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ellensdad
June 30th, 2009, 09:13 AM
I thought I would post my daughters story here because I'm sure many of you are or have experienced something similar through your swimming. Ellen has returned to swimming after an 8 month layoff due to shoulder pain/popping. She was diagnosed with tendonitis back in August at which point six weeks of PT combined with no swimming was prescribed. After six weeks of PT she was cleared to start breastroke. After two weeks of pain free breastroke she was cleared to start swimming freestyle. At the time, Ellen's freestyle included the following faults:

-very little core/shoulder rotation
-internal rotation during recovery - thumb first hand entry with right arm.
-forceful outward scull at start of catch/pull with right arm.
-Tended toward left side breathing.
-Dropping right elbow during catch/pull during left side breathing.
-High head position.

Three practices in, the symptoms returned. At that point we decided to pull her from the team and focus on further strengthening and technique changes.

Ellen started swimming with a new team at the beginning of June. Her new coach has helped her eliminate many of the above issues. Currently he has her spending much of her time swimming with a freestyle snorkel to help correct her head/upperbody position as well as work on core/shoulder rotation. He has placed a strong emphasis on using her large muscle groups (back and chest) during her freestyle pull. She has responded positively to this. She has had a couple of back to back two hour practices without any popping/pain. However, she has also had practices were she starts hurting a half hour into the practice although the popping seems to have been eliminated. She never experiences pain afterwards. Her pain only occurs as she is swimming. As soon as Ellen starts to hurt, she shuts down and tells her coach and he gives her something to work on that takes her shoulder out of the equation.

I took her to a new doctor a couple of weeks ago. Her exam was pain free but her doctor did feel some of the clicking/popping and felt that warranted an MRI to check for labrum damage. The MRI showed no labrum damage but did show "thickening of the rotator cuff tendon consistent with overhead athletes". He suggested, continuing working hard on strengthening which she is doing with particular emphasis on scapular stabilizers and external rotators.

Ellen is not on an elite track, she for the most part is a "BB" swimmer who just enjoys being part of a swim team. Oddly, after only a month of practice she achieved her first "A" time in 50 Freestyle LCM which she is very excited about.

So, how do you guys deal with this condition? Is there any hope of correcting this? Any success stories to help inspire Ellen?

Sorry for the long post and thanks in advance for any help.

Donna
June 30th, 2009, 10:27 AM
There are 2 things I do when I have shoulder issues.

1) MASSAGE - indulge in a good massage or find a therapist that specializes in ART(usually a sports chiropractor- fortunate to have a good one in Savannah). I typically find that I have alot of knots in my muscles that if I work them out I have no problems. Do some research on Trigger Point Therapy some pain is actually refered pain from a neighboring muscle but not necessarily the one you think.

2) Hyaluronic Acid - I use this to help with putting the synovial fluid back into my joints. Made a big difference for me as well as a few other swimmers in my area with joint issues. May or may not help in her instance.

Hope this is helpful.

spell_me
June 30th, 2009, 11:55 AM
Donna, can you tell me more about the hyaluronic acid? Is this a supplement? Is it something you use all the time as a preventative measure, or just when you're having problems?

I've been having shoulder problems, too, and I'm looking for any answers I can get.

humanpunchingbag
June 30th, 2009, 12:21 PM
So, how do you guys deal with this condition? Is there any hope of correcting this? Any success stories to help inspire Ellen?



Just my two cents: I have spent a lifetime dealing with bad shoulders. As a competitor I was a backstroke specialist and thus was stressing my shoulders maximally every workout. I also loved pull, so I slapped on the paddles and pull bouy every chance. There was entire years that I could not survive a work-out without icing shoulders after.

I did the physiotherapy, the icing, the rehab and everything in between. They are great and necessary, but they only address the problem, they do not prevent the problem. (BTW: I competed in a time when coaches said such gems as "There are only two types of shoulder problems: those you swim through and those that need surgery. You have the type that you will swim through, Fleming, no matter what your doctor says!!")

My solution (I doubt you will like this): get a stroke coach and correct the strokes now while your daughter is young and can still be molded. Allow the coach to step back her training and focus on correctional drills and accept the fact her times will, for a very brief period, slow down as she finds the "new" groove. The difference between the champions and the "couldhavebeens" is always technical: the champions have better strokes, therefore they swim much faster and they have far few injuries. Even subtle corrections can make immense changes in swimming skill, speed and incidence of injuries. Over the last few years I have remodelled my front crawl completely and I am, for the first time in my life, injury free despite training hard every day and being thirty years older than I was when I was competing at age group level.

ellensdad
June 30th, 2009, 12:32 PM
Actually, I love this advice and that's the road Ellen is on right now.

Great post, thank you.



My solution (I doubt you will like this): get a stroke coach and correct the strokes now while your daughter is young and can still be molded. Allow the coach to step back her training and focus on correctional drills and accept the fact her times will, for a very brief period, slow down as she finds the "new" groove. The difference between the champions and the "couldhavebeens" is always technical: the champions have better strokes, therefore they swim much faster and they have far few injuries. Even subtle corrections can make immense changes in swimming skill, speed and incidence of injuries. Over the last few years I have remodelled my front crawl completely and I am, for the first time in my life, injury free despite training hard every day and being thirty years older than I was when I was competing at age group level.

jordangregory
June 30th, 2009, 01:13 PM
Mr. Fleming
How did you go about fixing your stroke? Any particilar drills, books, videos, coach?

orca1946
June 30th, 2009, 06:41 PM
A true sports DOC that will help her & a very good stroke coach to work with all 3 people involved should help. DO NOT let her need surgery now or soon !

humanpunchingbag
June 30th, 2009, 06:48 PM
Mr. Fleming
How did you go about fixing your stroke? Any particilar drills, books, videos, coach?

Three things really:

1. Total Immersion Swimming. Not a style for everyone and I did not actually change my stroke completely based on the principles promoted by this style of training, but the book (of the same name) got me thinking about swimming correctly for the first time in my life. As a competitor in my youth all I did was concentrate on training until I threw up and then training some more. I thought the difference between myself and the Olympic class swimmers whom I trained with was simply physical ability, stamina and will power. Now I realize that it was all about those things and SKILL.

Look at it this way: its all a circle. The technically better swimmers swim faster with far less effort. They make the pace times easily with lots of rest time to spare, therefor they get longer to recover. Training is easier for them than the rest of us. They experience far less injuries, therefor they rarely miss training. They win more often and they enjoy swimming far more. Meanwhile the "couldhavebeens" are killing ourselves to make the sets on a "touch and go" basis, our shoulders are killing us all the time, and we always come fourth, just out of the medals.

Coaches who stress the technical in young swimmers produce far more mature champions.

2. I hired my daughter a stroke coach and attended every session. It did not help my daughter (her strokes are absolutely beautiful and efficient; her interest in swimming was completely eclipsed by her interest in boys), but those sessions really opened up my eyes to what can be done with good coaching and attention to detail.

I now train with that same coach and I listen to everything he has to say, even if he is not talking directly to me but is helping one of my team mates. This point alone is important as we all tend to make the same mistakes.

3. I teach karate: I took my karate training and applied it to swimming. Break each action into logical segments, train each segment exactly right, then re-assemble the entirety, keeping the exact movement of the segments to recreate a perfect whole.

Over the years I have suffered numerous set backs in my karate: a life threatening cut from a knife, a torn cartilage in my knee, a close call with a malignancy. Each time I was hospitalized I viewed the "down-time" as an opportunity/ excuse to slow down the training and concentrate on the technical end of performance. Hospital bed time became "visualization time" (difficult to do sometimes when you are having an adverse drug reaction), home recovery time became research time, while physiotherapy/ recovery training became slow motion technical training.

Injuries must be looked upon as an opportunity to step back and retrain yourself for better performance when you return to full training. Otherwise the injury down-time really is completely wasted. It may not seem important to a teen-ager, but time passes at the same rate for the young as it does for people like me who are pushing fifty. Time is our only true treasure and young and old alike cannot afford to waste any of it.

I am not there yet: I still need to recreate my flutter kick. After nearly thirty years of not competing in swimming, the ankle flexibility really suffers and thus your flutter kick suffers. Until just lately I never realized how important kick was to fast swimming.

Donna
June 30th, 2009, 08:28 PM
Donna, can you tell me more about the hyaluronic acid? Is this a supplement? Is it something you use all the time as a preventative measure, or just when you're having problems?

I've been having shoulder problems, too, and I'm looking for any answers I can get.

It is a supplement, I sometimes get it on line or at Walmart. I take 40mg in the morning and 40mg at night.

I started taking it because of my lower back problems which were really bad, so bad that I could not bend over to touch the block for the first 2 years I was swimming. I then learned about hyaluronic acid and tried it. For the first time in 2 years I actually had a pain free day. Over time I have more pain free days now than painful ones.

I actually took a month off of it and my shoulders started popping and my lower back hurt baddly. It took me 3 weeks to get back to feeling normal after this experiment.

Michael Heather
June 30th, 2009, 10:03 PM
Ellensdad,

Having gone through similar shoulder pain and popping last year, I can empathize with your daughter's plight. I am a butterflyer, and did not have much pain with the short axis strokes during my rehab, only free and back were problems. In my particular case, My PT corrected my stroke. He asked me to demonstrate free on the bench, and discovered that my recovery tended to twist my shoulder out of the socket, resulting in a. pain, and b. popping of the tendon over a bone designed to keep the joint together.

I was given several exercises to do to strengthen the small back shoulder muscles which get very little attention in the weight room (or anywhere else until the shoulder hurts too much). But the coup de grace for my pain was changing my recovery thusly: after finishing the free stroke, no matter how much body roll you use, the palm of the recovering hand should face the water's surface. If you watch a practice, you will notice that many swimmers tend to finish their stroke and continue the motion of the hand, resulting in a twisting motion that has the back of the hand turned toward the water until it (the hand) reaches shoulder level, at which time it turns around to prepare for entry and the beginning of the next stroke.

This palm down recovery allows the shoulder joint to avoid excess twisting and keeps all of the tendons right where they belong. Hope this helps.

The Fortress
July 1st, 2009, 02:42 PM
I was given several exercises to do to strengthen the small back shoulder muscles which get very little attention in the weight room (or anywhere else until the shoulder hurts too much). But the coup de grace for my pain was changing my recovery thusly: after finishing the free stroke, no matter how much body roll you use, the palm of the recovering hand should face the water's surface. If you watch a practice, you will notice that many swimmers tend to finish their stroke and continue the motion of the hand, resulting in a twisting motion that has the back of the hand turned toward the water until it (the hand) reaches shoulder level, at which time it turns around to prepare for entry and the beginning of the next stroke.

This palm down recovery allows the shoulder joint to avoid excess twisting and keeps all of the tendons right where they belong. Hope this helps.

Thanks for mentioning this, Mike. I'm doing this with my left arm and need to correct it. What exercises for the small back muscles did you find helpful?

sanwin
July 1st, 2009, 11:46 PM
AS someone who also has had years of shoulder issues. I agree find a coach who will make sure she has good technique. Also I think a Orthopedic MD who specializes in sports med and PT that is use to sports injuries,they can give great training advice. I also agree massage therapy works great. For me ice works great, I can not sit in hot tub after swim practice,my shoulders will hurt.I protect my shoulders so I can swim.