Swimming is known for being a wonderful form of exercise for people who experience arthritis, disability, asthma, or who are recovering from an injury. Many injured athletes that want to stay active will turn to swimming for cardiovascular and resistance strength building. But is swimming beneficial for exercise if you have a shoulder impingement? Let’s look at what shoulder impingement is, how it develops, and if swimming can help with SI recovery. 

What is Shoulder Impingement?

To really understand what shoulder impingement is, we need to present a quick anatomy lesson! Let’s take a look at what rotator cuff tendons, bursae, and acromions are. 

Your arm is kept in your shoulder socket by the rotator cuff. A rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus (upper arm bone). The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm. It’s also what keeps your shoulder blade in its socket. 

Your shoulder bursae, or subacromial bursae, are fluid-filled sacs that prevent bone from rubbing on muscle, tendons, or skin. Bursae provide padding and decrease friction, rubbing, and inflammation in your shoulder. When you lift your arm, these bursae allow the tendons and bones to glide without friction when you move and lift your arms. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful. 

Your acromion might appear to be your collarbone (clavicle) at first, but it is actually tucked slightly behind it. The acromion is the portion of your shoulder blade that meets your collarbone (highlighted below). 

diagram showing the acromion, bursa, and rotator cuff tendons

Shoulder impingement happens when the top outer edge of your shoulder blade (the acromion) rubs against or pinches your rotator cuff beneath it, causing pain and irritation.

There are two basic categories of shoulder impingement: primary impingement syndrome and secondary impingement syndrome. Primary impingement syndrome is when pain in the shoulder is caused by direct mechanical rubbing of the rotator cuff tendon. Secondary impingement syndrome is when there is “pinching” of the rotator cuff in the shoulder joint itself or overuse of the rotator cuff from attempting to stabilize the shoulder. 

How Does Shoulder Impingement Develop?

Most people know what it feels like to have swelling from an injury, like a sprained ankle. When your rotator cuff swells from rubbing or pinching, it can rub against the acromion. The same can be said about an inflamed bursa that rubs against the rotator cuff. These occurrences in the shoulders can lead to a vicious cycle of swelling and irritation. 

You can experience shoulder impingement if:

  1. Your rotator cuff tendon is swollen or torn in any way (increasing swelling). Rotator cuff injuries can happen during a traumatic event, from overuse, or from wear over time. A common rotator cuff tear is caused by falling on your outstretched arm or elbow. 
  2. If your acromion is tilted, you could suffer from shoulder impingement with an increased risk of irritation and swelling.
  3. If your bursa is irritated and inflamed (which is also caused by overuse of the shoulder). This inflammation, often called bursitis, can be caused by overhead motions, lifting heavy objects overhead, or leaning on your elbows for long periods. 

Can Swimming Help Alleviate Shoulder Impingement (SI) Joint Pain?

Based on everything you’ve read so far, you probably already know what we’re about to say here! Swimming can actually contribute to shoulder impingement syndrome. Often referred to as “swimmer’s shoulder,” this condition can be seen across swimmers. The repetitive overhead motion in the freestyle stroke is one of the most common causes of swimmer’s shoulder because of its constant overhead motion. 

If you suffer from shoulder impingement syndrome, we recommend seeing a physical therapist or sports medicine specialist for treatment. You’ll most likely be guided through a series of strengthening exercises to help your rotator cuff muscles. Icing, pain relievers, and limiting overhead motion activities could also help with recovery. We highly recommend seeing a professional to help guide you through a treatment plan. 

young female swimmer in blue swimsuit swimming laps

How Can Shoulder Impingement Syndrome be Prevented in Swimming?

If you are a swimmer that is looking to reduce the risk of experiencing shoulder impingement syndrome,  here are a few guidelines that you can follow.

  • Maintain proper form. Learn proper swimming techniques and swim accordingly.  
  • During freestyle swimming, avoid overreaching and crossing your midline as your hand enters the water. 
  • Keep an eye on the tightness in your chest and shoulder muscles. Releasing tension in these areas could additionally release tension that could lead to shoulder impingement. 
  • *Consider lifting weights to maintain muscle mass- especially in the shoulder and back regions. 
  • Avoid overuse injuries by monitoring your body. If you begin to feel a sharp pain in your shoulder when lifting your arm overhead, you may want to give your body a rest. 

We hope that this short blog post helped you learn more about shoulder impingement syndrome, why it might affect swimmers, and how you can prevent it. If you live in Boise, Idaho, and are looking for sports medicine treatment, reach out to ISMI to see how we can help you recover!

*Please always consult your physician before beginning any exercise program. This general information is not intended to diagnose any medical condition or to replace your healthcare professional. Consult with your healthcare professional to design an appropriate exercise prescription. If you experience any pain or difficulty with these exercises, stop and consult your healthcare provider. We do not provide medical aid or nutrition advice for the purpose of health or disease, nor do we claim to be dietitians. Any nutrition recommendation is not intended to diagnose, treat, cure, or prevent any disease.