Swimming, To swim or not to swim
Swimming is one of the most popular sporting exercises. Its cardio-pulmonary (heart & lung) benefit is obvious but it is not without 'side-effects' such as swimmer's shoulder which is a result of repetitive impingement of the subacromial (tip of the shoulder) structures at or above 90 degrees shoulder abduction (sideway elevation). This is one of the most common causes of rotator cuff (shoulder muscles) tendonitis and subacromial (beneath the tip of the shoulder) bursitis (inflammation of the bursa) and may lead to more severe capsulitis (inflammation of the capsular ligament) and frozen shoulder. Its symptoms could therefore be rather painful and debilitating. Pain is often felt locally at the shoulder joint area but could also very commonly radiate down to the upper and mid arm. It is common to have a painful arc in shoulder flexion (forward elevation) and abduction (sideward elevation) but all movements could be restricted to nil in very acute severe cases. The subacromial area is often swollen and tender especially anteriorly (in the front). The question raised is again to swim or not to swim? Based on what we have discussed that all activities or in-activities carry certain risks of injury to certain parts of the body, my answer is certainly yes, to swim, as long as we prepare our body adequately for it.
- Postural exercises —
This should include alignment of the whole spine, particularly to minimize thoracic kyphosis (upper back slouching) that could reduce scapular (shoulder blade) mobility, hence requiring excessive gleno-humeral (shoulder) joint motions and increasing risk of impingement. Sufficient technique coaching is important to ensure the body parts are in their strongest and most mechanical efficient positions for performance and to minimize injury. In other words, learn to swim!
- Mobility exercises —
of all involving joints to their best available range of movements, especially the gleno-humeral (shoulder) joints.
- Stretching exercises —
of all soft tissues and muscles to ensure best spinal and shoulder flexibility is available particularly for mechanical advantage of the muscles involved and to prevent muscle imbalance.
- Strengthening exercises —
for stability, co-ordination, endurance and power to achieve smooth crawling action.