The Effects of an Exercise Intervention on Forward Head and Rounded Shoulder Postures in Elite Swimmers

Swimmers commonly suffer from shoulder pain due to the repetitive and overhead nature of the sport. A condition called ‘swimmers shoulder’ has been characterized by shoulder instability, impingement and rotator cuff tendonitis. About one-half of college swimmers have shoulder pain that affect their training routine. Swimmers sometimes demonstrate alterations in posture such as forward head posture (FHP) and rounded shoulder posture (RSP). These postural changes are often associated with muscle imbalance of the neck and shoulder. Researchers wanted to find out if an exercise program could improve posture, strength, and shoulder function in collegiate swimmers.

28 swimmers were block-randomized into an exercise or control group based on their event. The exercise group performed an 8-week stretching and strengthening program, 3 times a week. The strengthening exercises consisted of body-weight arm exercises using an exercise ball for support, while foam rolls were used to assist with the stretching exercises.

At the end of the training program, the training group significantly improved their forward head posture and rounded shoulder posture. Isometric scapular muscle (trapezius and serratus anterior) also improved significantly; however, the increase was not significantly different from the control group’s improvement. Self-reported pain and function (ASES Scale) did not change significantly.

The authors noted that a lack of difference in shoulder strength between the training and control group may have been due to a lack of resistance intensity (ie, only using body weight without progression). They noted a 1999 study by Wang and colleagues that used TheraBand resistance exercises to increase scapular strength in patients with rounded shoulder posture.

In summary, exercises using a TheraBand exercise ball and foam rollers may help improve posture in swimmers; in addition, adding TheraBand resistance to the strengthening program will likely provide the training stimulus needed to improve strength in high-level competitive athletes.

Lynch, et al. The Effects of an Exercise Intervention on Forward Head and Rounded Shoulder Postures in Elite Swimmers. Br J Sports Med. 2010 Apr;44(5):376-81. doi: 10.1136/bjsm.2009.066837.