Sports Medicine Training Tips: Swimming
How can swimming injuries be prevented?
Swimmers, coaches and medical professionals continually seek to optimize performance and reduce the risk of injury in training and competition. The following are recommendations aimed at preventing swimming related injuries:
Core Stabilizations Exercises
One of the most important keys to preventing shoulder injuries is developing and maintaining your core strength. The majority of the force produced in swimming is done with the trunk and shoulder, however, most swimmers rely too much on their shoulders. Developing a strong core will reduce the stress on your upper limbs to move you through the water and reduce the occurrence of shoulder injuries.
Head and shoulder postural alignment is thought to influence muscular balance around the shoulder. Poor shoulder blade stability (postural strength) is correlated with shoulder impingement and pain. The shoulder blade can be viewed as the link in the kinetic chain from the legs and trunk to the shoulders.
Avoid Over-Stretching the Shoulder
A majority of swimmers have ample if not excessive shoulder mobility. Stretches that focus on stretching the front of the shoulder are not necessarily helpful and may contribute to shoulder looseness (hypermobility). Shoulder hypermobility along with muscle imbalance and fatigue can lead to shoulder pain.
Gradual Increase in Yardage
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. Special attention should be paid to any swimmers making such a transition, and distance increases should be gradual and monitored closely.
Communication among swimmer, parent, coach and medical professional is critical to both injury prevention and successful recovery.
Good Freestyle Technique
Good freestyle technique is critical in the prevention of shoulder injuries as freestyle is the most common training stroke. Good freestyle technique include the following characteristics:
- Body rotation: In swimming the body should rotate about an axis defined by a line from the top of your head through your neck, back, and legs. During body rotation the shoulders, torso and hips should all roll together as one. Adequate body rotation is essential to decreased shoulder stress by transferring the power from the core to the propulsive arm in the water. Body rotation also allows for a more efficient stroke and decreased distance per stroke.
- Bilateral (both sides) breathing: Developing a good, even body rotation through an efficient bilateral breathing pattern is key to reducing shoulder injuries.
- Hand entry: Enter water with a flat hand, fingertip first. Avoid entering with thumb first, as this puts the shoulder into excessive internal rotation, which contributes to shoulder impingement and pain.
- Avoid hand crossing midline at entry into the water: Crossing midline forces the shoulder into an impingement position which may contribute to shoulder pain.
- High elbow (bent elbow) catch and pull through technique: Swimmers should grab or catch the water with a bent elbow in order to utilize the larger, more powerful chest and back muscles, rather than rely solely upon the shoulder muscles.
How are swimming injuries treated?
The treatment needed will vary from injury to injury and swimmer to swimmer. At the UW Health Sports Medicine Center we take a comprehensive approach to treatment. This involves starting with an evaluation by a sports medicine physician or sports rehabilitation specialist (physical therapist or athletic trainer) and x-rays or MRIs, if needed.
Following this evaluation, most swimmers will undergo specialized rehabilitation that may include strengthening/postural exercises, flexibility exercises, manual therapy treatments and swim drills to correct stroke flaws. Video analysis - over-water and underwater video - of stroke biomechanics may also be used to identify stroke faults that may be causing pain.
Injury treatment plans may involve icing, relative rest with nonaggravating strokes, kicking drills and modification in training both in and out of the pool. At times, it may be appropriate to rest from swimming until symptoms improve. However, most swimmers are able to continue to participate with reduced distance or by only performing kicking activities.