Did you know that the average high school swimmer performs 1 to 2 million strokes annually with each arm? It is is no wonder that from an orthopaedic perspective, overuse conditions predominate as the type of injuries that swimmers will encounter. Aside from overuse injuries, incorrect technique can also predispose the swimmer to potential injury.
Poor stroke mechanics applied in freestyle or “front crawl” are frequently implicated in the development of shoulder problems. Similarly, the arm pull in butterfly and breaststroke can cause stress syndromes in the elbow and the with its specialised kick in breaststroke, similar similar stress injuries to the knee can occur.
Fun fact: 90% of complaints by swimmers that bring them to the doctor and/or physiotherapist are related to shoulder problems.
Swimmer’s shoulder is the most common injury seen.
- It is exists as an inflammation of the supraspinatus and biceps tendon within the subacromial space.
- The onset of symptoms is often associated with altered posture, glenohumeral (shoulder) joint mobility, neuromuscular control, or muscle performance.
- Additionally, training errors such as overuse, misuse, or poor technique may also contribute to this condition.
Many swimmers have inherent ligamentous laxity and often will have multidirectional shoulder instability – essentially, more movement in the joint.
However, all swimmers develop muscle imbalances where the adductors and internal rotators of the arm over develop (due to the nature of swimming). Unfortunately, this leaves a relative weakness of the external rotators and scapular stabilisers – simply because they don’t get used as much. Consequently, this muscle imbalance overuse and/or poor technique results in an anterior capsule laxity. These all culminate and allow the humeral head to move forward and up thereby, compromising the subacromial space (where the supraspinatus and biceps tendons run through) causing an irritation/impingement – Swimmer’s Shoulder.
Other Common Swimming Injuries
Knee injuries are almost exclusively to breaststrokers:
Did you know? A survey of 36 competitive swimmers found that 86% of them reported at least 1 episode of knee pain!
Foot and Ankle:
- Tendinitis of the extensor tendons
- Stress syndromes
- Lateral epicondyalgia
Wrist and Hand:
What Causes Swimming Injuries?
Swimming injuries most commonly occur as a result of:
- Poor technique
- Sudden spike in workload (non-graduated)
There are several factors that can predispose a swimmer to developing an injury. Your Physiotherapist is highly trained in identifying these and correcting them to reduce your risk of developing an injury. Some of the factors that can contribute to the development of an injury include:
- Poor rehabilitation following a previous injury
- Joint stiffness or swelling
- Muscle tightness
- Bony anomalies
- Poor scapulohumeral rhythm
- Poor motor control and motor planning
- Inadequate joint range of motion
- Inadequate recovery periods from training and racing
- Poor warm up / warm down
- Poor core stability
- Poor proprioception or balance
Swimming Injury Prevention
Prevention is key!
Evidence suggests that injury management should focus on prevention and early treatment, addressing the impairments associated with the condition, and analysing training methods and stroke mechanics. (Tovin, 2006.)
A large part of managing an injury involves communication between parents, coaches and your physiotherapist to not only to enhance recovery but prevent injury.
PhysioWorks has a swimmer screening service that is available both in the clinic and at your pool for the whole squad. Please contact us for more information about our swimmer screening and injury prevention program.
Swimming Injury Treatment
Treatment involves manual therapy but more importantly, finding the root cause of the injury and modifying stroke technique to prevent the issue from reoccurring.
Common treatment modalities include:
- Adopt a good stroke technique
- Mix it up! Avoid overtraining in one particular style of swimming
- Core strengthening, rotator cuff strengthening and land based exercises done pre, post and during your swimming season.
- TENS machine.
- Mobilisations and manipulations.
- Rest, Ice, Compression, Elevation (RICE).
- Acupuncture / Dry Needling.
Any further questions about the above injuries or prevention, please do not hesitate to consult your PhysioWorks physiotherapist.
Any further questions about the above injuries or prevention consult your local swimming physiotherapist.
Common Swimming Injuries
- Adductor Tendinopathy
- Back Muscle Pain
- Bicep Tendonitis
- Bulging Disc
- Bursitis Shoulder
- Chondromalacia Patella
- Degenerative Disc Disease
- Dislocated Shoulder
- DOMS – Delayed Onset Muscle Soreness
- Facet Joint Pain
- Femoroacetabular Impingement (FAI)
- Groin Strain
- Hamstring Strain
- Hip Labral Tear
- Knee Ligament Injuries
- Meniscus Tear
- Muscle Strain (Muscle Pain)
- Neck Arm Pain
- Neck Headache
- Overuse Injuries
- Pinched Nerve
- Piriformis Syndrome
- Plica Syndrome
- Poor Hip Core
- Rotator Cuff Calcific Tendinitis
- Rotator Cuff Syndrome
- Rotator Cuff Tear
- Sacroiliac Joint Pain
- Shoulder Impingement
- Shoulder Tendonitis
- Spondylolysis (Back Stress Fracture)
- Swimmer’s Shoulder
- Thigh Strain