This Month in Sports Rehabilitation: Swimming (July 2011)

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Swimmers Clinic



Swimming Biomechanics and Injury Treatment (pdf)

More than 120 million Americans participate in recreational or competitive swimming, and whether they are recreational lap swimmers, training for a triathlon, or preparing for the All-City swim meet, most swimmers seek to optimize performance and reduce the risk of injury in training and competition.


Hard Work, High Stress


Year-round competitive swimmers can average 6,000-10,000 yards per day using freestyle as their primary training stroke. At an average of eight to 10 arm cycles per 25 yards, a swimmer completes more than 30,000 shoulder rotations each week, placing tremendous stress on the shoulder joint (Heinlein et al, Sports Health, 2010).


Although the shoulder is the most frequently-injured body part in swimmers, back and knee injuries are also common. Approximately 50 percent of competitive swimmers develop shoulder pain severe enough to cause an alteration of their training schedule (Stocker et al, Clin J Sports Med, 1995).


Swim Injuries


Causes of swimming-related shoulder injuries include faulty stroke mechanics, training errors, overuse (repetitive micro-injuries) and muscular imbalances. Decreased body rotation, poor timing and straight arm pull are common stroke faults. Training errors include inappropriate yardage, intensity, frequency or progression. Swimmers making a transition to a new level of swimming (age group, high school, college) and potentially longer distance demands in practice are at an increased risk for injury.


Swimmers Clinic at UW Sports Rehabilitation


UW Health Sports Rehabilitation is committed to keeping swimmers of all ages and skill levels in the pool. Our team of physical therapists and athletic trainers perform biomechanical, underwater video swimming evaluations in combination with a thorough musculoskeletal examination to address swimming injuries. A treatment plan may include drills to correct stroke faults, training recommendations, and/or exercises to normalize strength, flexibility, and posture.


For individuals interested in improving performance, underwater video swimming evaluation and corrective stroke drills are offered. Our staff collaborates with the UW Health Sports Medicine physicians for comprehensive and efficient injury care.


The Stroke View System


UW Health Sports Rehabilitation uses Stroke View, a four-camera system that allows for simultaneous underwater and over-water video capture from multiple angles. Stroke View has a 22-inch monitor on the pool deck for immediate review and feedback. 


Improved Trunk Rotation


After working on various stroke correction drills, the swimmer is able to correct his stroke fault and now demonstrates good trunk rotation, as evidenced by an increased rotation of hips and shoulders along the body's "long axis" - a full head-to-toe rotation that generates optimum power.



  • Heinlein, S, Cosgarea, A. Biomechanical Considerations in the Competitive Swimmer's Shoulder. Sports Health: A Multidisciplinary Approach November 2010 (2):519-525.
  • Stocker D, Pink M, Jobe, F. Comparison of Shoulder Injury in Collegiate and Master's Level Swimmers. Clin J Sports Med. 1995 Jan;5(1): 4-8.
  • Bak K. The Practical Management of Swimmer's Painful Shoulder: Etiology, Diagnosis, and Treatment. Clin J Sport Med. 2010 Sept;20(5):386-390.