Swimming is both a popular pastime and competitive sport, particularly within Australia where the pools and beaches are packed during the summer with locals and tourists alike as well as elite athletes training for their chance at a medal at the Olympics. In fact swimming is Australia’s most popular sport with over 3 million Australian’s regularly involved. It is also our most competitive sport on the international stage with 188 medals (60 gold) at the summer Olympics compared to our second highest sport, Athletics with 73 total medals (21 gold).
Competitive swimming consists of 4 different strokes with most swimmers focusing on one stroke (except for those individual medley swimmers). Despite this freestyle is by far the most common stroke performed, with athletes that compete in other strokes still swimming their fair share of freestyle each session. A competitive swimmer may often be required to swim 10-15km a day! That’s more than 2500 repetitions per shoulder. With such a high level of training and repetition it isn’t surprising that swimmer’s will often experience injuries throughout their career with shoulders, knees and spine being the main areas of concern
Shoulder injuries are by far the most common injury in swimmers with anywhere between 40-91% of competitors experiencing shoulder pain. Whereas most sports generate power from the legs, swimmers gain most of their movement from the upper body. At one point “Swimmer’s shoulder” was suspected to be due to impingement of the rotator cuff muscles, however further research has shown that shoulder pain in swimmers is multifactorial, including poor technique/biomechanics. As a result of these factors swimmer’s may experience conditions such as shoulder impingement, overuse injuries such as tendinopathies, muscle fatigue and increased shoulder laxity.
So what can we do to help prevent and treat these injuries? Ensuring swimmers, coaches and health practitioners can identify early signs of injury and prevent where possible is of course the most ideal scenario. The most obvious step to preventing these types of injuries in swimmers is stroke correction. Correct stroke patterns to avoid overuse of smaller muscles and impingement as well as changes such as dropping elbow height, wider hand entry and earlier exit can help decrease these injuries in the shoulder. Minimising hand paddles and band sets can also help, especially when factors are identified pre-injury.
An additional focus should be given to strengthening, endurance and flexibility exercises out of the pool such for the rotator cuff, shoulder blade muscles, core and lower back muscles. These can be exercises using a theraband or exercise ball, dumbbells and body weight and can often be guided by a health practitioner such as a physiotherapist or exercise physiologist depending on what is identified during an assessment. If an injury is already present then rest (such as avoiding aggravating strokes) followed by specific rehabilitation exercises and gradual return to full training load is optimal to achieve a return to sport and minimise the risk of re-injury.