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Fundamental shoulder strengthening exercises for competitive swimmers
Written by Behnam Liaghat, recognized specialist by the International Federation of Sports Physical Therapy, based in Denmark at the University of Southern Denmark. Email: email@example.com
Following my recent blog about identifying joint hypermobility in swimmers, in this blog I will go through some of the top shoulder exercises for the competitive or elite swimmer to develop fundamental strength and neuromuscular control of the rotator cuff and scapular stabilizers.
In our recent research about young competitive swimmers with joint hypermobility (Liaghat et al., 2018), we found that swimmers with inherent shoulder joint hypermobility displayed reduced internal rotation strength and a tendency to poor activation of the scapular muscles. Another interesting finding was that swimmers with joint hypermobility not only display reduced absolute internal rotation strength, but these swimmers are weaker through the entire range of shoulder rotation. The suggested dry-land exercises in this blog can be designed to be beneficial for both hypermobile and non-hypermobile swimmers with few adjustments in range of motion, i.e. by increasing shoulder rotation to be as close as possible to the individual end range.
What are the benefits?
The four exercises specifically aim at improving shoulder retraction (refers to moving the scapula towards the spine), internal rotation and external rotations strength. To avoid injuries, it is important to target muscles on both sides of the shoulder to achieve a balanced intermuscular function. This is the rationale for including exercises for both internal and external rotation movements. Adequate strength in these movements has, besides injury prevention purposes, a positive effect on swimming stroke performance.
Some general guidelines for these exercises include performing them without producing any pain or discomfort and slowly through the entire range (approximately 6-8 seconds per repetition) to engage all important muscles. As there are no golden standard number of repetitions, you may want your swimmers to start with 3 x 30 seconds for the first 2-4 weeks and then move on to 3 x 8-12 repetitions with heavier resistance. Depending on the load applied and experienced level of muscle soreness, the exercises can be performed 3-5 times weekly. Make sure your swimmers breathe in a relaxed manner and engage the whole kinetic chain in all exercises.
When introducing these exercises to your swimmers, be certain that they can control the shoulder so excessive movement of the tip of the shoulder in either upward (towards the ear), backward or forward directions is avoided. In principle, reducing resistance and/or decreasing the range of movement may be applied to increase quality of shoulder control.
Active release of muscles before you start
Before instructing swimmers in performing these exercises, it is recommended to do some active release of the posterior rotator cuff muscles by standing against a wall with the arms perpendicular to the trunk and putting a pressure to the mid-point of the scapula with a lacrosse ball to target the infraspinatus area (Fig. 1). From here the swimmer can simply roll on the ball and add a shoulder external and internal rotation movement for up to two minutes to release tight and sore muscles (Fig. 2 A-C). The active self-release can be performed in supine for adding more pressure.
Now let us move on to the top dry-land exercises for fundamental shoulder strength
Exercise 1: Prone 1-arm diagonal lift
Either lie on the floor or on a gym ball supporting with your feet and one arm. Apply resistance with an elastic band. Slightly retract and depress your shoulder before lifting your arm with a 45 degrees angle away from the trunk´s midline. While lifting the arm, a maximum external rotation is performed in the arm so the thumb points towards the ceiling.
Level down by lifting the arm perpendicular to the trunk’s midline.
Level up by adding a back extension in the movement or lifting the opposite leg.
Exercise 2: Supine internal rotation 1
Either lie on the floor or on a gym ball supporting with your feet. Apply resistance with an elastic band. Slightly retract and depress your shoulder before turning one arm at a time internally as far as possible without losing shoulder control (e.g. protracting the shoulder towards the ceiling).
Level up by adding oscillation (fast movements back and forth) through the movement.
Exercise 3: Supine internal rotation 2
Description: Either lie on the floor or on a gym ball supporting with your feet. Apply resistance with dumbbells. Slightly retract and depress your shoulder before slowly turning one arm at a time externally in cranial direction and then back to vertical position in the underarm without losing shoulder control (e.g. avoid pushing the shoulder towards the ceiling).
Level up by adding more load and increasing range of external rotation.
Exercise 4: Prone external rotation
Lie on a gym ball supporting with your feet and one arm. Apply resistance with a dumbbell. Slightly retract and depress your shoulder before externally rotation your arm with the upper arm perpendicular to the trunk.
Level up by adding more load and increasing range of external rotation.
Every swimming coach should be familiar with these top shoulder exercises and include them in some content as part of the dry-land routines for injury prevention and for enhancing swimming stroke performance.
A special thanks to the Danish swimmers Matilde Lerche Schrøder and Line Virkelyst Johansen for giving their photo consents.
Liaghat, B., Juul-Kristensen, B., Frydendal, T., Marie Larsen, C., Søgaard, K., & Ilkka Tapio Salo, A. (2018). Competitive swimmers with hypermobility have strength and fatigue deficits in shoulder medial rotation. Journal of Electromyography & Kinesiology, 39, 1-7. DOI: 10.1016/j.jelekin.2018.01.003
Written by Behnam Liaghat, recognized specialist by the International Federation of Sports Physical Therapy, based in Denmark at the University of Southern Denmark.
With hypermobility, it is really a balance for the swimmer between taking advantage of the condition by reducing drag and avoiding excessive motion that may potentially damage the joint. I propose that you may easily acquire the knowledge to test many of your swimmers for generalized joint hypermobility, including shoulder hypermobility, within 1-2 minutes.
In our recent research study on young competitive swimmers, the main findings were that healthy swimmers with hypermobility in the shoulder had a decreased strength and a larger fatigue development. In addition, more experimental data indicated a poorer stability of the shoulder blade. As a swimming coach, you can prescribe exercises to target these deficits and help your swimmers take advantage of their joint hypermobility. Generalized joint hypermobility is evaluated with the 9-point Beighton scale, which requires the performance of five maneuvers, four passive bilateral and one active unilateral performance:
Passive dorsiflexion and hyperextension of the fifth MCP joint beyond 90°
Passive apposition of the thumb to the flexor aspect of the forearm
Hyperextension of the elbow beyond 10°
hyperextension of the knee beyond 10°
Active forward flexion of the trunk with the knees fully extended so that the palms of the hands rest flat on the floor
Each positive test scores one point, with cut-off values of more than 5/9 being indicative of the presence of generalized joint hypermobility. These cut-off values may vary, and some authors suggest lower cut-off values (e.g. 4/9) for males.
Since the shoulder is not represented in the Beighton scale, you may use a shoulder external rotation (positive score more than 90°) with the upper arm in neutral along the side of the body.
In case further investigation is required of the musculoskeletal condition of the swimmer or in case the swimmer experiences pain, please refer to a sports physiotherapist, who can perform additional tests and examination.
For more detail on this topic, please read the freely available research paper by Liaghat et al. (2018): “Competitive swimmers with hypermobility have strength and fatigue deficits in shoulder medial rotation”. https://authors.elsevier.com/a/1WU8g3kurobLDS
This episode of the Swimming Science Podcast features Jenni Brozena.
Jenni Brozena is the President and Owner of Aqueous, a healthcare education and human performance company specific to the aquatic athlete. The company’s cross-disciplinary approach brings exercise physiologists, physical therapists, athletic training, sports medicine doctors, athletes, and parents together to understand the body/water connection. The evidence-based approach is centered on the deliberate treatment of the unique needs of the aquatic athlete. She also currently serves as the Director of Aquatic Performance at Kinetic Physical Therapy where she and physical therapists utilize video analysis to build a deliberate treatment plan and return to sport goals for aquatic athletes. Her research has been accepted at the Biomechanics and Medicine in Swimming Symposium and the 3D Analysis of Human Movement Symposium. Her current research interests include neuromuscular core control during the body roll and utilizing video analysis as a patient outcome measure in the health care setting.
Thanks for joining me for this episode. I know the conversation broke up a few times and I apologize, I’m still very new with this! If you have any tips, suggestions, or comments about this episode, please be sure to leave them in the comment section below.
If you enjoyed this episode, please share it using the social media buttons you see at the bottom of the post.
Improving shoulder strength is a frequent goal of injury prevention and rehabilitation, often termed stability. Stability suggests balance and proportional strength around the joint exists. Shoulder joint stability is a result of passive and dynamic components. The bone geometry, relative intra-articular pressure, glenohumeral labrum and capsuloligamentous structures are the passive components. The dynamic components are those which contract around the joint, often the muscles and tendons. Both passive and dynamic structures provide proprioceptive (joint position) for the joint. Proprioception is an essential aspect of sports, as it is a main component of body awareness. Studies on throwing athletes have found a poor sense of position on the throwing side and a correlation with instability. Despite the importance of proprioception, the effects of strength training on proprioception is not well researched.
Strength Training on Shoulder Proprioception
Salles (2014) split 90 male undergraduate students into three groups:
Performed exercises at the same intensity
Performed exercises at different intensities
Performed no upper body exercise
The exercises were performed for 8 weeks and included bench press, lat pull down, shoulder press, and seated row. Before and after the training, a joint positioning test was performed on each arm.
Strength Training on Shoulder Proprioception Results
Nine subjects did not finish the study due to a lack of time. Before the study, there was no difference between groups. However, after the training group 1 had a less absolute error than group 2 during the joint position test. Group 2 also had greater improvements in sense of position than the control group.
Strength Training Improves Shoulder Proprioception
Overall, strength training appears beneficial for improving joint positional sense and a constant exercise intensity (8-9 RM) appears better than a varying intensity (8-9 RM and 12-13 RM). However, the effects of strength training during sport must also be studied, as fatigue and overtraining may influence these findings. Also, the effects of strength training and proprioception in those with shoulder injury, particularly swimmer’s shoulder, is an important research topic.
Nonetheless, it seems shoulder strengthening with a lower volume and constant intensity is most beneficial for improving shoulder proprioception. Therefore, consider adding shoulder strengthening for your return to swimming program and swimmer’s shoulder prevention programs.
By Dr. G. John Mullen received his Doctorate in Physical Therapy from the University of Southern California and a Bachelor of Science of Health from Purdue University where he swam collegiately. He is the owner of COR, Strength Coach Consultant, Creator of the Swimmer’s Shoulder System, and chief editor of the Swimming Science Research Review.
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