Swimming is a fantastic sport that combines body strength, flexibility and endurance. Swimmers are unfortunately prone to overuse injuries affecting the shoulder, neck, lower back and knees.
Some reports suggest that the average high school swimmer performs 1 to 2 million strokes annually with each arm. It is no wonder that from an orthopedic perspective, overuse conditions predominate as the type of injuries that swimmers will encounter. Aside from overuse injuries, an incorrect technique can also predispose the swimmer to potential injury. Some of the most common injuries seen in swimming are swimmer’s shoulder, shoulder labral tears, and breaststroker’s knee.
Swimmer’s shoulder. Swimmer’s shoulder is the term used to describe the problem of shoulder pain in the competitive swimmer. It is normally due to inflammation of one of the tendons in the shoulder. Symptoms include pain along the back of the shoulder that feels deeply set in the muscles, pain along the front of the shoulder, a decrease in shoulder range of motion, a decrease in strength and possibly increased joint laxity. Prevention includes strengthening the muscles around the shoulder (rotator cuff), allowing enough time to rest between swimming workouts to recover, proper technique and proper posture in and out of the pool. Treatment for swimming shoulder includes complete rest or a significant reduction of workouts, anti-inflammatory medication, a strengthening rehabilitation program, ice and practicing proper technique and posture.
Labral tears. The shoulder labrum acts to deepen the area for the humerus (upper arm) to lie. In swimming and water polo, the labrum is continually rubbed during the high volume of rotations that sometimes leads to a tear of that cartilaginous structure. Symptoms include a deep achy pain in the shoulder, pain with overhead motions, popping, clicking or grinding in the shoulder, shoulder weakness and a decline in performance. The best way to prevent a labral tear is to have a consistent shoulder strengthening program that focuses not only on muscular strength but also muscular balance. Conservative treatment for labral tears include termination of activity, icing, anti-inflammatory medication and physical therapy. If conservative methods are unsuccessful, surgical intervention is required with the appropriate post-surgical care.
Breaststroker’s knee. During breaststroke the leg whips out helping to increase the speed of the body through water. As the tension increases during this kicking phase, the force generated on the inside of the knee can cause problems to the Medial Collateral Ligament (MCL) which is the ligament that stabilizes the inside of the knee. Symptoms of breaststroker’s knee include general knee pain, swelling, sharp pain when placing the knee under stress and long-term breaststroke swimmers may become knock-kneed. Prevention includes proper technique and knee strengthening exercises. To treat this injury, athletes need to rest, ice, take anti-inflammatory medication and participate in a rehabilitation program.
Aaron Armstrong, MPE, ATC
Athletic Trainer
Elite Sports Medicine Clinic at the Sports, Spine and Rehabilitation Centre
esmbahamas@gmail.com
Aaron Armstrong holds a Bachelor of Science degree from Temple University in Philadelphia, PA in Athletic Training and has been a Board Certified Athletic Trainer since 2012. He also earned a Master of Physical Education degree in Athletic Administration from Idaho State University in Pocatello, ID.
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