Purpose of Review <p>Shoulder pain is the most common cause of pain in competitive swimmers. This review will cover the current available literature on the pathogenesis, assessment, management, and gaps in knowledge of swimmer’s shoulder; and provide insight into the practical clinical evaluation, treatment, and future directions from a multi-disciplinary group of authors with extensive clinical experience treating swimmers.</p> Recent Findings <p>Good thoracic mobility and extension is vitally important in the scapula’s success maintaining dynamic stability of the glenohumeral joint in swimmers. Both the front squat and overhead squat are good functional movement assessments for shoulder mobility and stability. Three evidence-based risk factors for shoulder pain in swimmers have been identified by experts and supported with evidence in the literature: low posterior shoulder strength-endurance, inconsistent training load, and poor stroke technique. Additionally, twenty-two other risk factors have been proposed by swimming experts, though these have not been investigated adequately in the literature.</p> Summary <p>Overdevelopment of the anterior shoulder muscles combined with tightness in the pectoralis minor and posterior shoulder capsule, imbalanced scapular stabilizers, and decreased thoracic mobility can lead to fatigue, dysfunctional swim stroke, and shoulder pain. Evaluation should focus on known risk factors and utilize functional movements. Treatment should be interdisciplinary and include relative rest, anti-inflammatories, stretches of the posterior capsule and pectoralis minor, and a progressive exercise program of shoulder and scapular strengthening.</p>