The 29-year-old has cut the individual medley from his program and will miss this week's national championships as he continues to recover and prepare for Games trials in Adelaide in June.

Fraser-Holmes said they were difficult, but ultimately necessary, decisions to make in order to keep his Tokyo dream alive.

"If you try to swim through it like I was trying to do during the back half of last year, you're going to be in a worse off position and not make the trials," Fraser-Holmes told the Newcastle Herald.

"If you go down the surgery route you won't be back in time to compete. So this was really my only option.

"I've got a great team around me. I've got a great physio, a great strength and conditioner, a great physiologist and a great coach. So I'm in the best hands possible to get the job done in June."

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Scans a few months ago revealed Fraser-Holmes had a "sizeable tear" in his subscapularis simply after "years of wear and tear".

"It's a pretty important muscle for swimmers, it would be like a hamstring for footy players," he said.

Fraser-Holmes has been on a "rehabilitation program" ever since and although a "slow process" feels like "it's progressing every week".

He didn't want to risk racing at nationals, which start on the Gold Coast on Wednesday, and potentially re-injure himself.

The London 2012 and Rio 2016 representative hopes a decade worth of "international experience" will help make up for any lack of competition.

Fraser-Holmes has also narrowed his focus in the water.

"I'll just be swimming the 200m freestyle and no medleys," he said.

"I've been limited in terms of what I can do at training with other strokes because of my shoulder.

"So we've bit the bullet even though I'm used to having multiple events."

Fraser-Holmes has the chance to finish top two and progress solo or possibly earn his ticket to Japan via a relay spot.

"It's two cracks in the one race," he said.

Fraser-Holmes, who returned to the sport following a 12-month ban issued in June 2017 by FINA for three missed doping tests, has a personal best of one minute and 45 seconds for the men's 200m freestyle.

He said the qualifying time is 1:46.5.

Meg Bailey will lead the Hunter contingent in action at the 2021 Australian Swimming Championships.

It's being held at the same Gold Coast venue where she represented the Dolphins at the Commonwealth Games three years ago.

Bailey, who won two gold medals at the recent NSW state titles, will contest both women's individual medleys (200m, 400m) as well as the butterfly double (100m, 200m).

Tristan Hollard has eyes on all three men's backstroke distances (50m, 100m, 200m) across the carnival while Abbey Harkin will do the same in the women's breaststroke (50m, 100m, 200m).

Charlie Hawke, 18, has a packed program with seven open events - 50m, 100m, 200m butterfly; 100m, 200m freestyle; 200m, 400m IM.

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