A fine balance Share by Harry Brownlow, September 2017 Adam Peaty now holds the 10 top times in the world for the 100m breaststroke. He is a phenomenon at only 22 years of age. To be an elite swimmer requires a combination of mental and physical stamina, perfect technique, hours of dedicated training and having the right sort of body! It helps to be tall and broad with big hands and feet. But you also need to be both flexible and immensely strong which is a very difficult balance to achieve. Being flexible in the shoulders allows for great reach which is key for fast swimming. However too much flexibility renders the shoulders liable to dislocate or partially dislocate (sublux) which is very painful. Building strength and gaining muscle mass has a tendency to both reduce flexibility and can lead to your own muscles pulling your shoulder out of joint. So training has to follow the knife edge between maintaining mobility yet increasing strength. This fine line is one of the reasons that so many swimmers have problems with shoulder pain. The other common causes of shoulder pain in swimmers are over-training and acromioclavicular joint (ACJ) degeneration. training has to follow the knife edge between maintaining mobility yet increasing strength Over-training is common in youngsters and elite athletes. It is the commonest cause of shoulder pain in Olympic swimming squads. Some countries have now banned the use of hand paddles because of this problem. Too much resistance in the water is bad for you! Recovery from over-training is really slow and hugely frustrating for all involved. ACJ degeneration is commonest in middle aged and long distance swimmers. It can cause pain, crunching, clicking and altered stroke. It is usually relatively easy to address with an injection or even a minor operation. I have treated National champions, cross channel swimmers, club swimmers, triathletes and casual swimmers. If you have a problem that is not settling why not let me have a look. With immediate access to Xray, Ultrasound and MRI we can help you understand your problem and how to overcome it.