Which two shoulder injuries are most commonly seen in swimmers?

• A. Tennis elbow and golfer's elbow
• B. Rotator cuff tendinopathy and shoulder impingement
• C. ACL tear and meniscal injury
• D. Achilles tendinopathy and plantar fasciitis

Answer: (B)

Repetitive overhead loading of the shoulder during swimming creates overuse stress on the rotator cuff tendons and the subacromial space. Rotator cuff tendinopathy develops from ongoing microtrauma and tendon degeneration due to high training volume and repetitive pulling and reaching, leading to pain and weakness around the shoulder. At the same time, the tendons and bursa can become compressed under the acromion during arm elevation, causing subacromial impingement. Factors common in swimmers, like limited external rotation (GIRD), posterior shoulder tightness, and scapular stabilization deficits, worsen this impingement by altering humeral head position and reducing the available space for the tendons. This combination—tendinopathy of the rotator cuff and subacromial impingement—is the pattern most frequently seen in swimmers.

The other injuries listed involve different joints (elbow, knee, or foot) rather than the shoulder, which is why they’re less typical for swimmers.