Swimming is among the most popular low-impact fitness activities, with more than a million
competitive and recreational swimmers in the United States and many thousands in SA. More
than one-third of these athletes practice and compete year-round. Elite swimmers may train
more than five miles a day, putting joints through extreme repetitive motion. Most swimming
injuries affect the shoulders, knees, hips, or back, depending on stroke.
WHAT CAUSES SWIMMING INJURIES?
With overuse comes fatigue and failure to adhere to proper stroke techniques. Often swimmers
demonstrate tremendous flexibility or joint laxity, which can be normal. Slight injuries and
micro-trauma can cause shoulders to become unstable and lead to shoulder pain and
tendinitis. Other repetitive injuries include inner knee problems and hip problems from
breaststroke kicking, and back injuries from dolphin kicks or dry-land cross-training.
WHAT ARE THE MOST COMMON SWIMMING INJURIES?
Swimmer’s Shoulder
The shoulder is the joint most commonly affected by swimming injuries or overuse. Shoulder
injuries may include rotator cuff impingement – pressure on the rotator cuff from part of
the shoulder blade or scapula as the arm is lifted. Biceps tendinitis (painful inflammation
of the bicep tendon) and shoulder instability, in which structures that surround the
shoulder joint do not work to maintain the ball within its socket, or can result from
fatigue and weakness of the rotator cuff and muscles surrounding the shoulder blade.
Lower Body Injuries
Knee injuries that involve the tendons and ligaments (breaststrokers’ knee) are common.
Breaststrokers may also experience hip pain from inflammation of the hip tendons.
Back problems, including lower back disk problems or another problem at the junction between
the spine and pelvis, termed spondylolysis, may be increased by the dolphin kick often used
in competitive swimming.
HOW CAN SWIMMING INJURIES BE PREVENTED AND TREATED?
Communication among athlete, parent, coach, and medical professional is critical to both
injury prevention and successful recovery
Use good stroke technique
Lessen repetitive strokes that are causing the overuse injury
Perform core strengthening and cross-training exercises as part of pre and early season
routines
Consider alternative training techniques rather than training through an injury
Use periods of rest to recover
Focus rehabilitation efforts on rotator cuff and scapular strengthening for most shoulder
injuries and pelvic and hip strengthening exercises for hip and knee injuries
Speak with a sports medicine professional or athletic trainer if you have any concerns about
injuries or prevention strategies
The athlete should return to play only when clearance is granted by a health care
professional
PHYSIOTHERAPY INTERVENTION :
We as Physiotherapists are skilled at diagnosing the specific injury , and then through
multiple modalities , we are able to treat the various common conditions discussed above and
accelerate injury repair.
Deep soft tissue release
Manual therapy and joint mobilisation
Electrotherapy
Shockwave therapy
Acupuncture
Exercise rehabilitation
To prevent the injury recurring, a personalised strength and flexibility programme should be
prescribed .
For the end of season and pre-season, players should seek our professional advice to do a
screening and biomechanical assessment , as this will detect any abnormalities early on and
then a structured programme can be designed for them as a preventative measure. This will
hopefully allow the players to have less injury time during the season.
Clinton Grobbelaar
( Physiotherapist )