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If you frequently read this webpage you know about the frequency of shoulder pain in swimmers. However, swim coaches, trainers, therapists, etc. do not know which strokes stress the shoulder.  The novice would think fly or free would be most stressful to the shoulder, but the amount of shoulder stress per stroke depends on the structures causing pain and can vary depending on the specific injury.  Backstroke is likely the most painful stroke in swimmers with shoulder pain.  Elite swimmers backstrokers roll their bodies allowing their hand to  enter next to their body with their elbow next to their side. Backstrokers who do not roll their shoulders properly will still have the same catch, but the lack of rotation greatly stresses the anterior aspect of the shoulder.  This in combination of full shoulder flexion and internal rotation can lead to instability or secondary shoulder impingement.   Therefore having proper shoulder strength and stability is necessary to prevent their injuries.


Dr. John Mullen, DPT, CSCS world-renowned physical therapist and strength coach.
  1. August 26, 2011

    Unfortunately, we still see a lot of swimmers doing exercises that make the problem worse in this area (often unknowingly). It pains me to see swimmers continuing to do exercises like weighted empty cans that are supposedly intended to mimic the stroke movement, when they’d be much better off training the entire shoulder girdle and upper spine, which is where the real deficits are often found. I understand there may be reasons for that type of isolation in a rehab setting to repair damaged tissue, but sadly a lot of the traditional exercises intended to prevent the problems can sometimes make the problems worse.

  2. August 26, 2011

    @ Allan it is a shame when someone is trying to help but making the problem worse.

  3. August 26, 2011

    The long-axis strokes are not quite versions of cross-crawl, and especially backstroke which is based on a gross movement referred to as an “ipsi-lateral” pattern of turning or rotation. If the pelvis, trunk and shoulder do not rotate to the same side, then we have isolated or instability stressors at the GH joint. Not good. Core stability in an IL pattern both in the water & out are crucial to reduce shoulder stress. Teach, train & treat sagital and frontal plane stability & success in the transverse plane is easier to achieve. Take care, Brett

  4. August 27, 2011

    In backstroke, the liquid athlete must be able to put the pelvis and scapulae on the same plane and that plane must be coupled to the timing & coordination of the GH mechanics during recovery, entry and on both sides of the stroke. SS is quite often link to a mismatch of body position and the intended path of arm motion (e.g. Correct technique is this…., but the athlete is only capable of this…, result is patomechanics with high number of arm cycles). Brett

  5. August 29, 2011

    Brett great points, thanks for your input.

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