Which shoulder muscle group is most at risk in swimmers, and what is a key preventive exercise?

• A. Rotator cuff (especially supraspinatus); rotator cuff strengthening (external/internal rotation), scapular stabilization, and proper warm-ups
• B. Biceps brachii; elbow flexor strengthening
• C. Pectoralis major; push-up variations
• D. Deltoids; lateral raises

Answer: (A)

Swimmers face repetitive overhead motion that stresses the rotator cuff, especially the supraspinatus, which sits under the acromion and helps initiate and control arm lifting. This makes the rotator cuff the most vulnerable to overuse injuries like tendinopathy and impingement during freestyle and other strokes. The best preventive approach targets this group with dedicated strengthening in both external and internal rotation to balance the shoulder forces, along with scapular stabilization to keep the shoulder blade moving well and maintain proper alignment of the arm within the socket. A thorough warm-up is also key to preparing the tissues for repetitive work. For example, light resistance band exercises for external and internal rotation, plus moves that promote scapular control such as wall slides or prone horizontal abduction, are effective. While other muscles are active during swimming, strengthening the rotator cuff and stabilizing the scapula directly addresses the most common injury risk in swimmers.