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Swimming is considered a very safe competitive sport, but overuse injuries do occur. With participants that include both men and women, as children, high school, college, and even professionally adults, swimming requires repetitive overhead motions.

Swimmers are typically prone to injuries that affect the upper extremity (particularly the shoulder joint), the knee, lower back, and hip. Common injuries caused by overuse and repetitive strain include, ligament damage (strains, tears, and instability), tendonitis, and spine disorders like spondylolisis and herniated discs.

Causes

  • The main cause of swimming injuries is overuse
  • As a swimmer fatigues the use of proper swimming technique decreases, causing stress on the muscles and joints that are already under stress from repetitive motions
  • Even a minor injury can progress to a serious injury due to the volume and intensity of swimming. Mild irritation of the shoulder can result in shoulder instability with severe pain.
  • Overuse injuries may occur at the knee from kicking or pushing of the wall, at the hip from the breaststroke kick, and in the back from the butterfly dolphin kick

Risk Factors

There are intrinsic and extrinsic risk factors for injury. Intrinsic factors are a child’s individual musculoskeletal issues, which can include skeletal immaturity (bones and joints that are still developing) or muscle weakness. Extrinsic factors are the environment in which an athlete performs, which can include the level of competition: how much, how hard and how long play lasts.

Other common risk factors for swimming injuries include:

  • The shoulder joint is at the greatest risk for swimming related injuries.
  • Common shoulder injuries include instability, rotator cuff impingement, and biceps tendinitis.
  • Knee injuries in swimming generally damage the ligaments and tendons
  • The breaststroke causes the highest occurrence of knee injury.
  • The kick in breaststroke also puts the hip at risk for injury.
  • Spondylolisis is a common injury to the lower back, which is often related to the dolphin kick during the butterfly, in addition to the severe arching of the back during a start for the blocks or when arching the back during pushing off from the wall for a turn.

Prevention and Performance

The best way to avoid swimming injuries to is learn the proper technique, and institute a training program developed by a sports health professional to help the athlete develop and strengthen the muscles they use to swim.

Other ways to avoid injury include:

  • Strengthening of the rotator cuff and scapula stabilizing muscles are key to preventing shoulder injuries.
  • Core strengthening exercises should be incorporated before and during the competitive season to decrease the risk of lower back injuries.
  • Proper swimming technique is critical to not only swim successfully but also prevent injury.
  • Decreasing the volume and intensity of swimming can help decrease the risk of swimming related injury.
  • Coaches and parents of swimmers should encourage athletes to communicate with them regarding any unusual joint pain they may be experiencing

Facts

  • Did you know that swimming is the most popular low-impact fitness activity?
  • Did you know that there are well over a million people per year in the United States that state swimming is their exercise of choice?
  • Did you know that more than one third of swimmers claim to be competitive athletes who practice and compete in swimming year-round?

Common Conditions

  • Shoulder instability
  • Shoulder impingement
  • Rotator cuff impingement
  • Biceps tendinitis
  • Hip instability
  • Hip strain
  • Low back pain
  • Spondylolisis
  • Lumbar spine herniated disc
  • Patella-femoral pain syndrome
  • Patella instability

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