Common swimming injuries: how to prevent and manage them

Although swimming is a non-contact sport that is considered relatively gentle on the body, injuries can still arise.
Whether you’re a recreational swimmer or a competitive swimmer, a pool swimmer or an ocean water swimmer, this is for you!

Common causes of swimming injuries

• Incorrect stroke mechanics and breathing technique
• Overtraining and/or inadequate rest
• Poor range of motion and/or flexibility
• Poor muscle strength or imbalances

Majority of swimming injuries are due to repetitive strain. Using correct technique is important to minimise the occurrence of injuries, however there may be movement restrictions or strength deficits preventing a swimmer from using desired technique.
Our osteopaths and physiotherapists can provide a movement screen that can identify areas of tightness and weakness to allow for better movement in the water. Improved movement (allowing optimal technique) will increase swimming efficiency and decrease the risk of sustaining a repetitive strain injury.

Common areas of injury

Shoulder

Muscle strains, inflammation of tendons and bursa sacs are common causes of sore shoulders in swimmers. Impingements of structures passing through the subacromial space (space where the collar bone meets the shoulder blade) is often a cause of pain in swimmers. Inflammation of the bursa and/or supraspinatus tendon can lead to narrowing of this space causing impingement. The supraspinatus muscle is one part of the rotator cuff complex (see blog from October 2023 for more information about the rotator cuff). The biceps tendon is also near these structures and can further be a cause of pain if inflamed.
Avoiding entering the water thumb first is one way to prevent the onset of shoulder impingements.

Neck

Strains of muscles around the neck and irritation of joint structures can occur due to the repetitive nature of needing to twist or lift the face out of the water to breathe when swimming. Swimming with your head in an extended position (looking forward instead of looking down) increases the load placed on the neck. Lifting the head out of the water instead of rotating the neck and upper back to breath can also lead to increased load.
In older swimmers, degenerative changes in the neck can cause joint inflammation and compression of nerves. As the majority of nerves that innervate the upper limb originate from the neck, compression of these nerves can be the cause of problems of pain in the shoulder and arm. One way to give your neck a break is to sometimes use a snorkel so that you don’t have to turn and lift your head to breathe.

Lower Back

As the body is horizontal in the water when swimming, there are forces placed on the spine such as gravity and buoyancy forces that can create altered posture to that experienced on land. A common reason for low back pain in swimmers is due to an increased lordosis (hyperextension/ inward curvature of the spine) of the lower back when swimming.

Having adequate core strength to control the amount of lordosis of the back in addition to good mobility of the spine can help to prevent lower back pain when swimming.

Poor kicking technique can also lead to increased strain on the muscles and joints of the lower back. Sometimes kicking technique is dictated by tightness in other muscles of the lower limb such as the hip flexor muscles.

An easy way to decrease excessive lordosis when swimming, is to try and bring your lower ribs closer towards your pelvis. Switching on the core takes awareness and isolated strength to sustain a light contraction of the abdominal muscles. Once achieved, this core control can also help to stabilise the hips and prevent excessive rocking/swaying through the lower back.

Knee

Knee pain in swimming is most common when swimming breaststroke but can also occur during other strokes. The breaststroke kick requires rotation/torsion of the thigh and shin bone which places repetitive strain to the inside of the knee. The rapid squeeze of the legs back to the midline requires a fast contraction of the adductor (inner thigh/groin) muscles against the resistance of the water. Muscle strains of associated muscles involved with the breaststroke kick are the most common injuries that may occur. Injury and inflammation of the ligaments supporting the knee such as the medial collateral ligament (MCL) may also occur. Poor hip mobility may prevent you from achieving the optimal angles to complete the kick which may place increased load on your knees.

If you’re swimming breaststroke as part of your training plan, you can decrease the risk of strains by performing a good warm-up/activation of the involved muscle groups. Additionally, it’s important to include your groin muscles in your recovery routine with stretching etc.

If you enjoy swimming and want to have a movement screen to check for any motion deficits or any muscle imbalances, we would love to help you!
We can identify any areas of concern, and provide hands on treatment and exercises to help ensure you’re in the best position to enjoy your swimming whilst reducing the risk of injuries.
Should you have a new or ongoing injury, we are here to assist you get back to your swimming as quick as possible.

• Andelys (Andy) Warren Osteopath and Advanced level swimming coach

 

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