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jamiev
May 14th, 2003, 09:09 AM
My daughter swims for USS Swim Club in Ohio. SHe has been dealing with a Rhomboid strain in her shoulder for almost a year now. This injury mostly occures when swimming butterfly. However repetitive motions for a prolonged period also seem to irritate the shoulder.

I am looking for advice because the problem seems to stem from Swimming butterfly. Long Course season started and she was doing very well - no shoulder pain until they swam fly in the last practice.

My questions are as follows:

1.) Is there a way that she can train and continue to provide additional strength with butterfly? Or is it best to just not deal with the butterfly until the shoulder is in better condition and closer to full recovery?

2.) What would be the best training method for a swimmer with shoulder injury?

3.) Is more laps always better training? Can she achieve the same benefit or better training by swimming less laps with a specific purpose during practice?


Coaching advice is welcome and appreciated - as I am concerned for her welfare. She has very high goals and I would like to help her achieve her goals without injury.
Thank you!

Gareth Eckley
July 3rd, 2003, 04:14 PM
I both swim and coach fly, and I can give you some info on how faulty technique could cause shoulder strain.

Does your daughter " muscle her way through fly "? Does she look smooth and relaxed in the stroke or is she working too hard. What does her coach say about her stroke ?

On hand ENTRY the head should be relaxed and eyes looking down. If the head is held high and stiff then extra strain is put on the Deltoids. The hands enter softly and are moved slowly forward and out into the catch position. The hand and arm do not push hard against the water in this phase. Reason: it slows forward momentum as extra drag is caused and also puts strain on the shoulders.

In any stroke pushing hard on the water while the arm is fully extended will cause shoulder strain.

Continuos smooth acceleration throughout pull and hand releases water near hip. The Recovery needs to be relaxed, initiated with a shoulder shrug, hands on edge, little finger up. If the hand is flat the water pressure will strain the shoulders. The hand should be on edge, Thumb down throughout the recovery. Besides being good form this also is easier on the shoulders.

Does she have good timing, if kicks and arms are not in synch the that could cause strain.

Is the training very hard, lots of fly and long distances 100 and 200 repeats. That would cause problems.

I suggest that she looks at the technique side first. She should be getting lots of drills, Body Pulse work with fins, Kicks on front, side and back. Drills of 1 arm fly then 2 left arm, 2 right arm, 2 full strokes etc. Also when she is asked to swim whole stroke, she could swim them as 3 Kicks then 2 full Strokes Arms & legs, 3 kicks , 2 strokes etc will ease the pressure and improve her timing. This will make her a better Flyer.

You need good flexibility for fly, at least 200 degrees. Test it by lying her on her front.Can you lift her straight arm 20 degrees off the floor, when it is in front of her head and 20 degrees off the floor when held out to the side.

I hope this helps, discuss this issue with her coaches as they see her in the water and should know excactly what she needs.

ike arola
July 18th, 2003, 04:05 AM
The human shoulder is not made for swimming. There are numerous muscles that affect the shoulder. Four of them are the "rotator cuff." Muscles are supraspinatus, infraspinatus, teres minor and teres major. These muscles "hold" the humerus in place. Injuries are very common among swimmers. Symptoms usually are pain or discomfort, when arm is streched during swimming and when pulling starts. Pain may occur also during arm recovery. Some may have symptoms, when lifting objects or sleeping on the injured shoulder. This status is called the swimmers shoulder.

A few things that may cause the swimmers shoulder:

1. Paddles, especially overtraining with paddles
2. Lack of dryland training; lack of flexibility and strength of shoulder muscles that support the rotator cuff
3. Wrong stroke technique or unwise stroke technique
4. Sudden increase of training
5. Anatomy of the shoulder (inherited)

How to prevent swimmers shoulder?

1. Strengthen the shoulder muscles. Rubber band or strech-cords are good for this. Various kinds of lifting movements will do (opposite to swimming movements).

2. Improve your posture (sitting, standing, walking etc.). Poor posture is typical for swimmers. Trained muscles tend to shorten. Pectoral muscles drag shoulders forward. Try to keep good posture in everyday life. This helps the shoulder muscles to relax.

3. Improve swimming technique and mechanics. Shoulder problems occurs mainly with freestyle and butterfly. Also if the shoulder joint is too mobile(naturally or caused by streching too much the wrong way), or/and the shoulder muscles are too weak, problems may occur.
Twisting the hand during the recovery in freestyle will cause unrelaxed motion in shoulder. If you can recover your hands in freestyle palms facing you and pinky downwards, the shoulder would be more relaxed.

If you already have shoulder problems:

1. Stop swimming fly for a while, it is not the end of the world. Instead, concentrate on breastsroke, it is quite similiar to fly (body movement and start of the pull).

2. Don`t use any paddles. Pulling often starts too early with paddles and strains on the shoulder muscles. There is often a tendecy to rotate the hand counterclockwise with paddles (right hand and the other way with left hand).

3. Avoid locked elbow in every motion in freestyle. Both during the catch and the end of the pull. Do the catch with a little bent arm (refer to Hoogenband, he never straightens his arms completely). I know someone will disagree with this, but something has to be done to prevent more injuries.

4. Start swimming backstroke recovery with thumb first and turn your hand just before entry in the water.

5. Avoid any other internal rotation of your hands: Reaching for the wall, in the beginning of breaststroke and fly.

What about recovery with straight arms in freestyle?
I think that it is quite alright, if the recovery motion is ballistic with good body roll.
Hope this will help!
- ike

sky_swimmer
February 4th, 2004, 07:34 PM
just wanted to toss in:

shoulders can be really tricky. Sometimes understanding pain is important. Sometimes a swimmer can experience referred pain, where the pain is showing up in one area of the shoulder or arm, and yet the problem is elsewhere is the shoulder area.

My first reaction is this: You need a good physical therapist... and I would look for one who was a college swimmer or triathlete. If you can find the right therapist, you can make sure that any weakness in the shoulder or shoulder joint can be strengthened.

I would want a therapist to continue to monitor and continue to demonstate good exercises in order to help.

shoulders can be really tricky especially to swimmers.

good luck

sky_swimmer

2go+h20
April 6th, 2004, 06:06 PM
If it was my shoulder I would be off to see a physical therapist who specializes in shoulders, or a sports medicine therapist who also deals with shoulders.
There are several contributing factors to shoulder pain as have already been stated.
A rhomboid strain can be indicative of muscle imbalance in her shoulder. And a lack of balance in the range of motion in the shoulder.
When swimmers are doing their rotator cuff exercises, they must be watched carefully. Many swimmers 'think' they are doing these exercises correctly, but I see over and over many imbalances in the shoulder due to the inability to isolate and strengthen these individual muscles. Usually what happens is that they do the movements, however the prime movers or those muscles the exercise is designed for, are not getting strengthened. As a result there will be weakness in supraspinatus, terres major and minor, infraspinatus, subscapularis, middle trapezius and serratus anterior.
Serratus Anterior is an important muscle that works to pull the shoulder blades back together. It will not be able to assist in the last end of the stroke if the stretching, and strength of the shoulder girdle is not balanced. (it can become overstretched if the Terres Major is tight).
Posture is indicative of balance. If the shoulder appears to be rounded chances are there is a lot of tightness in the Pectoralis minor and/or Pectoralis major and terres Major muscles. Also if there is a curve in her thoracic spine due to rounded shoulders and poor posture, then the range and mobility of the thoracic spine will also contribute to this.
Both of these muscles (terres Major, and Pec Minor) are very difficult to stretch by oneself. A therapist will show the swimmer how. I have a way to stretch both using a pull buoy but she should be seen by a therapist. The therapist will teach how to islolate and strengthen each individual muscle and then how to progress the exercise to using very light weights. (these muscles are small and if a person is using a large weight say 10lbs, usually I would guess; hard to really say without seeing- with the incorrect technique.
Poor technique in swimming will make the body muscles and spine compensate even more. When the stronger muscles get sore, it is definitely time to pull back, and have the shoulder assessed. And technique assesed.
Swimming should be a lifetime sport. Shoulder Health is a primary goal to achieve this.
Hope this helps.
Good Luck.
Let us know what happens.

The Fortress
November 5th, 2006, 11:28 PM
The human shoulder is not made for swimming. There are numerous muscles that affect the shoulder. Four of them are the "rotator cuff." Muscles are supraspinatus, infraspinatus, teres minor and teres major. These muscles "hold" the humerus in place. Injuries are very common among swimmers. Symptoms usually are pain or discomfort, when arm is streched during swimming and when pulling starts. Pain may occur also during arm recovery. Some may have symptoms, when lifting objects or sleeping on the injured shoulder. This status is called the swimmers shoulder.

A few things that may cause the swimmers shoulder:

1. Paddles, especially overtraining with paddles
2. Lack of dryland training; lack of flexibility and strength of shoulder muscles that support the rotator cuff
3. Wrong stroke technique or unwise stroke technique
4. Sudden increase of training
5. Anatomy of the shoulder (inherited)

How to prevent swimmers shoulder?

1. Strengthen the shoulder muscles. Rubber band or strech-cords are good for this. Various kinds of lifting movements will do (opposite to swimming movements).

2. Improve your posture (sitting, standing, walking etc.). Poor posture is typical for swimmers. Trained muscles tend to shorten. Pectoral muscles drag shoulders forward. Try to keep good posture in everyday life. This helps the shoulder muscles to relax.

3. Improve swimming technique and mechanics. Shoulder problems occurs mainly with freestyle and butterfly. Also if the shoulder joint is too mobile(naturally or caused by streching too much the wrong way), or/and the shoulder muscles are too weak, problems may occur.
Twisting the hand during the recovery in freestyle will cause unrelaxed motion in shoulder. If you can recover your hands in freestyle palms facing you and pinky downwards, the shoulder would be more relaxed.

If you already have shoulder problems:

1. Stop swimming fly for a while, it is not the end of the world. Instead, concentrate on breastsroke, it is quite similiar to fly (body movement and start of the pull).

2. Don`t use any paddles. Pulling often starts too early with paddles and strains on the shoulder muscles. There is often a tendecy to rotate the hand counterclockwise with paddles (right hand and the other way with left hand).

3. Avoid locked elbow in every motion in freestyle. Both during the catch and the end of the pull. Do the catch with a little bent arm (refer to Hoogenband, he never straightens his arms completely). I know someone will disagree with this, but something has to be done to prevent more injuries.

4. Start swimming backstroke recovery with thumb first and turn your hand just before entry in the water.

5. Avoid any other internal rotation of your hands: Reaching for the wall, in the beginning of breaststroke and fly.

What about recovery with straight arms in freestyle?
I think that it is quite alright, if the recovery motion is ballistic with good body roll.
Hope this will help!
- ike

This was an interesting post for those interested in shoulders. There's another post on this thread that deals specifically with fly.

geochuck
November 6th, 2006, 01:07 AM
The best treatment I had for my shoulders was an Egyptian Doctor who worked on my both shoulders that had tendons hanging by a thread. He was the fellow who who was doctor to the Egyptian Marathon Swimmers.
He gave me three little exercises to do and injected both shoulders with novicane. I did these exercises modified my stroke and was never bothered again with shoulder problems.

I had been told never to swim again by my orthopedic surgeon before I went to Egypt

tomtopo
December 10th, 2006, 06:05 PM
I know this is a lot of information but a proactive approach that strengthens the shoulder cuff and encapsulates the head humerus is a smart approach.

One thing that a swimmer can do is to isolate the shoulder cuff and strengthen it by performing static and isometric exercises. These exercises specifically address the area that they train and it doesn't take a lot of time. The benefits are great and the time is minimal compared to other training regimes. I do believe even swimmers unfortunate enough to have a weak or a hyperflexible shoulder cuff and accompanying muscles, can do things that greatly reduce their chances of swimmer's shoulder.

Please try to digest the following and I'll go back to your post and try to add some constructive suggestions if possible.

Good luck, Coach T.



Causes of Swimmers Shoulder
From Mat Luebbers,
Your Guide to Swimming.
FREE Newsletter. Sign Up Now!
Swimmers Shoulder Causes

There are many possible reasons for SS to develop. SS injury and pain from impingement and other related issues seems to occur under one or more of the following circumstances (Anderson, Hall, & Martin, 2000; Bak & Fauno, 1997; Costill, Maglischo, & Richardson, 1992; Johnson, Gauvin, & Fredericson, 2003; Maglischo, 2003; Pollard & Croker, 1999; Tuffey, 2000; Otis & Goldingay, 2000; Weisenthal, 2001). SS is considered an impingement related injury that seems to develop through a mechanism related to overuse or instability (Anderson, Hall, & Martin, 2000; Bak & Fauno, 1997; Baum, 1994; Chang, 2002; Costill, Maglischo, & Richardson, 1992; Johnson, Gauvin, & Fredericson, 2003; Koehler & Thorson, 1996; Loosli & Quick, 1996; Maglischo, 2003; mayo Clinic, 2000; Newton, Jones, Kraemer, & Wardle, 2002; Pink & Jobe, 1996; Pollard, 2001; Pollard & Croker, 1999; Reuter & Wright, 1996; Richardson, Jobe, & Collins, 1980; Tuffey, 2000; Otis & Goldingay, 2000; Weisenthal, 2001):

* faulty stroke mechanics
* sudden increases in training loads or intensity
* repetitive micro traumas related to overuse
* training errors (such as unbalanced strength development)
* use of training devices like hand paddles
* higher levels of swimming experience
* high percentage of freestyle swum in practices
* weaknesses in the upper trapezius and serratus anterior
* weakness or tightness of the posterior cuff muscles (infraspinatus and teres minor) or a hyper mobile or very lax shoulder joint.

Swimmers perform a great number of overhead arm motions in the course of a normal practice week; Pink and Jobe (1996) estimate that some swimmers may complete as many as 16,000 shoulder revolutions in a one week period, while Johnson, Gauvin, and Fredericson (2003) estimate this number could be as high as 1 million per year.
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To gain a sense of scale, Pink and Jobe (1996) compare swimmer's arm motions with 1,000 weekly shoulder revolutions for a professional tennis player or a baseball pitcher (Pink & Jobe, 1996).

Given the swimmer's quantity of movements and the range of those movements, micro traumas are inevitable, and damage from repeated micro traumas can develop into SS (Bak & Fauno, 1997; Chang, 2002; Costill, Maglischo, & Richardson, 1992; Johnson, Gauvin, & Fredericson, 2003; Pink & Jobe, 1996; Pollard & Croker, 1999; Otis & Goldingay, 2000). It appears that there are three main syndromes behind SS (Pollard & Crocker, 1999; Weisenthal, 2000):

* instability
* impingement
* tendonitis

Tuffey (2000) lists the triad of problems involved with SS as:

* biceps tendonitis
* subacromial bursitis
* rotator cuff tendonitis usually in the supraspinatus muscle.

Richardson, Jobe, and Collins (1980) summarize SS as a chronic irritation involving the humeral head and rotator cuff interacting with the coracoacromial arch during shoulder abduction resulting in an impingement, as do Otis and Goldingay (2000).



Here's another great article on the subject.

Shoulder Injury in Competitive Swimmers

By Larry Weisenthal
Huntington Beach, CA
Associate Clinical Professor of Medicine
University of California
Irvine School of Medicine, Medical Director

The following is an e-mail from a swim coach in Australia. His question and my answer may be of interest to coaches working with talented teenage swimmers with shoulder pain.

At present I have a 14-year-old girl who is starting to develop shoulder pain. Unfortunately she is, perhaps, the most talented of all my swimmers. I think she has the potential to be quite a good distance swimmer. Her freestyle pull is near textbook perfect. She maintains the highest elbow at catch and pull through of any swimmer I have seen (this may actually be exacerbating the problem). I may be panicking too early, however, having gone through my own shoulder problems as well as sharing the heartache and frustration another swimmer felt through her injury/recovery; I want to be sure Jenna is looked after early. The pain has come and gone before. There does seem to be some correlation with yardage increases and pain. The last few weeks we have been covering a little more fly as well which in the past has led to her shoulder pain flaring up.

Below is a summary of when and where she feels pain:

- Right shoulder only (she does breathe to both sides, however she definitely favors the left side)

- Freestyle – pain at catch and at end of pull through

- Fly – pain during recovery

- Back – not too bad, however sometimes pain at end of recovery and start of pull

- Breast – pain at start of pull through (not too bad though)

- Sometimes upon picking a heavy object up or by pushing herself up off the ground she feels like she is ‘pulling freestyle’ i.e. the pain?

The pain is a dull ache and lasts all day. It is not sore to touch. Physios suggested to her that there was weakness in stabilizers of scapula. She does have quite hunched over posture. She is a slender girl. Basically just from looking at her I get the feeling she is a prime candidate for shoulder probs. Her mother is a local MD. She is keen to read some literature on this.

Any advice or help would be greatly appreciated.

My answer:

Short version of the shoulder story (I’ll go into more detail later on):

90% of these problems are from impingement. The symptoms you describe are consistent with this. This can be reduced by some simple stroke modifications.

Two causes (besides technique).

1. Bad bone anatomy. Big or down-sloping or spurred acromion (bone you feel when you clap yourself on the shoulder) or else thickened coracoacromial ligament (runs from the lateral tip of the acromion to a little boney knob in the front of the scapula to which the short head biceps tendon attaches). Diagnose this with an MRI (14-year-old girls can have poorly ossified acromial head which can be difficult to see on a plain x-ray).

2. Lax/hypermobile joint. Humerus held up against scapula by ligaments called the joint capsule. Most good swimmers are very flexible (because their joint capsules are loose). Have her hold her arm straight ahead while standing up… elbow down, palm up. Look at the angle between the (upper) arm and forearm. Is it 180 degrees? Then she’s probably not hypermobile. If it is >180 degrees? Then she very well may be hypermobile. Problem with hypermobility is that the head of the humerus can migrate upwards, smashing the superior rotator cuff (supraspinatus) tendon against the "roof" of the shoulder (acromion and coracoacromial ligament). This is worse during the stroke… usually worst right at the very start of catch and pull through. This is because when downward/rearward pressure is applied, the head of the humerus is forced upward.

Oftentimes, swimmers have both problem #1 and problem #2.

Tests for #1 type impingement (in addition to MRI to define anatomy):

Neer Test:
Raise arm overhead, pointing straight up. Rotate hand so palm is outward. Dr/Coach then presses against palm, forcing hand over the top of the head. Does this hurt? If so, it is a positive test. Note that this is a position commonly advocated for swimmers. Swimmer on the side, hand reached straight forward, palm down. Is there any wonder that swimming causes shoulder problems when some swimmers are taught to swim by performing a Neer test on themselves with each stroke?

Hawkins Test:
Arms at side. Lift elbow up to the side, so that (upper) arm is at shoulder level, parallel to ground, fingertips pointing straight down. Now, rotate thumb backwards, while securing wrist to keep fingers pointing straight down, while examiner forcefully pushes shoulder forward. Pain? Positive test. Note that this position can be achieved also during the swimming stroke, with certain types of high elbow recoveries. Or think a butterfly recovery, with elbows slightly bent and thumbs down and slightly more easy to clear the water this way. But about 35% of elite flyers do recover palms down, thumb leading, so it is not incompatible with fast fly swimming. While your kid is actually having pain (not just trying to prevent pain), she might even tilt her thumbs slightly upward during recovery, to completely avoid internal rotation. Internal rotation being bad because it rotates the vulnerable supraspinatus tendon right underneath the most narrow part of the acromion and coracoacromial ligament (where there is the least space and where the tendon gets squeezed the most).

In brief, what else to do?

Oh, one more thing. Rule out that the pain is being caused by epiphysitis. Have the kid’s mom tell you about something called Osgood-schlatter’s syndrome. This is a very common problem in 14-year-old land athletes (soccer, basketball, running). The lower patellar tendon attaches to the top of the tibia right over a growth plate (epiphysis). Traction of the tendon against the growth plate can hurt like heck. Cure is aging enough so that the growth plate closes. Same thing can happen in the shoulder, where the acromial epiphysis can get inflamed from repetitive motion. This is very easy to diagnose. Put two fingers on the top of the acromion, right near the ("drop off") end of the top of the shoulder bone (where you’d clap your mate on the shoulder in a pub watching your favorite ruggers, say, "The Bulldogs," while exclaiming "How ‘bout them dawgs!" immediately after a try). Anyway just press firmly on the top of the bone with two fingers and see if you can force her to the ground, not with pressure, but by eliciting pain. If this doesn’t happen (i.e. you can’t force her down with pain), then you have ruled out epiphystis as a cause. If you can force her down, write back and we’ll talk about what to do about it.

Presuming the problem is garden-variety impingement syndrome, here’s what to do.

1. Kicking lane until she is having no more pain. My daughter’s team had a 15 year-old girl with a nearly identical problem who kicked for about 12 weeks straight last winter, but, 10 weeks after resuming full stroke swimming, swam a 4:47 400 IM LCM. Will it take 4 or 8 or 12 weeks? I don’t know. But definitely do this; your swimmer is only 14 and a stitch in time saves nine.

2. Posterior rotator cuff strengthening (to strengthen active stabilizers… i.e. the rotator cuff itself… to keep the head of the humerus down where it belongs and not migrate upward. Particularly important if the "elbow bend test" diagnoses hypermobility.

3. Stroke modification. Rule number 1. Avoid/minimize internal rotation of the hand/forearm/(upper) arm complex. Internal rotation is counter-clockwise on right and clockwise on left. Rule number 2. See #1. Rule number 3. Don’t apply downward/backward forces at the catch until the forearm has descended well into the high elbow position. The problem with paddles is that there is a tendency to begin the pull much too early, as it takes longer for the hand to drop to the catch position while wearing a paddle. The problem with a too early pull is that the head of the humerus is forced upward. Rule number 4. Don’t have a big, strong push back to "finish the stroke." This produces a "wring-out" effect, crimping off the small arteriole which supplies blood to the supraspinatus tendon. Don’t worry. Your great Aussie-coaching colleague Carew teaches an early exit. Perkins doesn’t finish the stroke but swims with an early exit. So does Franzi Van Almsick, WR holder in the 200 free.

How to avoid internal rotation?

1. Something I call the "Birmingham feather" (after a brilliant young Aussie coach who taught it to my daughter). Think rowing. After the end of the stroke, what does a competitive rower do? He "feathers" the oar so that the flat blade is parallel to the surface of the water. This is what Coach Birmingham taught my daughter to do. She still does it. So does my other daughter. So do I. As long as we remember to do this, none of us have any shoulder pain at all. In the article by Yanai and Hay at the University of Iowa published last year, they found that the number one cause of impingement was delayed external rotation (Birmingham feathering) during recovery.

2. Don’t swim with a locked elbow forward reach unless you are Ian Thorpe and have a great kick. Van den Hoogenband never completely straightens his left elbow, and he’s the fastest freestyle swimmer (100/200) in history. A female distance swimmer shouldn’t ever swim with a locked elbow stroke unless she is Astrid Strauss on steroids with an unbelievable kick racing Janet Evans in the ’88 Olympics. Otherwise, swim like Brooke Bennett or Diana Munz,. Shorter stroke; faster turnover; no Neer test, no internal rotation during recovery and entry. Early exit to avoid supraspinatus arty wring out. Locked elbow stroke only makes sense in the context of a great kick (e.g. US distance ace Erik Vendt). Otherwise, in a weak kicker (e.g. most female distance swimmers or swimmers such as Claudia Poll and Lindsay Benko), the more rapid turnover is needed to conserve momentum, which is rapidly lost with locked elbow orthopedic Neer impingement test and will be more likely to produce shoulder (rotator cuff) injury.

3. Basically, you want to have thumb ahead of pinky during recovery and entry. At the moment of catch and pull, it’s probably more efficient to have some internal rotation, but 80% of all impingement occurs at recovery and entry, and only 20% during pull through. However, if the swimmer is still having pain, then even keeping the thumb slightly forward (toward the direction that the swimmer is moving in or toward the approaching wall) of the pinky during pull through will eliminate internal rotation at all times, and minimize impingement as well. To allow for an effective angle of attack, the entry should be a little wider than usual, so that the initial part of the pinky during pull through will eliminate internal rotation at all times, and minimize impingement as well. To allow for an effective angle of attack, the entry should be a little wider than usual, so that the initial part of the pull resembles the initial part of the butterfly pull (where the hand typically enters wider than in freestyle and the start of the pull is an inward diagonal).

4. Fly is recovering with palms down, thumbs forward.

5. Back is thumb out, pinky in… but when do you rotate the wrist? Many backstrokers rotate immediately, to lead with the pinky as the hand moves out of the water and over the head. This is internal rotation (bad). You want to keep the thumb forward, pointing to the direction of travel until just before entry, when you feather the hand to enter pinky first.

6. Breast… your swimmer is getting pain I presume at the time she rotates her thumbs inward to begin the (high elbow) pull. Internal rotation again. Hard to describe how to modify this without seeing her swim in person. Maybe just a slight reduction in internal rotation (i.e. thumbs not so much inward) is all it will take to give her some relief.

Generally, avoid internal rotation wherever possible (e.g. if doing a hard lead kicking drill on the side, keep the palm of the hand up, rather than down). While reaching for the wall, do so with thumb up. While raising her hand in class, do so with palm back, thumb outward, etc.

tomtopo
December 10th, 2006, 06:14 PM
My questions are as follows:

1.) Is there a way that she can train and continue to provide additional strength with butterfly? Or is it best to just not deal with the butterfly until the shoulder is in better condition and closer to full recovery?

Don't let her swim with the pain. Allowing her to swim with discomfort is one thing and pain is another. When pain is felt during normal range of motions it's time to say stop. Rehab is in order or accommodations during swimming that allow for pain-free swimming. An ounce of prevention is worth a pound of cure is a great saying to live by when it comes to shoulder pain.

2.) What would be the best training method for a swimmer with shoulder injury? Pain free swimming often refers to adaptations during the recovery phase of the stroke. In the article it gave you some examples.

3.) Is more laps always better training? Can she achieve the same benefit or better training by swimming less laps with a specific purpose during practice?
I like what you're getting at and coaches from all over the world are fighting with the idea that swimmers are swimming too much yardage for the amount of time they spend in the pool. Unfortunately, convincing coaches who train Elite swimmers that their swimmers are swimming to far isn't going to happen. I think your daughter could cross train, kick, and perform shoulder rehab and isometric shoulder specific exercises and maintain and even improve her fly time. I actually don't see a choice if she has shoulder pain.

Good luck, Coach T.