Swimming Injuries and Prevention

Swimming Injuries and Prevention

Overview

The most common swimming injury is to the shoulder and the most common shoulder injury is due to impingement of the rotator cuff tendons, the biceps tendon and the bursa in front of the shoulder.

Why does this happen?

• due to tightness in the back of the joint
• hypermobile shoulder joint
• posture i.e. forward head, rounded shoulders, blades pulled forward, flexed mid spine
• tight muscles in the front of the shoulder - the pect. major and minor
• lengthened and weak muscles between the shoulder blades - mid and lower traps
• weak blade protractors - serratus anterior
• weak rotator cuff muscles
• tight lat. dorsi
• training errors
• overuse - i.e. not enough recovery
• misuse - i.e. improper form or equipment
• abuse - i.e. excessive training with paddles
• disuse - time off - atrophy

What to do?

1. Postural correction - i.e. correct forward head and sloping shoulders and stretch mid spine( i.e. over ball)
2. Stretch tight front shoulder muscles - i.e. pect. major and minor
3. Stretch lat. dorsi
4. Stretch back of shoulder joint and muscles - horizontal adduction stretch
5. Strengthening and stability exercises for shoulder blade stabilizers - mid and lower traps, serratus anterior and rhomboids
6. Strengthen rotator cuff especially external rotators
7. Education re: training, equipment, recovery etc.
8. Address mechanics of stroke - i.e. freestyle - do not cross the midline with hand entry, have symmetric and about 45 degrees of body roll, breathe on both sides, head position is neutral, and not too much length in stroke and have in a straight line; i.e. backstroke - pull through with elbows flexed, have enough body roll, and not too much time with arm turned inward; i.e. butterfly - arms enter not too far outside or too close to the line of shoulder, need strong hip and trunk; i.e. breaststroke - not too much elbow extension, hips should not be tight and should have strong hip external rotators and a strong and stable pelvis
9. Listen to your body

Remember the importance of trunk core stability and scapular(shoulder blade) stability in the prevention of shoulder injuries

Download the stretch sheet (PDF)

Most important stretches to do:

Pectoralis minor	Pectoralis major (lower)	Pectoralis major (mid)
Pectoralis major (upper)	Latissimus dorsi with back against the wall to prevent cheating	Cross adduction for back of shoulder
Extension stretch over ball or roll	Lower extremity stretches - i.e. front of thighs, buttocks, and calves

Strengthen and stabilize scapula(shoulder blade):

Rowing in prone	Prone extension	Prone horizontal abduction
Superman "T"	Superman "Y"	Superman "I"
Prone, supported on elbows	Quadraped position	Pushup position
Pushup position w/ hands on wobble board	Walk-outs from knees	Walk-outs from ankles

Rotator cuff strengthening:

Internal with elbow at the side with tubing	External with elbow at the side with tubing
Internal with elbow at the level of the shoulder with tubing	External with elbow at the level of the shoulder with tubing

Download the stretch sheet (PDF)

Happy swimming!

Florence MacDonald-Bain, Physiotherapist