6 causes of swimmer’s shoulder (and how PT can help)

Every type of physical activity or sport can pose a potential risk for injuries or painful conditions, including swimming. Up to 91% of swimmers experience shoulder pain at some point in their careers, though it’s more prevalent among adolescents. A common cause of shoulder pain in the sport is swimmer’s shoulder.

Swimmer’s shoulder is a common term used to describe irritation or injury in the shoulder that can develop with repetitive overhead movement. Whether you swim competitively or recreationally, this type of discomfort can make it harder to train, perform or even complete everyday tasks.

The good news is that swimmer’s shoulder often responds well to the right kind of care. Understanding what may be contributing to your symptoms is a helpful first step. Then we’ll talk about how physical therapy can play an important role in your recovery and long-term shoulder health.

The basics of swimmer’s shoulder

Swimmer’s shoulder isn’t a single diagnosis. Instead, it’s a general term used to describe shoulder pain related to repetitive swimming motions, especially overhead strokes like freestyle, butterfly and backstroke. 

This type of pain is often associated with irritation in structures such as:

• Rotator cuff tendons

• Biceps tendon

• Shoulder joint capsule

• Surrounding muscles and soft tissues

Symptoms may include:

• Dull or sharp pain in the front or side of the shoulder

• Pain during or after swimming

• Weakness or fatigue in the arm

• Limited range of motion

It’s also possible to develop this pain from sports with similar overhead movements to swimming, such as tennis or volleyball. If symptoms persist, worsen or begin to limit movement, it may be helpful to seek an evaluation from a physical therapist.

6 possible causes of swimmer’s shoulder

Several factors can contribute to swimmer’s shoulder. In many cases, it’s not just one issue but a combination of movement patterns, training habits and physical imbalances.

1. Overuse and repetitive motion

Swimming involves thousands of shoulder rotations per session. Over time, this repetitive motion can place stress on the tendons and muscles around the shoulder.

Without adequate recovery after strenuous swim sessions, this may lead to irritation or conditions like rotator cuff tendinitis.

2. Poor stroke mechanics

Regardless of your skill level, even small inefficiencies in technique can increase strain on the shoulder.

Examples may include:

• Crossing the arm too far across the body

• Dropping the elbow during the pull phase

• Over-rotating or under-rotating the torso

These movement patterns can change how force is distributed through the shoulder, which may contribute to irritation over time.

3. Muscle imbalances

The shoulder relies on a balance of strength and coordination between multiple muscle groups. 

Swimmers often develop strong front shoulder and chest muscles, but weaker muscles in the upper back and rotator cuff. This imbalance can affect joint stability and movement control. Over time, this may increase stress on certain tissues.

4. Limited shoulder mobility

Restricted mobility in the shoulder joint from past injuries— or even in nearby areas like the thoracic spine — can change how the shoulder moves during swimming.

If the body can’t move efficiently through the stroke, other structures may compensate, which can increase strain.

5. Training adjustment

Sudden changes in training volume or intensity may play a role in swimmer’s shoulder.

This might include:

• Increasing yardage too quickly

• Adding new strokes or drills without progression

• Not allowing enough recovery between sessions

Gradual training progression is often key to reducing the risk of overuse-related symptoms.

6. Poor posture outside the pool

Posture during daily activities — like sitting at a desk or using a phone — can influence shoulder mechanics.

Forward shoulder posture and rounded upper back positioning may affect how the shoulder moves during swimming, potentially contributing to discomfort.

How physical therapy can help swimmer’s shoulder

Physical therapy focuses on identifying the underlying factors contributing to your symptoms and building a plan that supports recovery and performance. Your treatment plan will likely incorporate:

• Movement assessment

A physical therapist may evaluate:

• Shoulder range of motion

• Strength and muscle activation

• Swimming-related movement patterns

• Posture and overall mechanics

This helps guide a more personalized treatment approach rather than a one-size-fits-all plan.

• Targeted strengthening

Strengthening exercises for swimmer’s shoulder often focus on:

• Rotator cuff muscles

• Upper back and scapular stabilizers

• Core muscles for improved body control

These exercises may help improve shoulder stability and reduce unnecessary strain that’s contributing to your symptoms.

• Mobility and flexibility work

If limited mobility is contributing to your symptoms, your plan may include:

• Shoulder mobility exercises

• Thoracic spine mobility work

• Stretching for tight muscle groups

Improving your shoulder mobility can support smoother, more efficient movement patterns.

Performance Rehab can help treat your swimmer’s shoulder with physical therapy

Some soreness after swimming can be normal, especially with increased training. However, certain symptoms may indicate a need for physical therapy. If you’re experiencing swimmer’s shoulder, Performance Rehab can create a personalized treatment plan to alleviate your symptoms and get you back to your regular activities, including swimming.

Ready to ditch the discomfort and get moving again? Connect with our experienced rehab specialists and take the first step toward a healthier, more active life. Request an appointment or contact us to get started.

Frequently asked questions about swimmer’s shoulder

• What does swimmer’s shoulder feel like?

Swimmer’s shoulder often feels like a dull ache or sharp pain in the front or side of the shoulder. Some people also notice weakness or fatigue during overhead movements.

• Is swimmer’s shoulder the same as a rotator cuff injury?

Not exactly. Swimmer’s shoulder is a general term that may include irritation of the rotator cuff, but it isn’t a specific diagnosis.

• Can I keep swimming with shoulder pain?

It depends on the severity of your symptoms. Some people may continue with modified activity, but persistent or worsening pain should be evaluated.

• How long does swimmer’s shoulder last?

Recovery time can vary depending on the cause and severity of your symptoms. A personalized plan from a physical therapist may help guide the process.

• What exercises help swimmer’s shoulder?

Exercises often focus on improving strength and stability in the rotator cuff and upper back, along with mobility work. These should be tailored to your needs to reduce the risk of pain or further injury.

• What causes shoulder pain in swimmers?

Common contributing factors may include overuse, poor technique, muscle imbalances and limited mobility.

• Can swimmer’s shoulder happen to beginners?

Yes. While it’s more common in frequent swimmers, beginners can also experience shoulder pain, especially with sudden increases in activity.

• Is swimmer’s shoulder preventable?

While it’s not always preventable, proper technique, balanced training and adequate recovery may help reduce the risk.

• Should I see a physical therapist for shoulder pain?

If your pain persists, worsens or limits movement, a physical therapist can help assess the issue and guide appropriate care.

• Does posture affect shoulder pain in swimmers?

Yes. Posture outside the pool can influence shoulder mechanics and may contribute to discomfort over time.