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Swimming injuries and how to avoid them

How familiar is this? You do not experience any problems, so you do not see the need for prevention in the sense of strength, stretching, coordination and technique exercises. Instead, the limited time you have is invested in swimming, running or cycling

How familiar is this? You do not experience any problems, so you do not see the need for prevention in the sense of strength, stretching, coordination and technique exercises. Instead, the limited time you have is invested in swimming, running or cycling training only.

Though, once an injury occurs, it often results in several weeks of downtime from training. Especially in the case of overloads in the shoulder area, which often occur during swimming, and where rehabilitation can take significant time.

CAUSES OF INJURIES

The very advantage of the shoulder joint is at the same time its weak point: a wide range of mobility. High mobility often comes at the expense of stability. The shoulder is largely guided by muscles, tendons and ligaments. These can be overloaded by a variety of causes.
The fact that the muscles that tend to shorten due to everyday postures, are precisely the main working muscles in swimming is one of them.

If the anterior arm and upper body muscles are not stretched well and the opposing back and shoulder muscles are not strengthened sufficiently, so-called muscular imbalances occur.
The unfavorable load distribution between muscle and joint can later lead to "arthromuscular imbalances" (dysfunctional muscle-joint relationship). This can result in painful muscle tension, strained tendons, muscular coordination and functionality problems as well as damage to the articular cartilage.
Training volumes or intensities that are increased too quickly, as well as improper swimming technique, are further causes of overload.

COMMON SWIMMING INJURIES

Impingement syndrome, in which soft tissues (tendons, capsular components) become trapped between the humeral head and the acromion, is a typical swimming injury. Pain occurs when lifting the arm laterally between 60 and 120 degrees. Nocturnal pain while resting is also typical.
Pain in the anterior aspect of the upper arms and loss of strength may involve the attachment of the biceps brachii muscle or indicate a rotator cuff tear.

The knee joint is a hinge joint; it can flex and extend. Only during the last few degrees of extension does a slight rotation occur. The shear forces that occur during breaststroke must be compensated for by ligaments and menisci. This can lead to irritation of the internal collateral ligaments and even meniscus problems or patellar tendonitis. This is referred to as the thoracic swimmer's knee.

Overextension of the lumbar spine (hollow back) during swimming can lead to local pain and also radiate into the legs or to cramps as a result of hypermobility of the lumbar spine.

HOW CAN THESE OVERLOADS BE AVOIDED?

Certain overload reactions of the body can be avoided by better swimming technique and a good body position in the water.
To prevent these common injuries, the following exercises are recommended:

MOBILIZATION:

STRETCH CHEST AND ANTERIOR ARM MUSCLES

Starting position: stand sideways to the wall (door frame, etc.), hand and bent elbow against the wall, 90° angle upper body-upper arm, leg of the opposite side in step position forward.

Variations: Arm above or below 90° against the wall. Or both arms at the same time, placing hand and elbow on door frame. To get more stretch on front upper arm muscle, arm should be placed against wall with elbow extended.

Execution / End Position: Rotate / tilt upper body forward until a slight pull is felt in the chest-arm area. Repeat other side.

STRETCH SHOULDER AND NECK

Starting position: place hand on the side of the head at the level of the ear on the opposite side. Variations: Place hand in front of or behind the ear.

Execution / End position:
Pull your head to the side until a slight stretching sensation is felt in the shoulder/neck area. Repeat other side.

Depending on the position of the hand, the stretch will be felt on the side, or rather on the front or back.

STRETCH HIP FLEXORS

Starting position: Kneeling, the leg to be stretched is behind.

Execution / End Position: With abdominal muscle tension, push the pelvis forward until a slight pull is felt in the front groin or inside of the thigh. Repeat other side.

Variations: Additionally, tilt the upper body to the opposite side and extend the arms upward.

STRENGTHENING:

STRENGTHEN ABDOMINAL MUSCLES

Without actively lifting the legs. The otherwise activated hip flexors would pull the pelvis into the unwanted hollow back position.

Starting position: supine position on the mat. Legs slightly bent such that the lumbar spine is supported. Hands behind head, press heels into mat and pull toward body.

Variations: Supine position on ball. Place legs at an angle of approx. 90°.

Execution / final position: Straight abdominal muscles: lift head and shoulders straight off the floor, look toward the ceiling (not toward the knees), chin toward the sternum. Oblique abdominal muscles: similar to above, while head and shoulders rotate to the left or right lifted off the floor.

Variations: Place one hand under the head, extend the other arm backward and grab a resistance band, which in turn is attached to a table leg or door handle. By lifting the upper body and pulling on the band, the entire anterior muscle chain is exercised in a swimming-specific manner.

STRENGTHEN ERECTOR MUSCLES

Starting position: while standing, attach resistance band to wall bars or door handle, wrap ends around hands, legs about hip-width apart, knees slightly bent, palms facing forward, arms on body.

Variations: Arms 45°, 90° or over 90° away from body.

Execution / final position: With arms extended, stretch the band backwards, push chest forward, pull shoulder blades together back-down. More effective than holding the exercise statically is a dynamic movement with 3.5 sec holding time.

This exercise simultaneously mobilizes the thoracic spine in extension, relaxes the pectoral muscles and trains coordination for full body extension.

STRENGTHEN ROTATOR CUFF

Starting position: Wrap the resistance band around both hands so that it is under tension, elbows bent 90° with a slight distance to the upper body, palms facing each other.

Variation: Elbow sideways further away from the body, up to 90°.

Execution / final position: straighten upper body, push chest forward-upward pull shoulder blades together, move palms away from each other, hold.

This exercise can also be performed isolated for one side. In this case, one end of the band is fixed to a door handle.

ADDITIONAL CONSIDERATIONS:

A stretch should always be painless. On a pain scale of 1 to 10, 7 should not be exceeded.
To reduce muscle tension after exercise, a holding time of 20-30 seconds with 2-4 repetitions is sufficient. To stretch already shortened muscles effectively, a holding time of 45-60 seconds is necessary.

It is possible to perform the stretching and mobilization exercises statically or dynamically. The dynamic variants are recommended before sports, and the static ones afterward.

ABOUT DANIEL WIENBREIER

Daniel Wienbreier is a self-employed physiotherapist, licensed trainer for triathletes and runners and an active athlete himself. He combines the experience from these three areas, among other things, in the implementation of bike fitting. As an athlete, he can look back on the following successes: 39th place World Championship Ironman Hawaii overall, European Amateur Champion 70.3 Ironman, German Vice-Champion Middle Distance, European Vice-Champion Duathlon U-23.

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