05.03.2020 – Investigation of a tight left shoulder of a female swimmer

Date: 05.03.2020

Duration: 1000-1100 – 1 hour

Venue: Marjon Sports & Rehab Clinic

Reflective Summary:

This client complained of a pulling sharp pain in her left shoulder during rotation of her arm when swimming front crawl.  She also plays water polo but doesn’t experience any pain because her left arm isn’t her throwing arm.  She experienced this pain at the beginning of the season during end of October, beginning of November but put it down to being unfit. It eased off because she trained less but it has gotten worse during the last couple of weeks which is due to the increase in matches in the build up to Varsity and the end of the season league competition.  She plays water polo 2/7 and swim trains 2/7.  She is also training to be a life guard which involves monthly training sessions.  The tight shoulder is aggravated by swimming but eases when resting.

The client feels discomfort mid-stroke and end of stroke (external & internal rotation) during front crawl – pain level 4-5/10.  Immediately my impression is overuse of one of the rotator cuff muscles.  On palpation there was tension in the soft tissue at the top of the shoulder on the posterior side.  There was no tension in the teres minor or teres major muscles.

Active movements revealed full ROM in all movements except in flexion (ROM 150-1600) of the left shoulder. Also reduced ROM in abduction of the left shoulder (1300).  Passive ROM revealed tightness at the top of the range in the left shoulder, in flexion, internal rotation and external rotation.  There was no pain.

Resisted movements revealed a slight weakness in external and internal rotation of the left shoulder. The results led me to believe that there was a weakness in the rotator cuff muscles (Supraspinatus and subscapularis) in the left shoulder due to overuse/overload during training and increased competition.

A programme of exercises to strengthen the rotator cuff muscles were prescribed as follows:

3 sets of 8 repetitions of up an over exercise with resistance band (client lying in prone – arms outstretched in front with resistance band – pulling the band overhead and down along the back).  Exercise can also be performed with obstacles rather than a band.

3 sets of 8 repetitions of external rotation holding resistance band combined with double arm raise.

3 sets of 8 repetitions of lateral raise with resistance band.

3 sets of 8 repetitions of front raise with resistance band.

The exercises were demonstrated to the client.  The client executed each exercise after the demonstration.  The exercise programme is to be repeated daily.

Return to Reflections at a Later Date:

Leave a Reply

Your email address will not be published. Required fields are marked *