Swimming involves very repetitive movements of the shoulder, your son may have developed an overuse injury of the shoulder. Generally XRAY and Ultrasound are not the best imaging for these type of injuries. MRI is considered the gold standard for soft tissue conditions.
Why has your son developed this injury? This is not easy to answer without a proper assessment and examination. Most musculoskeletal conditions can be related to a dysfunctional movement pattern, generally caused by an imbalance of strength, flexibility and/or stability. It does not alway have to be an isolated shoulder problem too, for example, if you have a stiff neck this can lead to shoulder problems due to the change in mechanics causing extra load on the shoulder. So although the shoulder may have been tested and examined, I would stongly suggest having the neigbouring joints assessed too.
If your son has been swimming for a long time, and has not participated in other sports, this may also be a risk to further injury too. Some studies performed on tennis players showed that the earlier the player specialized in the sport (before the age of 14) there was an increased risk of injury, Other findings interestingly were also an increased risk of depression, drug use, failure/drop out of the sport and did not improve chances of successful transition into professional ranks compared to players who specialised in the sport after the age of 14.
Other things to consider with your son's shoulder problem are
1) Sitting posture (particularly at school)- how much time spent sitting?
2) increased use of mobile devices (laptops, ipads, smartphones etc)
3) School bags- weight, backpack vs over the shoulder bags.
Hope all this information helps, and i hope your son gets back to competitive swimming. If you would like any more information, please feel free to contact me. firstname.lastname@example.org
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