs with age may also lead to rotator cuff tendinitis.

Symptoms:

  • Pain is more likely in the front of the shoulder and may radiate to the side of the arm. However, this pain always stops before the elbow. If the pain travels beyond the arm to the elbow and hand, this may indicate a pinched nerve.
  • There may also be pain with lowering the shoulder from a raised position.
  • At first, this pain may be mild and occur only with certain movements of the arm. Over time, pain may be present at rest or at night, especially when lying on the affected shoulder.
  • You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.

Treatment initially involves resting the shoulder and avoiding activities that cause pain. It may involve:

  • Ice packs applied 20 minutes at a time, 3 – 4 times a day to the shoulder
  • Avoiding or reducing activities that cause or worsen your symptoms to worsen
  • You should start physical therapy to learn exercises to stretch and strengthen the muscles of your rotator cuff.
  • With rest and exercise, symptoms often improve or go away. However, this may take weeks or months to occur.

For more information about managing your symptoms at home and returning to sports or other activities, contact me at Range of Motion Physical Therapy, Lucan.

 


What is Tennis Elbow?

What is Tennis Elbow?

Tennis Elbow

Over the past few weeks at Range of Motion Physical Therapy in Lucan; I have seen a couple of clients reporting elbow pain. The pain has been consistent with Tennis Elbow, which is not normally relating to tennis players specifically, however one of my clients is a tennis player and recently changed her serve grip and pain started to flare up around her elbow a couple of weeks ago.

Tennis Elbow is an injury to the muscles and tendons on the outside (lateral aspect) of the elbow that results from overuse or repetitive stress. The narrowing of the muscle bellies of the forearm as they merge into the tendons create highly focused stress where they insert into the bone of the elbow.

Mechanism of Injury:

There are two main types of elbow pain, Lateral and Medial Epicondylitis

Lateral Epicondylitis: Injury to the lateral (outside) aspect of the elbow is the most common upper extremity injury. Tennis elbow is generally caused by overuse of the extensor tendons of the forearm, particularly the extensor carpi radialis brevis. Commonly experienced by the amateur player, this injury is often a result of poor technique.

Medial Epicondylitis: Medial (inside) epicondylitis is less common and also referred to as Golfers Elbow and characteristically occurs with wrist flexor activity and pronation. Medial (inside) epicondylitis can result from tremendous stress on the medial tissues of the elbow, also by improper pulling technique with certain swim strokes, especially the backstroke (also referred to as “swimmers elbow”).

It should also be noted that elbow epicondylitis is not limited to those playing tennis, golf or swimming and can result from any activity that puts the lateral or medial compartments of the elbow under similar repetitive stress and strain (e.g., hammering, turning a key, screw driver use, computer work etc).

Signs and Symptoms of Tennis Elbow:

  • difficulty holding onto, pinching, or gripping objects
  • pain, stiffness, or insufficient elbow and hand movement
  • forearm muscle tightness
  • insufficient forearm functional strength
  • point tenderness at or near the insertion sites of the muscles of the lateral or medial elbow

Rehabilitation: What Should you do?

Epicondylitis often becomes a chronic problem if not cared for properly and as soon as possible. For this reason, it must be stressed that the rehabilitation should not cause you pain. Rehabilitation should be progressive, working from Isometric to eccentric exercises and then building strength and flexibility before returning to your previous level of sports or activity.

The initial rehabilitation process should involve reducing inflammation and pain, following the RICE principle. Goal is to decrease inflammation and pain, promote tissue healing, and retard muscle atrophy.

Below is a progression of Home Exercises you can do for tennis Elbow:

[embedyt] http://www.youtube.com/watch?v=-OHtWYDhCm0[/embedyt]

 

Contact us at Range of Motion Physical Therapy, Lucan in order to be assessed and treated for any of the above conditions and to be guided through a progressive rehabilitation programme to ensure you return to pain free movement