Painful Shoulder in Swimmers: A Diagnostic Challenge

In brief: Painful shoulder can cause significant disability in swimmers, and in elite swimmers it may even force premature retirement. Treatment of this problem has been difficult, and surgery has been perceived as generally unsuccessful. The author asserts that "swimmer's shoulder" is not an anatomically based diagnosis and that the frequent lack of a specific diagnosis probably has hindered treatment. New investigative tools, such as arthrography and NMR imaging, have improved the chances of reaching an accurate diagnosis. The author lists the many regional problems that can cause shoulder pain, describes physical, clinical, and laboratory tests for use in diagnosis, and outlines approaches to management of the problem.