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

More Essential Stretches for Swimmers

May 4, 2010

Stretching is an important part of any warm up and cool down. Sport specific stretching allows you to warm up the specific muscles required for the sport. In swimming, the four competitive strokes are:

Butterfly
Backstroke
Breastroke
Freestyle

These strokes encompass the use of practically all the muscles in the body, the main muscles that are responsible for the movements that make up a stroke are called the primary muscles. Primary muscles used for all strokes are:

Other muscles that allow for controlled smooth movements are secondary muscles these are:

Anterior deltoid
Posterior deltoid
Pectorals
Serratus anterior
Latissimus Dorsi
Triceps
Hip stabilisers
Hamstrings
Quadriceps
Gluteals

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Trapezius
Biceps
Upper abdominals
Lower abdominals
Calf

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There are many different types of stretches that a swimmer can use. The main types of stretching are:

Static Stretching – Holding a position that stretches the muscle for ~ 30 seconds.
Passive Stretching – Similar to static, but someone else holds the position for you.
Dynamic Stretching – Controlled leg and arm swings that gently take you to the limits of your range of motion. It mimics the action of the muscles during the event. Often used in warm ups or in preparation for an event.
Ballistic Stretching – Forcing a joint beyond its normal range of motion by bouncing into a stretched position. Unpopular these days due to the high risk of injury associated with it.
Active Isolated (AI) Stretching – Using a muscle to stretch the opposite muscle by contracting one muscle and moving the opposite muscle in a stretched position.
Isometric Stretching – Alternatively stretching a muscle and contracting it to facilitate its relaxation.
Proprioceptive Neuromuscular Facilitation (PNF) – Combination of passive and isometric stretching.

A combination of these stretches is appropriate for swimmers. Try them out and see which ones help you most. Regular stretching improves force, and speed. One bout of stretching won’t make a difference.

Here are some examples of stretches that are particular the primary muscles used in swimming.

click to view	Anterior deltoid, serratus anterior and pectorals stretch – Rotate your body so that you can feel a stretching sensation over the front of the shoulder and chest.
click to view	Triceps stretch – With your opposite hand, pull your elbow downwards and towards your head so that you feel the stretch over your upper arm
click to view click to view click to view	Posterior shoulder stretch 1 – Pull the arm towards the chest Posterior shoulder stretch 2 – Some traction can be applied by leaning the body away from the hand. Posterior shoulder stretch 3 – All your body weight should be positioned over your shoulder; your opposite hands helps to push the arm down towards the floor. The shoulder angle is kept at 90 degree, and so is the elbow joint. This stretch is felt at the back of the shoulder.
click to view click to view click to view	Latissimus dorsi stretch 1 – Accompany this stretch with breathing exercises. As you exhale, lean a little further over the side. Latissimus dorsi stretch 1:1 – Starting in a forward position, crawl your fingers towards to maximise the stretch, hold this position, then change your direction to one side to feel the stretch over the opposite side. Latissimus dorsi stretch 1:2 – Starting in a forward position, crawl your fingers towards to maximise the stretch, hold this position, then change your direction to one side to feel the stretch over the opposite side.
click to view click to view click to view click to view	Hip stabilisers stretch 1 – To stretch your right hip, put the right leg diagonally behind the left, lean over to the left side, so as to increase the length and stretch over the right side. Hip stabilisers stretch 2 – Cross your right leg over a straightened left leg, and rotate to your right. You will feel this stretch through your lower back, but predominantly through your right hip. Hip stabilisers stretch 3 – This will stretch your right side, holding onto your left knee, gently pull it in towards your chest to feel the stretch on the outside and back of your right hip. Hip stabilisers stretch 4 – This will stretch your right side, holding onto your left knee, gently pull it in towards your chest to feel the stretch on the outside and back of your right hip.
click to view	Quadriceps stretch – Keeping your knees and thighs together, stretch the front of your thigh by standing up straight and pushing your hip forwards.
click to view	Hamstrings stretch – You don't need to flex your foot to stretch your hamstrings, let it relax and lean forwards from your hips, your back should not be overly arched.

Written by Jessica Ellison · Filed Under Injury Prevention, Sports Injury, Swimming | View Comments

Stretches for Swimmers

October 23, 2009

Muscle flexibility is very important in swimming as events are won by milliseconds. A flexible body will help to improve your swimming performance by achieving maximal propulsion from each stroke. Here are some recommended stretches that can be done to improve your flexibility. Read more

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

The Ten Most Common Mistakes Made By Triathletes

December 18, 2008

Wayne Goldsmith got it down nicely in this article. With triathlons becoming an increasingly popular sport in Singapore and around the region, we at Back2Sports are also seeing a corresponding rise in injuries with triathletes and biathletes. Wayne has some good advice for us.

Written by MCR · Filed Under Cycling, Running, Swimming | 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