Back in the Pool

While many Oakville swimmers enjoyed some well-needed recovery time during the summer, another season is just getting started with the first meet right around the corner. As these swimmers start to ramp up their training, inevitably a number of them will start to develop pain and injuries. Swimming requires highly repetitive motions, which tend to lead to muscle imbalances in strength and flexibility. As such, the majority of swimming injuries is related to overuse and chronic overload, which can be prevented with proper training and stroke mechanics. What are the common injuries experienced in swimmers and what are some ways to prevent them?

Shoulder

Studies have shown that roughly 40-91% of swimmers have experienced shoulder pain due to swimming.  For a great review on swimmer’s shoulder, with practical tips and exercises, refer to our past blog here.

Knee

Knee injuries are the second most common source of pain in swimmers. Similar to shoulder injuries, overuse is a major risk factor. Breaststroke swimmers have the highest reports of knee problems, with the most common injury being MCL sprains and strains to the hip flexor and adductor muscles. Freestyle swimmers tend to experience more patellar tendonitis, due to repetitive quadriceps contraction. In order to prevent these injuries the dry land program should incorporate core stabilization, hip flexibility exercises and lower body strengthening, with particular focus on the quadriceps, gluteus medius and piriformis muscles. Furthermore, avoidance of an overly wide breaststroke kick will help decrease strain on these commonly injured areas.

Spine

Low back pain is the third most common injury experienced, especially in swimmers who focus on butterfly and breaststroke. Muscle strains and ligament sprains are most common, due to core weakness and fatigue of the low back muscles. However, swimmers can experience more serious injuries such as spondylolysis, due to the hyperextension required in the lumbar spine. Endurance training of core muscles is key for prevention of low back pain. Athletes experiencing low back pain should avoid using fins and kickboards, due to the excessive hyperextension produced in the lumbar spine during their use.

Practical Tips for Athletes, Coaches and Trainers:

  • Athletes need to let their coaches/trainers/therapist know as soon as a new pain develops. The earlier an injury is addressed, the less likely it will become a chronic problem.
  • Improve stroke technique – Due to the repetitive nature of swimming, an improper stroke repeated over and over will eventually lead to injury.
  • Coaches and trainers need to be aware of changes in stroke. Athletes will make subtle changes during their stroke to avoid pain and/or injury. Rehabilitation following an injury should focus on physiotherapy, strengthening as well as improvement in stroke flaws.
  • A Pre Season Screening (or very early in the season) of the athletes is the best time to find and correct problems.
  • Identify the source of the pain in order to know how to modify/change training:
    1. Have stroke mechanics changed?
    2. Has the intensity, frequency or length of workouts changed?
    3. Has a new dry land exercise been introduced?
    4. Recent growth spurt?

Sheddon Physiotherapy and Sports Clinic does a pre-season screen on the senior teams for our local swim club (Oakville Aquatics) to determine if any swimmer is at risk for injury.  In swimmers who have already developed symptoms, the physiotherapists at Sheddon will focus on the causes that are associated with the onset of symptoms and work on decreasing pain and strengthening the athlete to get them back in the pool injury-free.

Khodaee et al., (2016). Medical Care for Swimmers. Sports Medicine. 2:27