The sun is shining and the weather is heating up. For many of us, that means it is time to jump into the pool or beach and go for a swim. Swimming is a popular sport that requires strength, flexibility and endurance. However, both enjoyment and performance can quickly diminish when an injury occurs.
It is important to consider the contributing factors as to why a swimming related injury may arise, so that preventative strategies and targeted treatment modalities can be utilised to keep you in the pool or ocean for longer.
There are intrinsic and extrinsic contriubting factors associated with swimming related injuries. Intrinsic factors are individual differences that make someone more susceptible to injuries; whilst extrinsic factors are environmental factors that influence injuries.
At the Injury Clinic Physiotherapy, the vast majority of swimming related injuries occur when there is a mismatch between training load and tissue capacity, resulting in overload.
Intrinsic factors:
- Shoulder joint range of motion
- Strength
- Core control
- Joint laxity
Extrinsic factors:
- Sudden increase in training volume
- > 15 hrs swim /week
- Unilateral breathing pattern
- Recent change of stroke technique
- History of shoulder injury
- Recent change in coach (and therefore likely change in training loads)
- Increased use of hand paddles
- Increased use of drag increasing training devices (bags, elastic cords, drag suits etc).
Common swimming related injury presentations we see at The Injury Clinic:
Shoulder pain:
- Swimmer’s shoulder is a general diagnostic term used to describe an umbrella of shoulder injuries secondary to swimming. Most commonly, swimmers shoulder refers to glenohumeral joint capsular irritation and inflammation.
- This irritation of the shoulder joint is generally secondary to overloaded or fatigued muscles of the shoulder. This may result in the humerus (arm bone) not sitting as optimally within the acromion (socket).
- The shoulder joint then may sit in a position that is not optimal for movement, such as swimming, and as such, is prone to becoming irritated and inflamed.
Neck pain:
- Whilst there are a variety of different swimming techniques, all techniques involve a large component of head/neck control.
- Neck muscles that control our neck movement and head position may become overworked and fatigued.
- Joints within the neck can become irritated and stiff due to the repetitive nature of the breathing action in swimming. This may result in discomfort and decreased neck range of motion.
Low back pain:
- The action of swimming requires our low back to be in an extended position for certain periods of time.
- This may result in increased stiffness at the low back and discomfort with certain movements. For example, movements such as but not limited to, leaning backwards, lying on stomach, and certain gym exercises.
Knee pain:
- Pain on the inside of the knee can commonly occur when swimming breaststroke. This is because breaststroke requires rapid rotation kicking action, placing forces through the inside of our knee.
- Swimmers may describe a constant dull ache on the medial side of the knee joint, most likely during or post swimming breaststroke.
Ocean Swimming vs Pool swimming:
Particularly in the summer months, ocean swimming can quickly become a popular addition to our training and exercise routine. Ocean swimming training is essential to triathlon training or in preparation for open water swimming events to become accustomed to the difference in swimming environments.
However, it must be understood that ocean swimming and pool swimming are very different swimming modalities.
So what is the difference between open water swimming and pool swimming?
- Temperature: open water is colder than the average swimming pool. Colder water may result in an increased breathing rate and heart rate, and can be uncomfortable or numbing when swimming for longer periods of time.
- Stroke rate: athletes of all levels tend to swim with an increased stroke rate (number of strokes per minute). This change in swimming technique is to adapt to variety in conditions such as swell, chop and turbulence created by swimmers nearby.
- Breathing technique: different breathing techniques may be adapted in order to ensure a swimmer can remain on course. This generally involves a swimmer intermittantly looking both to the side and in front of them when taking a breath.
- Visibility: open water visibility can vary significantly. Many swimmers find it disorientating when unable to see further than a few metres when swimming in open water, and some may find the sensation quite uncomfortable.
- Environmental predictability: the pool environment is incredibly controlled and regulated. The ocean can be incredibly unpredictable with changing tides, swell, chop and wind.
Summary:
- Swimming is a fantastic exercise that incorporates components of body strength, flexibility and endurance. The majority of swimming related injuries are attributed to training load exceeding tissue capacity.
- There are a variety of intrinsic and extrinsic contributing factors to swimming related injuries. Uncovering these contributing factors is essential to both rehabilitation and prevention of an injury.
- Ocean swimming must be considered as a different training type compared to pool swimming. This is because swimmers may adopt a different swimming technique, and external environmental variables.
If you’re a swimmer and are experiencing an injury, don’t hesitate to get in touch and consult with one the the physiotherapists at The Injury Clinic Physiotherapy Geelong.
