Swimmer Shoulder Rehab: Why Pain-Free Doesn’t Mean Performance-Ready
In competitive swimming, shoulder pain is one of the top reasons athletes miss training or worse, get pulled from major meets. And while rehab plays a crucial role in recovery, one lesson I’ve learned over the years is this:
Pain-free doesn’t mean ready to train.
At ATHLETIC INC, and in my work with swimmers at Singapore’s National Training Centre, I’ve seen athletes complete rehab only to break down again during high-volume preparation. Not from contact. Not from trauma. But from a shoulder that wasn’t ready for the demands of swim training.
The issue?
We often stop at “cleared” when we should be preparing athletes to stay available and resilient in the pool.
What Most Rehab Gets Wrong in Swimming
Typical rehab looks for:
Full shoulder range of motion (ROM)
Pain-free resisted tests
Return to daily activity
But swimmers aren’t training for “daily activity.”
They’re completing thousands of strokes per week, often with minimal rest, high fatigue, and repetitive force through a narrow range of movement.
Cleared isn’t enough. We need to ask:
Can this shoulder handle the sport?
Our Rehab-to-Performance Framework: 4 Pillars of Shoulder Readiness
At ATHLETIC INC, we go beyond clearance. We build swimmer shoulders that are built to endure.
Our physios assess across 4 key pillars:
1. Mobility
We test:
Shoulder IR and ER at 90°
Abduction + IR
Combined elevation (streamline position)
Limited mobility often leads to compensations and inefficient strokes. That’s a fast track to overload.
2. Stability
Clinical screens we use include:
Load and shift
Sulcus sign
Apprehension test
Even strong swimmers may lack passive joint stability. If the capsule isn’t doing its job, the rotator cuff will burn out trying to do it all.
3. Strength
We use the ASH Test (I-position) to test:
Internal and external rotation strength
Left/right asymmetry
Swimmer-specific shoulder benchmarks
Manual testing doesn’t cut it. Objective strength testing gives us data that guides return-to-swim decisions with confidence.
4. Power
This is where rate of force development (RFD) becomes essential.
Using Velocity-Based Training (VBT) and ASH data, we track how fast force is produced not just how much.
This is key for:
Starts and breakouts
Sprint efforts
Maintaining performance under fatigue
This is the gap where most rehabs stop short. But performance doesn’t care if you’re pain-free it demands power, speed, and repeatability.
Shoulder Capacity Testing: Your Final Clearance
Before a swimmer returns to full training, we run capacity-based assessments:
Push-up test
Inverted row or pull-up
Prone endurance holds
These tests challenge the shoulder in functional positions, under fatigue not just static strength. They give us insight into how the shoulder will actually perform in the water.
Why This Matters for Swimmers in 2025
With the World Aquatics Championships 2025 fast approaching here in Singapore, athletes are pushing harder than ever. And while performance is the goal, availability is what keeps you progressing.
The reality:
Most shoulder injuries in swimming aren’t sudden. They are overuse injuries that develop quietly when load outweighs capacity.
If the shoulder can’t tolerate the demands of the sport, it’s not truly rehabbed.
Your Next Step: Build a Shoulder That Lasts
So, if you’re a swimmer or a coach, or a parent don’t just ask:
“Is the pain gone?”
Ask:
Can this shoulder handle 5–6 sessions a week?
Can it pull hard off the wall, week after week?
Can it maintain control under fatigue?
We’ll help you go beyond pain-free and build a shoulder that performs.
MEET THE AUTHOR
DEXTER KIN
Founder & Clinical Director
Lead Physiotherapist & Performance Coach
Team Singapore National Swimming Physiotherapist
Hangzhou 2022 Asian Games
World Aquatics Championships Doha 2024
SPECIALISATIONS
Strength & Conditioning
Sports massage, Manual Therapy and Dry Needling
Rehabilitation to Performance
Swim-Specific Screening & Performance Optimisation