By Georgia Zuill – Physiotherapist and Elite Swimming Athlete of 10+ Years
Understanding Shoulder Strength Imbalance in Swimmers
Swimming is a competitive sport that demands repetitive shoulder movements, which can lead to muscle imbalances and injuries. Physiotherapy support is vital for managing both short- and long-term shoulder health and stability. Without physiotherapy input and strengthening programs, swimmers are at higher risk of developing shoulder tendinopathy, shoulder bursitis, shoulder impingement, overuse shoulder injuries, and other rotator cuff or shoulder pathologies. Consistently following a physiotherapy-directed prehab shoulder strengthening program helps minimise these risks.
Current Evidence Base for Shoulder Muscle Stability and Imbalances
A recent study published in the BJPT explores changes in shoulder girdle strength over three consecutive years in elite adolescent swimmers. This research provides valuable insights for physiotherapists working with young athletes, emphasizing the importance of monitoring and addressing muscle imbalances to prevent injuries and enhance performance.
The study conducted by Habechian et al. (2018) focused on 31 elite adolescent swimmers, including 22 boys and 9 girls, aged between 14 and 18 years. Over three years, the researchers measured the isometric strength of key shoulder muscles: internal rotators, external rotators, lower trapezius, and supraspinatus using dynamometry.
One of the key findings from the study was the significant differences in muscle development in each muscle group and between boys and girls. For boys, there was a notable increase in the strength of the internal rotators from the first to the second year. Conversely, the strength of the external rotators in boys steadily decreased over the three years. In girls, however, there were no significant changes observed in the absolute strength of the internal and external rotators.
The study also highlighted changes in the strength of the supraspinatus and lower trapezius muscles. In boys, supraspinatus strength decreased from the second to the third year. For girls, lower trapezius strength showed a significant decrease over the three years. Additionally, the study found that for both sexes, the ratio of external rotators to internal rotators decreased over the years, indicating a growing imbalance in shoulder muscle strength.
These findings underscore the critical role of balanced shoulder muscle strengthening programs for young swimmers. An imbalance, particularly with stronger internal rotators and weaker external rotators, can predispose swimmers to shoulder injuries. Often presenting as supraspinatus tendinopathy, shoulder bursitis, or shoulder impingement, these issues are commonly referred to as swimmer’s shoulder. A physiotherapy appointment to address these imbalances is crucial in preventing injuries and optimising performance. This evidence helps us understand which muscles need to be assessed and monitored.
Time to Book a Physio Appointment at Saunders Physiotherapy
Regular assessment of shoulder muscle strength can help track changes and identify imbalances early. At Saunders Physiotherapy, we utilise Kangatech technology to identify strengths and weaknesses in the muscles around the shoulder, especially the rotator cuff muscles. The KangaTech assessment involves testing internal rotation and external rotation strength at neutral and 90 degrees, as well as shoulder extension and abduction strength.
This group of tests provides a comprehensive view of the strength of your rotator cuff and trapezius muscles, allowing us to develop a thorough and individualised rehabilitation program. Having an even strength profile in these muscles minimises the risk of future injury and enhances your performance in the pool or ocean.
We also have access to force plate technology that allows dynamic assessment of various movements. This technology maximises the effectiveness of your rehab program and identifies any deficits or concerns in your movement pattern that could put your shoulders at risk of injury in the future.
At Saunders Physiotherapy, we implement comprehensive shoulder strengthening and stability program assessments using this data. These programs can be introduced and adjusted depending on the season, making it beneficial to come in for an assessment at any time. Having a physiotherapist assess and monitor you over your swimming career is vital to long-term performance and reducing injury risk.
Our qualified and experienced physiotherapists at Saunders are experts in managing swimmers’ shoulders. Georgia and Henry, our physiotherapists who are also experienced swimmers, have managed to stay in the sport for many years using strengthening and stability programs to manage their own injuries.
Book in today to get a comprehensive assessment and an individualised strength and stability program.
