Swimming Injuries

Stretch, stretch, stretch. Every day. All over. Lesson to your body. If it really hurts, just stop. Figure out what you are doing wrong.

In some cases stretches are the worst thing we can do. In particular many of the stretches we see swimmers doing before every swim actually serve to loosen the shoulder capsule. What we call swimmer's shoulder is very often caused by laxity in the shoulder joint, this one biomechanical issue then manifests itself in defferent pain issues. We get impingement, anterior subluxations, other assorted problems that result from muscle substitution but at the core is shoulder joint laxity. So while we think we are helping ourselves we are making the situation worse. This issue was covered well in swim magazine about a year ago. I have always wished it would have been the article that would be reprinted on the website but alas it wasn't. Perhaps we can asked that it be reprinted here, it is without a doubt the most important article I've ever seen in the magazine. To reprint it, possibly here could be considered a public service.

Kevin--you're right of course..Stretch properly. I agree with you about that Swim article. I see many people stretching the wrong way.

I understand the issue and it's exactly why I mentioned the stretching. The problem stretches I'm talking about aren't some sort of strange things no one has ever heard of. The ones in the article, I've sense confirmed these impressions with my physical therapist, are the ones we see everyone do when we hit the pool. Clasping the hands behind the back and lifting, putting one arm on the wall and "stretching the pecs", pulling one elbow across your body. I see people do it every time I go to the pool, the teacher in the local "dolphins" program has the kids do them. Both these children and adults like us are stretching our shoulder capsules (gladly I may add) all the while thinking we are helping ourselves. You're asking why are we getting injured I'm saying this is part of it. As to technique, there's a very important aspect of the high elbow style that can be overlooked and then lead us to injury. For shoulder health a high elbow recovery needs to go hand in hand with good hip rotation. I've come to learn right here in this board that what's important is whether we break the coronal plane on recovery. "Coronal plane" is the plane that cuts through the shoulders and head and hips. If you stand back to the wall, the wall is the coronal plane. Breaking this plane when we swim is bad news. The source of many injuries. So, for illustration purposes imagine swimming perfectly flat but using a high elbow recovery. One would have to break the coronal plane with the elbow to accomplish the recovery. Another way to think of it is that you're arm would be "behind" you as you recover it. On the other hand, if we have good hip rotation we are on our sides when we recover our arm. For illustration assume you're all the way on your side, you could now recover your arm without breaking the coronal plane. So to your question of does the high elbow cause problems? Among people who don't understand these nuances, probably so. Hopefully a few people will see this on the board and recognize this as the source of their own problems.

Kevin, I agree with your response. Stretching seems in some cases to cause injuries in itself if not done properly. Sometimes I think a more appropriate shoulder exercise prior to entering the water would be light and controlled arm rotations and armswings. Something to merely get the blood flowing in the area, while also getting a little range of motion preparedness. That wasn't however the main point of my posting, I wasn't looking for a remedy for a personal injury, my own shoulder injuries have all been due to activity outside the pool. I guess what I'm getting at is it seems more and more swimmers, especially at younger and younger ages are being injured, and the main injuries are obviously shoulder-related. Is there something technical that is being taught that could be contributing to this? I have a hypothesis, but I'm afraid I'm not qualified from a physiological standpoint to make such a judgement. I think the high-elbow recovery with the face-down freestyle puts more stress on the joints than an older-age freestyle. Although it is more efficient, it seems that the better the body position on top of the water, the more overhead-like the recovery motion is. And a lot of shoulder injuries are associated with a repetitive overhead motion. With all the physicists and dynamics experts and kinesiologists that have poured time and effort into developing the strokes through the years, with research and study after study the sport has come so far. But I think it would also be interesting to get some physio's and ortho's involved to study the potential for injury, and add their 2 cents to the discussion as far as the bodily-wear and tear side goes.

I've read many of the same things you have about stretching cold muscles. My physical therapist confirms the idea that stretching a cold muscle is difficult and more importantly for your use as a coach, time consuming. In the perfect world our friends in the health field would have us warm up, stretch, exercise, then stretch again at the end of the workout. In real life however I'm sure most of them wold consider it a step up if we stretched just once per workout. I think you could work in some stretching either after warm up or after the workout. As for proper technique, I think a local physical therapist would be the way to go. Once you explain that you are an age group coach and you are concerned about the children's health I am certain he or she would spend 30 minutes or so with you demonstrating no only which stretches to incorporate but also exactly how to do them properly and how to recognize if someone is doing it improperly. Lastly, if you don't have the swim magazine article from a year ago maybe one of our friends in internet land can email you or I and we can make sure you get a copy.

Kevin, I forgot to ask another thing from you Kevin, considering you seem to have some expertise in this discussion... I've never been big on stretching, I rarely stretched prior to swimming and still don't, preferring to use real slow swimming to let the muscles and joints loosen up. It's basically been the same with anything I do or have done, run, bike, baseball... personally I've never had a sports-related injury of these sorts. Mine (3) have always been impact related and only one was actually during a sports activity. You can't prepare for banging knees. Needless to say, I'm of the opinion that stretching is grossly overrated. I've also read articles that have alluded to the fact that stretching may not prevent injuries at all. Where this is an issue for me is being an age-group coach, the other coaches like to run stretching and I tend to just let it go by the wayside. A couple reasons... 1. (above), 2. The kids usually are using iomproper stretch technique and/or don't care to stretch properly, 3. Hey, at 12 years old, those kids are already stretched out. 400 yds of slow warm-up will suffice to get the muscles prepared for a workout. Plus, some of those stretches you've mentioned are the ones that we teach to kids to use for stretching prior to practice and meets. Stretching the shoulders and pecs and tries and lats seems to put a lot of stress on the involved joints. Stress that I'm not so sure an age-group level swimmer needs. What would you suggest? I think I made mention previously, I think some blood flow and range-of-motion are far more important than flat out stretching prior to practice. Do you think some stretching is necessary, and under what guidelines would you add stretching to your pre-practice regimen? Thanks, RM

Kevin - Thank you for commenting on the coronal plane - what I call the front plane of the body. I see three technical developments that lead to shoulder injuires. a) Swimming flat will lead to shoulder problems for many swimmers. Swimming flat means the hands and elbows have to be behind the coronal plane. Only the most flexible swimmers are going to get away with this without shoulder problems. b) High elbow catch which is one of the current techniques being pushed because the Australians do it. Unless you have sufficient strength, keeping the elbow close to the water during the initial phase of the stroke will lead to significant shoulder strain. c) Pulling outside the shadow of the body. By this, I mean the right hands stays outside the right side of the body and the left hand stays outside the left side of the body. THis puts many strain on the shoulders far moreso that crossing over during the pull. Unfortunately, "B" and "C" are being pushed as significant trends in swimming these days. AND, not only are they being pushed at the upper age group level, it is being pushed in the pre-teen age groups be some coaches I know. This leads to stressed joints and instability. The great, fast swimmers are unique in that many of them are extremely flexible and very strong. They get away with things that much of the swimming population cannot do without problems. Coaches and swimmers should not simply assume that everyone can do what the great swimmers do. That means that coaches have to go back to basic proper technique. Pull under your body, finish your pull, rotate onto your side, recover with your hand in the coronal plane, start your pull in the coronal plane, etc.. Stroke mechanics have to be individualized to the swimmer - thus the saying - "Different Strokes for different folks." Paul Windrath ps - I do not believe Spitz would have been faster today with the "new" techniques. Anyone who has watched him swim understands that his physical structure allowed him to do things even today's swimmers cannot do.

Thanks Kevin, I have heard of the coronal plane in a discussion somewhere, not sure if it was on this site or not. There is an aweful lot of hip rotation needed to be sure the high elbow recovery stays inside this plane. If one knows that their hip rotation is not sufficient to warrant an extremely high elbow recovery, then I would think they should have a slightly more neutral overarm recovery, not flat but lower it progressively. Or increase their hip rotation. Hip rotation is very fundamental, but I rarely see anyone who has the hip rotation necessary for the high-elbow recovery. I would suggest that other mechanics that need to be taught in freestyle are a hand-low-to-the-water recovery, shoulder-width entry, not crossing the center line during the underwater pull. There is no reason any one of thoe points should be missed during a technique session either.