How To Avoid Shoulder Injuries In Triathletes and Swimmers

Shoulder injuries are common complaints in triathletes especially those that are new to the sport, or are trying to increase to a longer distance triathlon such as half Ironman or Ironman.

Many shoulder injuries that I see as a sports medicine doctor are related to overuse (too much swimming volume) and/or poor swim technique. There’s been a couple studies that have demonstrated the anatomical differences that occur in a triathlete’s shoulder with repetitive swimming.

We know from studies looking at shoulder MRI findings of triathletes that there are a high incidence of rotator cuff injuries including partial tears of the rotator cuff, as well as early arthritic changes to the AC (acromioclavicular) joint. A lot of these injuries can be prevented by simply developing proper stroke and swim technique.

Many triathletes swim with excessive shoulder rotation and limited hip rotation. The excessive shoulder rotation places undue strain on the shoulder joint, in many cases resulting in injury. One of the key issues I tend to focus on with any athlete with a swimming related shoulder injury is to determine how effective their hip rotation actually is. I’m surprised by the number of triathletes that seem surprised when we start discussing hip rotation instead of shoulder rotation as essential component to their swim technique.

I almost always recommend that triathletes take some type of triathlon based swimming instruction, since the type of swimming necessary for effective, fast, and injury free open water swimming is different than the Red Cross instructions we received growing up.

While it may seem counterintuitive, slowing down the swim stroke rate ( which increases the stroke length) can enhance and improve body roll while swimming, while maintaining or increasing swimming speed. Read that last line again. Proper body roll at a slower swim stroke rate can increase swimming speed. This concept is what many swim coaches talk about “swimming on the hips”. injuries can occur when the swimmer tries to maintain a high stroke rate while also attempting to increase their hip roll. Essentially these triathletes are putting stress not only on the shoulder from a propulsive (straightahead) force but also increase rotational torque across the shoulder as they try to drive their hip roll by excessive shoulder rotation.

Proper warm-up before a swim workout can also help to reduce the risk of injuries to the shoulder. As one of the doctors that travels with the USA triathlon team, the one thing I’ve noticed with this elite group of triathletes is the amount of warm-up time including stretching, stretch cords, and stroke drills these elite triathletes perform. Top-ranked American triathlete Matt Chrabot typically spends 10 to 15 minutes warming up with stretch cords even before he gets in a pool for a swim workout.

So do you want to avoid shoulder injuries and seeing a sports medicine doctor? Then look into local swim coaching resources. There are some great swim resources available for triathletes looking for help with their swim technique.
San Diego-based swim coach Kevin Koskella has some great free online swim video technique resources available at his website. Kevin actually talks about the “swimming slower to go faster” concept.

I have also been impressed with triathlon coaches Jim Vance’s open water swim clinics and Ruthie Vesler’s coached swim workouts. Check them out to get some help with your swim technique.