In short: Swimmer's shoulder is shoulder pain caused by repeated overloading during swimming. During the stroke, the shoulder works through a wide range of motion with a high number of repetitions. The structures most often irritated are the rotator cuff tendons and the bursa under the acromion, especially when the arm is raised above the head. Treatment usually starts without surgery: adjusting training, avoiding the movements that hurt and doing targeted exercises. If the pain does not ease after 2 weeks or gets worse, have your shoulder examined.
Swimming is gentle on the joints but can overload the shoulder
Swimming is often recommended as a joint-friendly sport. In many cases this is true, because swimming does not involve the impact loading found in running or jumping.
However, competitive or regular swimmers may experience specific overuse problems. These most commonly affect the shoulder joint. The shoulder is a very mobile joint and is therefore prone to injury and wear.
What is swimmer's shoulder?
So-called swimmer's shoulder refers to shoulder pain resulting from repetitive strain during swimming. During a swimming stroke, the shoulder works through a wide range of motion with a high number of repetitions.
Endurance swimmers can perform thousands of repetitive movements during a single training session. A long-distance swimmer makes roughly 5,000 to 7,000 shoulder rotations in a two-hour session. If muscle imbalances, insufficient recovery or technical errors are added to this, pain can develop.
What happens in the shoulder when you swim
A group of four muscles holds the arm in the shoulder joint and helps to lift and rotate it. Their tendons form a covering around the head of the upper arm bone. This group is called the rotator cuff. Between the tendons and the bone on top of the shoulder (the acromion) lies a lubricating sac called a bursa, which lets the tendons glide smoothly when you move your arm.
When you raise your arm, the space between the acromion and the tendons becomes smaller. The acromion can then rub against the tendon and the bursa below it and irritate them. Doctors call this impingement. In swimming, the arm is lifted above the head with every stroke, so this movement is repeated many times in each session. Young athletes who use their arms overhead, for example in swimming, tennis or volleyball, are therefore particularly at risk of rotator cuff pain.
The irritation can take the form of inflammation of the tendon (tendinitis), inflammation of the bursa (bursitis) or impingement. Repeating the same shoulder movements again and again stresses the tendons and can even lead to an overuse tear. In addition, the blood supply to the tendons decreases with age, and with it their ability to repair themselves.
Typical symptoms
Pain may occur during swimming, after training, when lifting the arm or at night. Sometimes it is accompanied by a feeling of weakness, restricted movement or pain in certain shoulder positions.
The problems may be related to overloading of the tendons, the rotator cuff muscles or the structures around the shoulder joint. Typical signs are:
- pain and tenderness at the front or side of the shoulder,
- pain when lifting the arm and reaching above your head, sometimes also when lowering it,
- pain spreading from the front of the shoulder to the side of the arm,
- in overhead sports, pain when throwing, spiking or serving a ball,
- as the problem progresses, severe pain at night, loss of strength and movement, and difficulty getting dressed or brushing your hair.
At first the symptoms are often mild, so people frequently do not seek treatment early. If your shoulder wakes you up at night, you may also want to read our article on shoulder pain at night.
Prevention and compensation
Correct swimming technique, sensible training loads, sufficient recovery and compensatory exercises are important. Strengthening the shoulder girdle muscles and stabilising the shoulder blade also matter. For endurance swimmers, training also includes further supporting measures, above all physiotherapy, so that the shoulder can cope with such a load.
If the pain keeps coming back, it is not advisable to simply “swim through it”. It is better to find the cause and adjust the load before the problem gets worse.
What you can do yourself
If the pain did not start with an injury and you have none of the warning signs listed below, the following usually helps:
- cutting down on swimming and other movements that trigger the pain for a while, especially using your arm above your head,
- not stopping using the shoulder completely, but moving it gently,
- not making up your own strenuous exercises; a doctor or physiotherapist will show you suitable ones,
- applying a cold or warm pack wrapped in a tea towel for up to 20 minutes, two to three times a day,
- taking ordinary painkillers so that you can keep moving the shoulder; a pharmacist can advise you on a suitable one.
Pain usually only starts to ease after about 2 weeks. Full recovery can take 6 months or longer. Doing shoulder exercises for 6 to 8 weeks helps to stop the pain returning.
When to see a doctor
Book an appointment with an orthopaedic specialist if the pain is getting worse or does not improve after 2 weeks, or if it is very difficult to move your arm or shoulder. A torn tendon can get larger if you keep loading it, so ongoing shoulder pain should be seen by a doctor.
See a doctor or go to an emergency department straight away if:
- the pain came on suddenly or is very severe,
- you cannot move your arm,
- your shoulder or arm has changed shape or is badly swollen,
- you have pins and needles that do not go away, or no feeling in your arm or shoulder,
- the pain started after an injury or a fall.
A fresh injury is first treated at an accident and emergency department; HR Clinic is not an emergency service. After the initial treatment, you can book a follow-up, further treatment or a second opinion.
Examination and treatment
The doctor will ask about your symptoms, your training and how the pain has developed, press on different parts of the shoulder, check its range of motion in several directions and test the strength of your arm. They will also examine your neck to rule out pain coming from a pinched nerve. An X-ray shows the bones, but the tendons cannot be seen on it, so with rotator cuff pain it is often normal. An MRI scan or an ultrasound shows the tendons, the bursa and any tear.
Treatment usually starts without surgery. It includes rest and activity changes, especially fewer overhead movements, anti-inflammatory medication and physiotherapy. The physiotherapist first restores the shoulder's range of motion and, once the pain improves, adds strengthening of the rotator cuff muscles and work on posture. If this is not enough, the doctor may consider an injection of a steroid with a local anaesthetic. Many patients improve gradually, but full recovery can take several weeks to months.
When surgery may be considered
If treatment without surgery does not relieve the pain, the doctor may recommend an operation. For impingement, its aim is to create more space for the tendons under the acromion; for a torn tendon, it usually means reattaching the tendon to the upper arm bone. After impingement surgery, the pain usually takes 2 to 4 months to settle completely, sometimes up to a year. The doctor always decides on the right approach at the consultation.
If a doctor at HR Clinic recommends surgery, it usually takes place within two weeks of the diagnosis. If everything is in order, the procedure can even take place within a week of the consultation. Rehabilitation follows. We describe the whole process on the How it works page.
How the procedure works at HR Clinic is described on our page Shoulder arthroscopy.
Frequently asked questions
Should I stop swimming if my shoulder hurts?
Cut down on swimming and other movements that trigger the pain for a while, especially using your arm above your head. Do not stop using the shoulder completely, though; move it gently. If the pain keeps coming back or does not improve after 2 weeks, have your shoulder examined.
Can swimmer's shoulder hurt at night?
Yes. The pain can also occur at night. When the shoulder tendons are irritated, night pain is typical and, as the problem progresses, it can disturb sleep.
Do I need a referral for the examination?
No. A referral from a general practitioner is not necessary; you can book a consultation online or by phone. Patients pay for their care at HR Clinic themselves.
Does your shoulder hurt when swimming or after training? Book a sports orthopaedic examination at HR Clinic online or call us on +420 515 225 520.
Updated: 27 October 2026
First published on May 27, 2026.