Shoulder Injuries in Swimming: Technique Adjustments for Prevention and Rehabilitation
Rod Havriluk, Ph.D. and Ted Becker, Ph.D., R.P.T
USA Swimming Sports Medicine and Science Network Meeting, 2011, Jacksonville, FL
Although swimming is generally considered a sport with a low risk of injury, a distressingly large number of competitors suffer from shoulder problems at some point in their career. For example, over one-half (51%) of a group of 137 elite swimmers (participants in a national competition) reported injuries (Haupenthal et al., 2006). “The most affected segment was the shoulder (53%) and tendinitis was the most frequent diagnosis (72%).” Specialists in butterfly and freestyle were diagnosed with shoulder tendinitis with a frequency almost triple backstrokers and breaststrokers.
There are three primary risk factors for shoulder injury: excessive training distance, muscular imbalances, and improper technique (Becker & Havriluk, 2006). Many experienced swimmers (i.e. older teens) have all three risk factors, but can only control one. The coach usually controls training distance. Muscular imbalances are often not identified or given inadequate attention. Technique, however, is the one factor under the continuous control of the swimmer. It is, therefore, vital that swimmers learn to position the arm to avoid shoulder stress.
An ineffective (and stressful) arm entry was found in most college swimmers (over 50%) for both butterfly (Becker & Havriluk, 2010) and freestyle (Havriluk & Becker, 2011). At the completion of the arm entry, the hand was closer than the shoulder to the surface in a position classically related to joint surface aggravation or “impingement syndrome.” Modifying the arm entry with a downward angle positions the hand deeper than the shoulder to begin the pull. The resulting arm position is stronger (more mechanically advantageous), and most importantly, less stressful on the shoulder.
In addition to arm position, there are also arm coordination issues related to shoulder stress (Havriluk, 2011). For example, if the arm is held motionless in front of the body as the opposite arm recovers (as in catch-up stroke), the ensuing torso rotation will stress the shoulder. Eliminating catch-up coordination (by immediately beginning the pull after completion of the arm entry) is another way to prevent or rehabilitate shoulder injuries.
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Becker, T., & Havriluk, R. (2006). Bilateral and anterior-posterior muscular imbalances in swimmers. In J. P. Vilas-Boas, F. Alves, A. Marques (Eds.), Biomechanics and Medicine in Swimming X. Portuguese Journal of Sport Sciences, 6(Suppl. 2), 327-328.
Haupenthal, A., Schutz, G., Rushel, C., Faquin, A., Menezes, F., & Pereira, S. (2006). Injuries Incidence in Brazilian Swimmers of Different Strokes. In J. P. Vilas-Boas, F. Alves, A. Marques (Eds.), Biomechanics and Medicine in Swimming X. Portuguese Journal of Sport Sciences, 6(Suppl. 2), 333-336.
Havriluk, R. (2011). Do Expert Swimmers have Expert Technique? – Comment on Arm Coordination and Performance Level in the 400-m Front Crawl by Schnitzler, Seifert, and Chollet (2011). Research Quarterly for Exercise and Sport, in press.
Havriluk, R., & Becker, T. (2011). Mechanical advantage and hand force generation in freestyle swimming. Manuscript in preparation.