The prevention and treatment of swimmer's shoulder.

Specific stroke modifications may be of great advantage to reduce shoulder pain in front crawl swimmers. Shortening the stroke by staring arm recovery the end of the push-through reduces "wringing-out" of the supraspinatus tendon. Lifting the head at arm entry, leading recovery with the hand and encouraging body roll and alternate breathing all reduce impingement of the tendon against the coraco-acromial arch. Specific stretching exercises, with neuromuscular facilitatory techniques, have an important preventative value. Proper sleeping posture is to be encouraged, using pillows to support the arm and reduce direct pressure over the supraspinatus tendon. Physical modalities and medication have a very limited role to play. Surgical decompression of the coracoacromial arch may be curative in those cases not responding to conservative management.