common swimming injuries

As the summer Olympics approach athletes and fans prepare for the athletic contests. One of the most popular sports in the summer is swimming, so with that in mind, we will take a look at some common swimming related injuries and some preventative approaches.

Shoulder:
When we think swimming injuries, the shoulder comes to mind as the most commonly involved joint. In fact, the term ‘swimmer’s shoulder’ was coined to discuss the unique anterior shoulder pain that swimmer’s experience as a result of their sport resulting from the triad of swimming biomechanics, muscular overuse and fatigue, and glenohumeral laxity and instability. The typical swim stroke of shoulder adduction and internal rotation leads to hypertrophy of the pectoralis major and lattisimus dorsi and the under recruitment or over exertion of the teres minor, pectoralis minor and serratus anterior. As the arm is in constant overhead motion, the inability of those muscles to provide adequate stability can lead to increased pain and pathology.

Knee:
Symptoms involving knee pain would not necessarily be thought to occur in swimming, but it is the second most common complaint amongst swimmers. The breaststroke is the most likely to result in pain and the usual area of concern is the medial knee compartment, with some anterior pain, as well. The unique whip like kicking motion of that stroke in conjunction with water resistance can lead to a variety of medial knee pathology including MCL tenderness, pes anserinus, or hip flexor and adductor strains. The patella may also be overloaded if swimmers are constantly kicking and maintaining tension on their patella tendon.

Back:
As swimmers propel themselves underwater they rely on hyperextension of their spine in order to streamline their bodies. Constant hyperextension can lead to developing extension based low back disorders, spondylolysis, and degeneration over time. Breaststroke and butterfly tend to place the most strain on the low back.

Prevention:
The common denominator in developing an injury as a swimmer is stroke mechanics. If the stroke movement deteriorates due to fatigue, muscle imbalance or stress, pain ensues. As athletic trainers, our job is not to change their stroke mechanics, but rather, to work with the coach and athlete to identify overload that is leading to pain. Once identified, the coach can correct the movement and reinforce proper stroke mechanics. To help swimmers increase their strength, endurance and shoulder stability, simple exercises can be performed as a ‘prehab’ strategy. Exercises that address the external rotators, rhomboids, lower trapezius and serratus muscles can effectively stabilize the head of the humerus and decrease strain as a result of their sport. Incorporating a core stability training program can help avoid low back pain and degeneration.

When athletes improve their underwater form, strengthen their shoulders and stabilize their core, they can better handle the high training loads that lead to success. Working with swimmers to address these areas can also keep them under the water and out of the athletic training room.

Reference:
Wanivenhaus, F., et. al. (2012). Epidemiology of injuries and prevention strategies in competitive swimmers. Sportshealth. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435931/pdf/10.1177_1941738112442132.pdf