As summer lures millions of people back to their pools and local beaches to beat the heat, many swimmers are unaware of the injury dangers they face.
According to Dr Joseph Horrigan, Director of The Soft Tissue Center at DISC Sports & Spine Center in Newport Beach, California, the top three most common swimming injuries are “swimmer’s shoulder,” meniscus tears and low-back strain.
Fortunately, there are simple preventative measures to take that can save you a lot of pain.
“Swimmer’s shoulder is medically known as subacromial impingement,” Dr Horrigan explains. “The shoulder is a ball-and-socket joint with a bony roof over the joint. In simple terms, this impingement — or pinching — occurs between the ball of the shoulder and the roof of the shoulder. Tendons and a fluid-filled sac known as a bursa become inflamed and painful from being impinged in the shoulder.”
The most common cause of this impingement is the manner in which the hand enters the water during the freestyle stroke, with the thumb first at the top of the stroke. This position of internal rotation elevates the shoulder causing impingement, and the problem is exacerbated by a high volume of swimming strokes pinching the tendons repeatedly.
Knee injuries occur most commonly during breast stroke kicks, which involve a frog-like motion of the legs. Dr Horrigan says, “This unique ‘frog kick’ can stress and strain the medial collateral ligament (MCL), and can pinch and tear the C-shaped cartilage in the knee known as the meniscus.”
The low back can be stressed by the more aggressive butterfly stroke, which involves rapid bending and extending of the low back. This motion can aggravate the joints in the spine (facet joints), or existing disc injuries could also become inflamed. Today’s competitive swimmers also use the “dolphin kick” in which the body is whipped to generate speed and distance.
“Most people recall seeing underwater footage of the great Michael Phelps as an example of this ‘dolphin kick,’” Dr Horrigan says. “This motion may be too much for a low back that is already sensitive and problematic.”
Avoiding the damage
To help prevent swimming injuries like these and others, Dr Horrigan shares the following tips:
Acclimate: Allow yourself the opportunity to adapt to the amount of swimming you perform regularly. If you take on too much of anything before you’ve acclimated to the activity and workload, you risk overuse injuries. This may include all of the injuries that go with swimming, such as swimmer’s shoulder, meniscus tears and low-back strain –not to mention fatigue and overtraining.
Know your limits: Every exercise is not for all people at all times. Some of us may have ligaments in the back of the shoulder that are too tight, which changes the pivot point of the ball-and-socket joint and can cause more impingement. Those who have dislocated their shoulders previously may also find the range of motion of swimming to be too uncomfortable.
Similarly, if a knee is already unstable, the frog kick is most likely asking for trouble. Because meniscus tears will vary in how they present pain in patients, it is best to avoid aggravating such an injury with a breast stroke frog kick if you already know you have it.
Anyone with acute low back pain may be better served by simply walking in a pool while they build up strength. The buoyancy of the pool can help with movement and provides good exercise for those starting in a deconditioned state, where they are unable to walk normally without discomfort. And if you do walk a great deal in a pool, make sure to wear heavy socks or Aqua Socks to protect the bottom of your feet.
Consult your doctor: Lastly, if you have not exercised in years and you have decided to use swimming as a new form of exercise for your overall health, stress management or weight loss, make sure you see your family physician for a physical examination before embarking on a rigorous swimming program.