Your issues might be the result of poor technique and/or rotation limitations in other parts of your spine. Often triathletes present with loss of mobility in the thoracic spine due to training in the time trial position and recovering slouched over a desk. Often swimmers extend their neck to “sight” during open-ocean swimming or have difficulty maintaining their head in neutral positions during training and racing—this results in increased compression, inflammation, and pain on the joints. It is important to maintain good joint mobility, muscular flexibility, and strength balance to avoid injury—for instance, breathing on both sides.
Technique Is Key: Slight cervical rotation should be sufficient to maintain your downward eye in the water and “breathe in the pocket” (the space created by the crown of your head).
Pain Management: Working with a physical therapist will help restore normal joint and muscular mobility. Movements like upper trapezius stretch, open-book stretch, and doorway pectoralis stretch should help improve mobility required for swimming.
Casey Maguire is a Los Angeles-based orthopedic physical therapist who has treated professional triathletes, cyclists, and multiple athletes in the NBA, NHL, NFL, and USTA. His focus is on functional biomechanics.