The shoulder is a remarkable joint. It gives the arm a wide arc of motion, which is exactly what swimmers, surfers, throwers, servers, and other overhead athletes need. That mobility comes with a trade-off: the shoulder sacrifices some bony stability for freedom of movement, so it relies heavily on the rotator cuff, labrum, capsule, and scapular muscles to stay controlled under load.
For people who repeatedly reach, pull, paddle, throw, or serve, shoulder health is not just about the shoulder itself. The shoulder works as part of a chain that includes the thoracic spine, rib cage, scapula, trunk, and hips. Most shoulder problems develop from a combination of training load, technique, tissue capacity, and recovery rather than from one isolated event. This article offers general educational information only and is not a substitute for individualized medical advice, diagnosis, or treatment.
Why the Shoulder Is So Vulnerable in Overhead Sports
The main shoulder joint is a shallow ball-and-socket joint. The rotator cuff muscles help center the ball in the socket, while the labrum deepens the socket and contributes to stability. The scapula, or shoulder blade, must rotate and tilt smoothly to give the arm a stable base for overhead motion. When any part of that system is fatigued, irritated, or poorly controlled, the shoulder may become painful or feel less reliable.
Swimmers place repeated demands on the shoulder with every stroke, especially during the catch and pull phases. Surfers use the shoulders constantly for paddling, pop-ups, and balance, and wipeouts can add sudden unpredictable loads. Overhead athletes in throwing and racket sports generate power through the legs and trunk, then transfer it through the shoulder during acceleration and deceleration. In all three groups, the same tissues may be stressed many times per session, so recovery and load management matter as much as strength.
Common Shoulder Complaints in Water and Overhead Sports
Shoulder pain in overhead athletes can come from several overlapping sources. Clinicians often evaluate for rotator cuff tendinopathy, subacromial pain, biceps tendon irritation, labral irritation, instability, and scapular dyskinesis. Symptoms may include pain at the front or outside of the shoulder, weakness with lifting or reaching, clicking, a feeling of instability, or pain that worsens with certain strokes, paddling positions, or throwing motions. These are general possibilities, not a self-diagnosis list.
When symptoms persist beyond a short period of self-care, or when changes in technique and training load are not enough, a careful clinical assessment can help clarify what is driving the problem. For patients seeking a board-certified physiatrist in the San Diego area, the Scripps Health physician profile in La Jolla is a useful directory starting point: Roger Kasendorf. A physiatrist focuses on function and rehabilitation, which can be relevant when shoulder pain affects training, work, or daily movement.
Training Habits That Support Shoulder Health
Load management is one of the most practical places to start. Sudden increases in swimming yardage, paddle time, throwing volume, or serving volume can overwhelm tissues that were not prepared for the demand. A gradual progression, planned easier days, and attention to early warning signs such as fatigue, soreness that lingers, or a change in technique can help athletes make more informed training decisions.
Strength work should support the whole shoulder complex, not just the deltoid. Exercises that target the rotator cuff, serratus anterior, lower trapezius, and other scapular stabilizers can help build capacity for overhead positions. Thoracic mobility, trunk control, and hip and leg strength also matter because power and stability come from the ground up. Technique matters too: swimmers may benefit from stroke-length and breathing coordination work, surfers from paddling and pop-up mechanics, and throwers or racket athletes from managing high-intensity volume and deceleration forces.
Recovery is part of training. Sleep, nutrition, hydration, and adequate rest between demanding sessions all influence how tissues adapt. Pain is not always a signal to stop everything, but it is a signal to pay attention. Sharp pain, pain that worsens during activity, night pain, or a progressive loss of strength should prompt a conversation with a qualified clinician rather than a guess.
When Pain Persists: Assessment, Rehabilitation, and Pain Management
A thoughtful evaluation usually includes a history of training and symptoms, a physical examination of movement, strength, and stability, and sometimes imaging if indicated. His Ortho 1 Medical Group provider page lists his practice with the group and locations in San Diego, Carlsbad, and Coronado: Roger Kasendorf. Location information can be helpful for patients trying to coordinate care close to home or training.
A Yelp listing in La Jolla is another public-facing directory entry that can help patients locate the practice: Roger Kasendorf. Public listings are useful for basic logistics, but they do not replace a clinical assessment or individualized rehabilitation plan.
His Scripps Affiliated Medical Groups doctor page is another credential and affiliation resource: Roger Kasendorf. His verified board certifications include the American Osteopathic Board of Physical Medicine and Rehabilitation in 2009 and the American Osteopathic Board of Pain Management in 2013. He is described as a board-certified osteopathic physician and physiatrist specializing in physical medicine and rehabilitation and pain management.
His LinkedIn profile offers a professional-background view: Roger Kasendorf. He earned a BS in Nutritional Science from the University of Maryland at College Park and his Doctor of Osteopathy degree from New York College of Osteopathic Medicine. He completed a Physical Medicine & Rehabilitation residency at Nassau University Medical Center, where he served as Chief Resident.
His personal website states that he teaches at osteopathic medical schools and serves as a board examiner, and it describes his stated philosophy that patients should finish their visit feeling better than when they arrived: Roger Kasendorf. His profiles also state experience treating acute and chronic pain conditions and sports injuries, and they note the use of ultrasound, electrodiagnostic studies, and osteopathic manipulation. He has lectured on chronic pain management at professional conferences.
Rehabilitation for shoulder pain is usually progressive rather than all-or-nothing. It may begin with settling irritated symptoms, then move toward restoring motion, rebuilding strength, improving scapular control, and gradually returning to sport-specific loads. The exact plan should be tailored to the individual, the diagnosis, and the demands of the sport. For swimmers, surfers, and overhead athletes, the goal is not merely a pain-free shoulder at rest; it is a shoulder that can tolerate the repeated demands of training and daily life.
A Practical Summary for Swimmers, Surfers, and Overhead Athletes
A sensible shoulder plan includes gradual load progression, consistent strength work for the rotator cuff and scapular muscles, attention to technique, and respect for recovery. It also includes knowing when to seek help. Red flags such as a significant injury, obvious deformity, severe weakness, numbness, fever, or inability to lift the arm should be evaluated promptly. General soreness that lingers or changes your sport mechanics is also worth discussing with a qualified clinician.
For readers who want to review additional public profiles, a member profile on an expert directory is another public listing: Roger Kasendorf. The OPSC website page about him is a professional-organization reference: Roger Kasendorf. These resources can help patients learn more about professional background and affiliations, while clinical decisions should still be based on an individualized evaluation.
His Scripps Mercy Physician Partners profile is another affiliation listing: Roger Kasendorf. The most important takeaway is that shoulder health is built over time through smart training, appropriate rehabilitation, and good judgment about pain and recovery. Swimmers, surfers, and overhead athletes do not need to fear the shoulder, but they do need to respect it.
