Danielle Labuschagne
- Mar 5, 2020
- 3 min read

Physio in SWIMMING INJURIES

Swimming has always been a great passion of Chantel & Danielle as both competed competitively at provincial level in school & varsity. It is a great non-weightbearing cardiovascular sport enjoyed by all age groups and levels of ability that combines body strength, flexibility and endurance. Unfortunately, swimmers are prone to overuse injuries that relate to faulty biomechanics.

Luckily, at Dphysio, we can help correct & guide you to perform optimally pain-free!

Causes are from one or a combination of:

⦁ Poor stroke mechanics

⦁ Poor breathing technique

⦁ Poor posture

⦁ flexibility or range of motion of neck or lower back

⦁ Hyper flexibility of joints with insufficient muscular stabilisation

⦁ Decreased rotator cuff or scapular muscle strength

⦁ Insufficient core strength/stability

⦁ Decreased hip muscle strength

⦁ Overtraining

⦁ Insufficient rest period

Swimmers Shoulder

Shoulder pain is the most frequent orthopaedic injury in swimmers.
Swimmer's shoulder usually presents as subacromial impingement involving the rotator cuff tendon, bicipital tendon, or subacromial bursa.
Primary subacromial impingement involves compression of these structures due to the arm inward rotation during swimming.
Secondary impingement usually occurs due to increased joint & ligament laxity (swimmers shoulder range of motion often exhibit excessive external rotation and limited internal rotation).

Swimmers Back

The spine is also predisposed to injury in the elite swimmer, mainly with butterfly and breaststroke swimmers.
Swimming athletes are positioned horizontally in the water. The gravity and buoyancy forces travel through the body causing the low back to be positioned in extension during butterfly and breaststroke. This puts stress on the lumbar spine joints.

Causes:

Hyperextension of the lumbar spine during freestyle and butterfly
Poor kick technique
Stress fractures are a potential cause in young swimmers
Disc degeneration and facet joint degeneration in the older swimmer.
Improper timing of this butterfly stroke increases strain on low back the possibility of neck, shoulder, or back pain.
Poor flexibility of the spine and low back
Insufficient core strength to maintain straight alignment of body in water
Aggressive weight training using poor techniques
Overuse of devices eg paddles on hands, fins, kick boards- exposing the open kinetic chain of swimming to different loads and exaggerating lumbar lordosis
Tightness in the hip flexors or inadequate body roll during swimming may lead to compensation at the lumbar spine.

Swimmers Knee

Knee pain is usually found in breaststrokers.

Repetitive stress placed on the medial (inside) knee produces pain during the whip-like motion of the kick. This causes strain on the medial collateral ligament and compression on the lateral knee, possibly causing: MCL injury; irritation of the medial plica; bursal irritation at the muscular insertions of the adductor and hamstring muscles.
Breaststroke swimmers are also at a significant risk of groin injury such as adductor muscle strains.
Other knee injuries include patellofemoral pain, and medial synovitis.

Swimmers Neck

Neck pain is mainly seen in the older athlete.

Causes:

Facet joint arthritic change, and disc degeneration and/or nerve root irritation that could cause pain in the neck and/or shoulder. Arthritic change may limit neck rotation, making correct breathing patterns difficult.
Swimmers who unilaterally breath are more prone to neck pain.
Looking forward rather than directly downward, and extending the head too high when taking a breath increases the load on the neck and create pain.

How can Physiotherapy help?

Reducing pain, inflammation & tightness by therapies such as:
Deep tissue massage & myofascial release
Dryneedling
Joint mobilisation
Electrotherapy (ultra-sound, TENS units, Laser)
Strapping & taping
Postural correction
Modifying the training regime
Correcting stroke technique
Prescribing an injury specific exercise program consisting of:
Strengthening of the rotator cuff and scapular stabilizer muscles
Stabilisation exercises for hypermobile joints
Correction of muscle imbalances (such as tight hip flexors, weak glutes and core)
Stretching anterior chest musculature that may be shortened such as the pectoralis muscles
Optimization of pelvic and joint mobility both in static (without movement) and dynamic (with movement)

Stretches

is important for swimming because of the great range of muscles used in this sport. Unprepared muscles don’t perform as well as muscles which have been warmed up ahead of exercising. It is also important to stretch your pecs to prevent a poor posture of rounded shoulders.

Examples:

⦁ Posterior shoulder stretch