The shoulder has a huge range of motion compared to most joints, but that also makes it one of the less stable joints. Swimming competitively can really put the shoulder to the test, so much that ‘swimmer’s shoulder’ is the nickname given to the condition subacromical impingement. Swimmer’s shoulder occurs when tendons or other tissues of the joint are irritated or damaged, usually due to repeated overuse.
Five-time Olympic gold medallist Missy Franklin endured such severe problems with her shoulders during her career that it eventually led to her retirement from the sport in 2018, at the age of 23. In March 2017, she confirmed on social media that she had had surgery on both shoulders after MRI examinations revealed inflammation of the bursa, flat sacks that sit inside the joint and aid smooth motion. You can read more about Franklin’s surgery here and about her long-term struggle and retirement here.
After ultrasound, MRI is the most frequently used radiological method in evaluation of the shoulder, especially when deep injuries to articular structures are suspected. Below is an example of degeneration of the supraspinatus tendon (top arrow) caused by overuse and reactive inflammation of the bursa (subacromio-subdeltoid bursa, lower arrow) which produces pain and discomfort in the shoulder during sporting activities.
Note: image is an example – not that of the athlete named above.
MRI is usually used to assess shoulder injuries, as it shows the complex structure of the joint very clearly. Radiologists know the anatomy of the shoulder well and can tell from images when something is not as it should be. Their detailed description of which tissues are damaged can play an important part in planning the athlete’s recovery.
For more information about swimmer’s shoulder, click here.