Go Go Physio has been providing Injury prevention talks to the lovely peeps training for the Can Too charity in a bid to raise money for charity. We have provided talks to runners in Randwick and swimmers in Coogee all in a quest to prevent the dreaded overuse injury. Here is the latest talk on preventing swimming injuries. A recent study by Wanivenhaus et al, (2012), found that shoulder injuries are the most common for swimmers with a prevelance between 41-90%.
The most common shoulder injury is shoulder impingement. Shoulder impingement is where the soft tissues around the humeral head are impinged under the coracoacromial arch. This is thought to be due to (1) stroke biomechanics and/or (2) overuse and fatigue of muscles of the shoulder, scapula, and upper back and/or (3) glenohumeral laxity with subsequent shoulder instability. So when muscles of the rotator cuff, pecs and upper back fatigue micro trauma can occur due to the decreased stabilisation of the humeral head.
So how can you prevent shoulder injuries during your training?
Lets start with stroke technique because 9 times out of 10, this is to blame for causing injury, so get it checked out!
1. Body Rotation : Developing a good, symmetrical body rotation through the development of an efficient breathing technique is key to removing shoulder injury.
Swimming with a flat body in the water with limited rotation along the long axis of the spine causes the arms to swing around the side during the recovery phase.
This swinging action results in large amounts of internal rotation at the shoulder joint which is the major source of impingement and rotator cuff issues.
2. Hand Placement into Water: A hand pitch outwards with a thumb first entry into the water leads to excessive internal rotation which, from approx 3200 strokes per hour, can eventually lead to acute pain in the shoulder as an 'over‐use' injury. Instead of entering thumb first, change your technique to enter with a flat hand, finger tip first.
3. Swimming Posture
Many swimmers don't give due attention to their upper body posture when swimming. If you inherit poor posture from your daily working life it can really affect how your muscles work when in the pool or ocean.
Poor posture can lead to impingement, often through a severe cross over at the front of the stroke.
This can easily be improved by working on flexibility in the muscles at the front of the shoulder and chest. Doing this together with improved stabilisation of the muscles at the back of the shoulder improves posture and removes cross-over at the front of the stroke.
Additionally you can screen yourself for muscular tightness and weakness around the shoulder:
- Glenohumeral Internal rotation deficit
Yes? Try the above stretch
- Scapula (shoulder blade) position
Yes? Try these exercises: serratus
- Poor upper back posture
Yes? Try these exercises: POSTURE CORRECTION
- Rotator cuff weakness Yes? Try these exercises: cuff strengthening
- Instability – are you over flexible around the shoulder?
Yes? Click on cuff strengthening above
So the take home message for injury prevention is check yourself before you wreck yourself! Good luck with the training guys.