Swimming with shoulder pain and how stroke mechanics can make it worse or better
Nicola Tik
Shoulder pain and swimming have a complicated relationship. Swimming is often recommended as a gentle option for people in pain, but for the shoulder specifically it can be one of the more demanding activities going. This article looks at why that is and what tends to help you keep swimming comfortably.
The shoulder is the primary driver of propulsion in most swimming strokes. In front crawl, each arm pulls through the water hundreds of times in a single session, rotating, reaching, and pulling against resistance throughout. That volume of repeated overhead and pulling movement places significant demand on the muscles, tendons, and joint structures of the shoulder.
Problems tend to develop not because swimming is inherently damaging to the shoulder, but because the load accumulates faster than the structures can adapt to it. A sudden increase in distance, returning to swimming after a break, or a small issue with stroke mechanics that repeats thousands of times in a session can all tip the shoulder from coping to struggling.
The way the arm enters the water and pulls through is one of the most significant factors in shoulder load during front crawl. Crossing the centre line on entry, where the hand enters the water in front of the opposite shoulder rather than in line with its own, creates an awkward angle through the shoulder joint on the catch and pull. Over a long session, that repeated mechanical stress can contribute significantly to shoulder pain.
Dropping the elbow during the pull phase, rather than keeping it high and leading the movement, also increases the strain on the shoulder by reducing the efficiency of the stroke and asking the joint to work at a less favourable angle.
These are not always easy to feel from the inside. Many swimmers are not aware of these patterns until someone observes their stroke from above or in front. If you swim regularly with shoulder pain, it is worth considering whether a session with a coach or a filmed review of your stroke might offer useful information.
During a period of shoulder pain, backstroke is often better tolerated than front crawl because it moves the shoulder through a different range and reduces the overhead demand. Kicking sets with a float, which take the arms out of the equation altogether, are a way to maintain fitness and time in the water while giving the shoulder a rest from pulling load.
Reducing distance temporarily rather than stopping is a sensible approach for most people. Shorter sessions done consistently tend to support recovery better than complete rest followed by a return to full distance.
Bilateral breathing in front crawl, alternating the side you breathe on rather than always breathing to one side, distributes the rotational demand on the shoulder more evenly and is worth trying if you currently always breathe to the same side.
The muscles of the rotator cuff and upper back play a central role in stabilising the shoulder during swimming. When they are strong and working well, the joint is better protected through each stroke. When they are fatigued or underprepared for the volume of swimming being done, the joint tends to take more of the strain.
Consistent strength work targeting the rotator cuff and upper back, done a couple of times a week alongside swimming, builds the resilience the shoulder needs to manage higher volumes more comfortably over time.
If you would like to try a guided exercise for the shoulder, VIDA has a short video you can follow at your own pace.