For Swimmers : Common Injuries, Treatment and Prevention tips

July 7, 2010

Do you swim leisurely or competitively? If yes, continue to read on.

Recently, one of our physiotherapists, Chng Chye Tuan was interviewed by Style:Men on the common musculoskeletal injuries face by swimmers in the July's issue. Do read on to find out what he has to share.

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What are the common problems competitive/regular swimmers face?

The most common swimming injury is the rotator cuff impingement / tendonitis.

Ball joint of the shoulder compress the tendon against the roof of the socket (acromion) in 2 phases of freestyle – the pullthrough and recovery phase.
Pull-through phase in the freestyle stroke involves the arm pulling against the resistance of the water. The outstretched arm with internal rotation of the shoulder stresses the tendon and pinched it against the acromion. The pinching can irritate the tendons and give a sudden catching kind of pain.
The recovery phase involves a body roll and raising the elbow up and out to allow the upper limb to recover out of water efficiently otherwise the shoulder will be working harder at an awkward position to pull the hand out of water.
Repeated pinching will give rise to inflammation and fraying of the soft tissues.

What are the usual causes?

The usual contributing factors are mainly due to over training, poor technique, poor core muscles and unilateral breathing.

Over training – when muscles are fatigued, the stabilising component from the rotator cuff muscles becomes compromised thus increasing the chances of the humeral head translating upwards and impinging the rotator cuff tendons. The ball component has to be centralised within the socket of the shoulder to optimise stability and muscle function.
Technique – the freestyle and backstroke requires the swimmer to roll their trunk such that the drag is minimise and the propulsion force can be maximised. Too much drag will increase the resistence, tiring out the shoulder muscles sooner.
Strong core muscles and truck control enable the swimmer to do a body roll along the longitudinal axis so that it is easier for the shoulder to pull the upper limb out of water.
Unilateral breathing can develop a muscle imbalance leading to improper muscle activation and overuse.

What kind of treatments do you recommend?

An assessment of the shoulder girdle, spine and core strength will be performed to be able to properly manage a swimmer’s shoulder.

A key treatment to approach the swimming shoulder is to rehabilitate the rotator cuff muscles to be able to centralise the humerus at different shoulder positions.

Exercises will be prescribed to specifically target these rotator cuff muscles, correcting any imbalances. These exercises include strengthening the weak muscles to improve dynamic support and also stretching exercises to the tight muscles pulling the joint out of position.

As most competitive swimmers will not be able to cease training completely, kinesiotaping complements the rehabilitation therapy by improving the rotator cuff’s ability to stabilise the shoulder joint via better joint awareness from the corrective

Are there preventive measures that swimmers can take to minimise such problems?

Regular stretching exercises, core stability training and work on the techniques. During the early stage of feeling the impingement (catching or pinching) pain, seek help from a sports physician or physiotherapist as soon as possible.

Written by chyetuan.chng · Filed Under Injury Prevention, Shoulder, Sports Injury, Swimming | View Comments

3D Medical Animation of a Rotator Cuff Surgery

June 24, 2009

This is a good video following up our earlier article on Arthroscopic Rotator Cuff Repair

Also here is another excellent video on Shoulder Impingment.

Written by chyetuan.chng · Filed Under Shoulder, Video | View Comments

Arthroscopic Rotator Cuff Repair

April 16, 2009

A rotator cuff tear is a common injury of the shoulder. It can be due to a traumatic event where the tendon gets torn in a fall or due to overuse where repetitive overhead activities causes wear and tear of the tendon. Pain is the most significant symptom with a rotator cuff tear followed by loss of range of movement in the shoulder. Arthroscopic rotator cuff repair, which involves minimally invasive surgical techniques, helps to heal the tendon back to the bone. Such surgeries are usually done as a day operation. Rehabilitation of the shoulder post operation takes about 6 months before patients return to functional activities.

Written by chyetuan.chng · Filed Under Injury Management, Peripheral (NonSport), Shoulder, Shoulder (NonSport), Sports Injury, Treatment Option, Uncategorized | View Comments

Anatomy of the Shoulder

September 30, 2008

The shoulder joint is perhaps one of the most complex in the human body. This animation demonstrates how the various bones, muscles, bursas come together.

Written by Admin · Filed Under Shoulder, Shoulder (NonSport), Video | View Comments

How would you like your Swimmer’s Chicken-Wings?

August 4, 2008

If you are serious about competitive free-style swimming, you know that form matters. And if you are training competitively, you are more than likely (~66%) to be nursing some sort of shoulder injury. Recently, you heard from some that the "chicken-wing" is causes and aggravates shoulder injuries. Others say, it doesn’t? So should you chicken wing-it or not? Well, it is safe to get back into the water. What matters is not whether or not to chicken-wing, but HOW you chicken-wing it. Read more

Written by MCR · Filed Under Shoulder, Swimming | View Comments