The rotational petal is designed to achieve the widest range of motion (ROM) with the most degrees of freedom of any common system in the body. The excessive mobility of the shoulder in the glenohumeral and humeral head joints is balanced by the stability of the acromioclavicular (AC) and sterno-clavicular joints.

In swimmers, the shoulder is usually treated as a subacromial passage that includes the tendon of the rotator cuff, the bicipital tendon or the subacromial deposition. The main subacromial impacts involve compression of these structures between the acromion and the greater tuberosity. The cause of primary impingement is usually a tight posterior capsule (causing the migration of the short head of the biceps anteriorly) or abnormal subacromial morphology.

During the pulling phase, the scapula is extended as the arm is adducted, extended, and internally rotated. Physical therapists should focus on disorders related to the appearance of symptoms, including glenohumeral hypermobility or instability, weakened body posture, reduced endurance of rotator cuff muscles, modified nucleocapsid rhythm, or poor neuromuscular control or a tight posterior capsule.

A swimmer with excessive body roll may cross the midline of the body during the pulling phase, and this increased horizontal addition may lead to passing. The lack of body roll will also force the arm to compensate by further horizontal addition for adequate propulsion.

The physical examination of a swimmer's shoulder usually reveals distortions in the active range of motion, particularly in the mid or end range of elevation. A common mistake is insufficient or excessive body roll. An example of abuse is a swimmer who trains excessively with arm strokes, increasing the pressure on the shoulder. Sensitivity is characterized by three parameters: the level of pain, what is needed to trigger the symptoms, and the latent time or the time needed for the symptoms to resolve after the challenge. For example, a patient who points to the anterior lateral aspect of the shoulder with a finger and describes sharp pain with aerial movements may have involvement in the subacromial region or the joint.

To improve an athlete's participation in a sport, the stabilization of muscles and modification of activity are crucial. For swimmers, it is essential to understand the underlying tissue disorders and functional limitations to establish a prevention or treatment plan for the shoulder. Typically, pain associated with inflammation is present, and initial therapy may involve manual techniques such as mobilizations of grade I or II to alleviate discomfort. Additionally, the tension of the anterior thoracic muscles can be reduced through appropriate exercises to maintain optimal shoulder function.

If the treatment program results in the swimmer being removed from the water, then a careful reintegration into training is necessary. During the rehabilitation process, when the swimmer is able to reach above shoulder height without pain and exhibit resilient movements from 0° to 90° without pain, then the swimmer is encouraged to return to the pool and swim 1000-2000m slowly and comfortably, avoiding sets that involve fast movements. When the swimmer is pain-free during resistance movements in all styles, then add 500m every three practices. During this stage, it is advisable to avoid double practices and sprint sets. When the swimmer covers 4000-5000m without pain, then quickly incorporate all four intensities and sprint sets.