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ellensdad
November 11th, 2008, 09:59 AM
I apologize for posting this non Masters topic here but I honestly could not think of a better place to post.

My just turned 13 rear old daughter was diagnosed with bursitis/impingement in her right shoulder in early August. She was experiencing popping/pain during all strokes at various phases. Seems she is paying the price for years of swimming Freestyle with an internally rotated right arm during recovery and catch. Her orthopedist prescribed 6 weeks of PT and no swimming for 6 weeks.

Unfortunately, we chose a PT based pretty much on logistics. The initial visit consisted of a brief conversation about Ellen's swimming but nothing really specific. Then a quick range of motion exam followed by a two minute massage.

The PT left for a few minutes and returned with a red Theraband and a generic rotator cuff rehab printout. We then proceeded to go through the exercises on the sheet. Twice a week for the next six weeks the visits involved a quick massage followed by Ellen going through the exercises that she had been doing religiously at home in front of the PT aid. I should also mention that there was very little emphasis put on stretching and no re-evaluation by a PT at any point in the process.

After six weeks we returned to her Orthopedist. He was quickly able to recreate the dull thud that can be heard in Ellen's shoulder when she lifts her elbow from her side then brings it forward passing above her shoulder.

He quickly prescribed six more weeks of PT which Ellen did at home. He also said she could begin swimming Breaststroke provided there was no pain.

So here we are twelve weeks later. Ellen started swimming Freestyle last week. Three pain free practices, the fourth brought back the popping/pain.

I am hoping there is somebody in the Westchester/Putnam area in New York who can recommend a good PT who works with swimmers.

Any help would be greatly appreciated.

Glenn
November 11th, 2008, 07:19 PM
Here are my suggestions:

1. Find a coach in your area to look at her stroke and assess what she may be doing wrong. Terry Laughlin (Total Immersion) is in Rockland county I believe.

2. Find a sports medicine doctor who is familiar with swimming.

3. Have your daughter do kicking only workouts. It is amazing what you can do with kicking only workouts.

4. Don't ever have her use paddles.

I had a shoulder problem a year ago and spent 3 months kicking and it worked out well for me (and I'm 59). I still do my shoulder exercises 2 times a week. I did the kicking with a snorkel so that my arms could be at my sides. I still do the kicking part of the workout that way.

Good Luck!!!!

ellensdad
November 11th, 2008, 07:35 PM
Glenn, thank you. I took her over to the TI studio in New Paltz twice for lessons. Excellent experience. Ellen learned a lot that she can incorporate wants she's ready.

I am having a heck of a time finding a PT that knows swimming.

blainesapprentice
November 11th, 2008, 08:27 PM
I would contact The NY hospital for Special Surgery in the city...and specifically ask for Dr. Jo Hannafin. She's a sports orthopedic surgeon who specializes in shoulders and knees in athletes...and has had tons of experience with swimmers. She did both of my shoulder surgeries 4 years ago. I understand you might not want to see another doctor, although she really is fantastic...and would send you home with specific rotator cuff exercises as well, but she also might be able to reccommend local PTs in the area. I'm from Orange County, NY and she recommmended my post surgery therapists.

USMSarah
November 12th, 2008, 09:23 AM
I really liked what Glenn had mentioned... kicking a lot can do wonders, not only giving the shoulder some rest, but she can work on her underwater kick off the walls more. Also, when she is ready to put her arms back into it - have her work on drills and perfect strokes. Scrap the paddles and pull buoy. Lots of stretching after warmup. As she gets older and begins a weight lifting program - really watchout.

Definitely find a dr who knows a lot about swimming. Since your daughter is so young - I would rather have you all confide in someone who can understand her situation a lot better.

I had shoulder surgery in college, my doc was a former D1 swimmer in his college days - so I felt more than confident taking his advice and being treated by him. It's doing a lot better now, but you have to swim smart after an injury. Good luck to you and I hope your daughter starts to feel better.

zegmal
November 13th, 2008, 11:58 AM
A few thoughts--
--On stretching: be careful here, the shoulder joint capsule does not need and should not be stretched especially with teenage girls who are generally crazy flexible. See the US swimming website for some articles on good and bad stretching. My advice is just forget about stretching and just make sure to warm-up.
--Great idea to focus on technique. When I had shoulder programs I did a bunch of google searches and found some articles that discuss how to lessen impingement in freestyle and backstroke. It mainly has to do with the angle of your hand and making sure you do not cross over on entry.
--Give PT lots and lots of time. Shoulders take a long time to heal. Six weeks is nothing. This can take months. If she wants to keep swimming I suggest doing kick workouts WITHOUT A KICKBOARD. She can also work on transitions. She might try fistgolves too which take a lot of strain off the shoulder and will teach her to engage her back muscles.
--If her shoulder in addition to popping is also slipping, she might have a labrum tear. The only way to know for sure is with an MRI.
--But PT and time can make a huge difference. Good luck

ellensdad
November 13th, 2008, 04:27 PM
I'd like to thank everybody for your thoughtful suggestions and support.

We have decided to pull Ellen from her team for the rest of the season and focus on strengthening her shoulder. She can give it a go again in the Spring season with an emphasis on technique. Hopefully, a full five months of PT will do the trick.

Until we find another PT we will focus on the exercises found in this article:
http://www.usaswimming.org/USASWeb/ViewMiscArticle.aspx?TabId=445&Alias=Rainbow&Lang=en-US&mid=700&ItemId=700

Thanks again for the help.

Typhoons Coach
November 14th, 2008, 09:59 AM
Good luck with everything; I would have her get in every now and then throughout the 5 months just to try and keep up a little with her endurance (as long as there is no pain when she is swimming)....this would be a great time to put emphasis on her motor (the kick)...