CBD Lotion to Reduce Inflammation and Impinged Shoulder Pain

Swimmer’s Shoulder is one of the most commonly searched shoulder injuries. When I was in chiropractic college, I remember the ominous tone of my professor warning us about how shoulder problems are “notoriously difficult to treat”. He cautioned us that patients often take a long time to recover and are prone to recurring and even worsening problems over time.

This is because of our shoulder anatomy, which is a complex arrangement of bones, ligaments, tendons, muscles, nerves, bursae, and blood vessels, all of which are crammed into a tiny space. As a result, even a modest amount of inflammation can cause big problems, as well as a lot of pain. 

The shoulder is a truly amazing part of the human body. As a ball and socket joint, the “ball” of the humeral head fits into the “socket” of the shoulder blade, or scapula, which allows the arm to move in three different directional planes. The collar bone, or clavicle, is also part of the shoulder.

There are four shoulder muscles associated with the shoulder, called the rotator cuff muscles (so named because they allow for movement, including rotation).

• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis muscles

These muscles attach to the bones of the shoulder as the rotator cuff tendons. The deltoid muscle is also part of the shoulder. In addition to tendons, there are several ligaments in the shoulder that attach bones to other bones and provide stability.

There are three nerves, accompanied by blood vessels, that pass under the shoulder joint, as well as bursae that provide cushioning for movement. 

Swimmer’s Shoulder

All this anatomy provides plenty of opportunity for biomechanical issues. Swimmer’s shoulder is one such problem. This is an overuse injury associated with the repetitive movement of the shoulder, which can cause inflammation, tears, and scarring.

But this problem is not limited to an injury in swimmers; anyone that does repetitive shoulder movements, such as baseball and tennis players—is susceptible. Swimmer’s shoulder is also known as shoulder tendonitis or shoulder impingement. Specifically, the rotator cuff tendons become inflamed due to overuse of the rotator cuff muscles, which press on other nearby structures causing pain. Inflammation of the supraspinatus tendon is the most common cause of pain in swimmer’s shoulder.

Swimmer’s shoulder is characterized not only by a painful shoulder, but also reduced range of motion, shoulder instability, and muscle weakness or fatigue. It is even possible for bone spurs to develop on the shoulder blade, or in extreme cases, for tears to occur in the muscles and tendons of the rotator cuff. Joint laxity, or instability in the shoulder ligaments, is a risk factor for developing swimmer’s shoulder, as are poor swimming stroke mechanics. 

Swimmer’s Shoulder Prevention

Before we get into looking at treatment, let’s consider how this shoulder injury can be prevented in the first place. According to an article published in the North American Journal of Sports Physical Therapy, prevention should primarily focus on correcting training errors, addressing impairments (such as poor posture and weak muscles), and optimizing joint mobility as well as joint stabilization. Increasing mobility in the thoracic spine is also helpful.

In terms of swimmer’s shoulder prevention, it is extremely valuable to consult with a physical therapist. A knowledgeable therapist can provide exercises, stretches, and treatment to address the health and functionality of the shoulder as well as recommendations for training strategies. Given that a competitive swimmer can do over 4000 strokes in a day, proper stroke mechanics are critical to avoiding swimmer’s shoulder. Help with stroke mechanics can be provided by both physical and athletic therapists and trainers.

Swimmer’s Shoulder Treatment

Physical therapists are also invaluable in the treatment of swimmer’s shoulder. Many of the same approaches to prevention can also be applied to treatment, including exercises to strengthen the shoulder, stretches to improve range of motion, and improving stroke mechanics to ensure optimal function.

According to Brian Tovin of The Sports Rehabilitation Center in Atlanta, the principles of treatment for swimmer’s shoulder (as well as prevention) are as follows:

1. Address postural issues, such as stretching tight pectoral muscles
2. Ensure proper mobility of the shoulder joint, using exercises and manual therapy
3. Stabilize the shoulder blade (scapula), using exercises, manual therapy, and muscle re-education
4. Strengthen the rotator cuff, using different strengthening techniques
5. Address training errors, ensuring proper stroke mechanics and resting as needed. 

Sports medicine primary care physicians, orthopedic surgeons, and rehabilitation specialists can be consulted for severe and treatment-resistant cases of swimmer’s shoulder. In rare instances, such as when tears or bone spurs are present, surgical interventions may be necessary. 

Swimmer’s Shoulder Manual Therapy

Manual therapy for swimmer’s shoulder can take many forms, including conventional massage, specialized massage, techniques such as active release therapy, and joint mobilization. Manual therapy can address many of the principles of swimmer’s shoulder treatment and prevention, including addressing postural issues, ensuring proper mobility, and stabilizing the shoulder blade. Manual therapy can also be incorporated into strengthening exercises, where the therapist applies manual challenge or resistance to address muscle weakness. 

Some types of manual therapy can be augmented using topical lotions or creams that may be enriched with anti-inflammatory ingredients. Medical creams and lotions may include topical pain relievers (such as Voltaren), while natural products more commonly include capsaicin or menthol. Capsaicin comes from chili peppers and acts directly on the body’s pain channels to decrease the sensation of pain. Menthol comes from mint plants and has a cooling effect on the skin; like capsaicin, it acts directly on specific pain channels to relieve pain. 

Some manual therapy practitioners treating swimmer’s shoulder are using lotions or creams that contain cannabidiol, or CBD. CBD is a cannabinoid found in hemp, a sub-species of cannabis. CBD in the US was legalized with the 2018 Farm Bill.

CBD is being widely used by consumers to treat a variety of conditions, including sleeplessness, anxiety, and pain. With swimmer’s shoulder, the purpose of applying CBD to the skin around the shoulder is to decrease underlying pain and inflammation. Many of the effects of CBD are mediated by the endocannabinoid system. 

Topical CBD is not absorbed into the bloodstream but does act in the skin and nearby tissues. This makes it a good option for treating pain that is more superficial, such as in joints like the knee and shoulder.

Topical CBD can be used as part of a manual therapy treatment, which often uses lotions or creams for lubrication. It can also be used at home by the patient for sustained benefits. Topical CBD is extremely safe. 

Anti-Inflammatory Supplements

In addition to the use of topical anti-inflammatories, oral anti-inflammatory medications may help to decrease inflammation in swimmer’s shoulder. The most commonly used are over-the-counter anti-inflammatories such as Aspirin, Alleve, and Advil. For more severe cases of swimmer’s shoulder, prescription anti-inflammatory medications may be given, such as Celebrex.

Anti-inflammatory dietary supplements may be helpful in reducing inflammation naturally. These include things like omega-3 fatty acids, curcumin, zinc, and cat’s claw. There are a range of natural anti-inflammatories that have different mechanisms of action, such as reducing levels of inflammatory chemicals and regulating inflammatory pathways.  

CBD is not technically considered a dietary supplement, but as an extract derived from plants, it shares common properties with other supplements. In addition to topical application, CBD can also be taken orally to reduce pain and inflammation. CBD decreases inflammation in a few different ways, including lowering oxidative stress and reducing levels of inflammatory chemicals.

While topical CBD is good at treating pain in tissues that are close to the skin, oral CBD gets into the bloodstream, making it a good option for pain that is experienced more deeply. CBD is available in different forms, including water-soluble CBD, CBD oil, and CBD capsules.

Water-soluble CBD is more bioavailable than CBD oil, which means that more of it enters the bloodstream for distribution throughout the body. Water-soluble CBD is also absorbed more quickly, so it has a faster onset of action. It is safe to use both oral and topical CBD at the same time.

Swimmer’s Shoulder Summary

Swimmer’s shoulder is an injury that results from overuse and irritation of the shoulder joint. The complex anatomy and functionality of the shoulder make swimmer’s shoulder difficult to treat, but there are prevention and treatment strategies that are effective in most people.

Areas to address include posture, shoulder mobility, stabilization, muscle strength, and stroke technique. Manual therapists and sports physicians with expertise in treating swimmer’s shoulder should be consulted for personalized treatment. At-home management, including topical CBD lotion and oral anti-inflammatory medications and supplements (such as CBD) can also be used. 

The content on this site is for informational and educational purposes only and have not been evaluated by the Food and Drug Administration. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions or before beginning any nutrition, supplement or lifestyle program.

Dr. Genevieve Newton, publishers of this content, or Fringe, Inc. takes no responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.