by Tanya Mackenzie at Manchester Shoulder Clinic - www.manchestershoulder.com

1. Return to Swimming Program after Shoulder Surgery or injury !
GENERAL GUIDELINES
Guideline: No more than 3
A pain scale of 0 to 10 is commonly used, with 0 representing no pain and 10 representing unrelenting pain. The 'no more than 3' rule allows the swimmer to swim until they reach a 3/10 pain
level. Once a 3/10 pain level occurs, it is best to rest the shoulder. If they have 3/10 symptoms prior to practice do not start that training that day. Solution: Once a 3/10 occurs swimmer can kick
on their back with their arms at their side or in streamline (if their symptoms don't increase with streamline) with fins.
Guideline: No Kickboards
Kickboards are not recommended. Swimmers commonly push their shoulders down on the board, leading to overpressure on the joint Solution: Kick on your back in streamline or kick on your
side or with their arms next to the side. Or keep kick board close to the body to decrease stress on the shoulders
Guideline: No Paddles
Paddles place higher stress on the shoulder. Only use paddles once the shoulder is fully recovered. Solution: Discontinue pulling until symptoms have fully resolved for at least one month.
Guideline: Bottom Hand
When coming off a flip turn, the swimmer should initiate their pull with their bottom hand. For athletes with shoulder pain, it is necessary to give the overworked shoulder a break. In almost all
overuse injuries the bottom hand off the turn is the injured shoulder. Solution: Reverse your rotations off the wall and start your stroke with your opposite arm. Another option is starting your
stroke with your top hand.
Guideline: Proper Pacing
Solution: Attempt to even split your races and sets during practice see the paced Return to Swimming Distance below.
Guideline: Snorkel
Swimmers with shoulder pain have higher neck muscle activation using a snorkel will minimize head rotation and neck muscle activation. Solution: Consider using a snorkel during workouts.
Guideline: Strokes
It is usually best to start with breaststroke and progress to the crawl stroke second, followed by the backstroke and finally the butterfly stroke. Confirm this with your therapist.
Guideline: Breathing
Bilateral breathing reduces the stress on shoulders.

2. Return to Swimming Program after Shoulder Surgery or injury !
Instructions for interval return to swimming program (discuss this with your coach who will guide you through it)
• Prior to returning to swimming you must have full range of motion and full strength in the rotator cuff and scapular muscles. Your physiotherapist will give you the go ahead to start
• First establish a slow steady cadence concentrating on perfect swimming technique until the end of the 1000m PHASE 3. After this, you can start to increase your swimming speed
• Focus on introducing one stroke at a time. Once you have achieved to end PHASE 3 in that stroke keep that stoke at 1000m while introducing a next stroke. Starting that stroke at PHASE 1.
• After completion of all strokes to PHASE 3., swimmers should be ready to return to normal workouts and can then introduce speed work too.
• It is not be advisable to take part in single arm drills or pulling drills until after all strokes are achieved up to end of PHASE3.
• Once completed all strokes to the end of phase three start back-to back sessions 4x/week for 2 weeks, then 5x/week for 2 weeks, then return to 6x/week onwards.
• Swimmers must complete the phase they are in 3 times without pain before progressing to the next phase.
PHASE ONE 100m-300m
Day 1. Swim 100m Rest 5 mins Swim 100m
Day 2. Swim 100m Rest 5 mins Swim 100m
Day 3. Swim 100m Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 4. Rest day
Day 5. Swim 100m Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 6. Swim 150m Rest 5 mins Swim 150 m
Day 7. Swim 300m
Day 8. Rest day
PHASE TWO 300m-600m
Day 9. Swim 300m
Day 10. Swim 300m Rest 10 mins Swim 100m
Day 11. Swim 300m Rest 10 mins Swim 100m
Day 12. Rest day
Day 13. Swim 300m Rest 10 mins Swim 100m
Day 14. Swim 300m Rest 5 mins Swim 100m Rest 5 mins Swim 100m

3. Return to Swimming Program after Shoulder Surgery or injury !
GOOD LUCK!! ENJOY!!!!
Day 15. Swim 300m Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 16. Rest day
Day 17. Swim 300m Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 18. Swim 300m Rest 5 mins Swim 100m Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 19. Swim 600m
Day 20. Rest day
PHASE THREE 600m to 1000m
Day 21. Swim 600m
Day 22. Swim 600m Rest 10 mins Swim 100m
Day 23. Swim 600 Rest 5 mins Swim 100. Rest 5 mins Swim 100m
Day 24. Rest day
Day 25. Swim 600 Rest 5 mins Swim 100. Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 26. Swim 600 Rest 5 mins Swim 100. Rest 5 mins Swim 100m Rest 5 mins Swim 100m Rest 5 mins Swim 100m
Day 27. Swim 1000m