Shoulder injuries are the most common injury among swimmers.  Many swimmers have very lax shoulder joints, which is a benefit to them in their sport but also places them at an increased risk of injury.  Swimmers often train with high mileage which often leads to fatigue and decreased swimming technique.  Poor form combined with shoulder laxity can lead to bony structures in the shoulder bumping into tendons in the shoulder which can cause wear, inflammation, and pain.   In order to avoid this it is important for swimmers to strengthen the muscles which stabilize the shoulder blade.  In addition to strength, it is important to improve the coordination of these muscles so that as they fatigue they are still able to stabilize the shoulder blade and keep the athlete free from injury.

     Another a common complaint among swimmers is knee pain.  This is most frequently due to the whip or frog kick employed in breaststroke.  This kick places a sudden valgus force on the knee, forcing the knees together faster than the feet.  This position places a stretch on the ligaments on the medial (inside) surface of the knee and a compression of the structures on the lateral (outside) surface.  Unfortunately, the mechanics of this kick call for the swimmer to repeatedly put forces on the knee which have a great potential for injury.  This kick also has the potential to cause irritation in the hip which can lead to hip pain.  In order to avoid these injuries, it is important for swimmers to build strong hips and a strong core to avoid having these same stresses put on the knee and hip during other activities they might be involved in such as PE classes at school.  It is also important for swimmers to train in a variety of strokes in order to minimize the repetition and decrease wear on the tissues in the knee and hip.

      It is also common for swimmers to experience pain in the lower back.  This is partly due to the optimal body position in the water which calls for the head and shoulders to be high in the water.  To achieve this position, swimmers often utilize increased low back extension (backwards bending) which puts increased pressure on the disks, nerves, and muscles in the lower back.  This position also decreases activation of the abdominal muscles which help stabilize the lower back.  Because swimmers are in this position for long periods of time, it is common for this posture to transfer to standing posture which can compound the problem.  To avoid this it is important to build strength in the transverse abdominis muscle which supports the back and keeps the spine in proper alignment.  This muscle is one of the core muscles which, when strengthened and trained properly, can help prevent a wide array of chronic and traumatic injuries, as well as contribute to athletic performance.

Dr. Heather Shaughnessy is a triathalete, and clearly understands the possibility of injury during herow swimming training.

     Though swimming is a low impact sport compared to many others, it does come with its own unique set of injuries and complications.  The factors described above give a brief overview of some common problems for competitive and recreational swimmers alike.  There are many other factors that can contribute to an injury.  For a full evaluation and an individualized plan of care, call Accelerate Physical Therapy today to set up an appointment with one of our licensed physical therapists.

Preventing Swimming Injuries is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Heather Shaughnessy, DPT

Often times, adolescents have not developed proper control of the muscles which stabilize the body’s core.  Though some athletes have been playing for many years and are often very good at their sport, they usually still lack the core coordination and strength required to keep them healthy.  In the sport of volleyball the core is important for generating strength and arm speed for a harder overhead swing during spiking and serving.  Without enough core stability, the athlete ends up using the shoulder muscles to generate speed.  Asking these smaller muscles to do the work of the larger core muscles puts them at a disadvantage and will inevitably lead to breakdown resulting in injury. 

Also necessary for a harder spike is thoracic extension, the backward bending of the upper and middle back.  This is important for allowing the arm a greater range of motion through which to swing, thus giving it more potential for speed generation.  Thoracic extension often goes hand in hand with having good posture.  In our culture of TVs and computers, adolescents and adults alike often end up with a forward head posture, shoulders which are rounded forward, and a slumped upper back.  This posture is a result of tightness in the chest muscles and weakness in the upper back muscles.  By addressing these issues an athlete can increase their thoracic extension, thereby allowing the core to do more of the work generating power.

Also hand in hand with core strength is hip strength.  Some even consider the hips to be part of the body’s core.  When an athlete has hip weakness it is often in the hip abductors and external rotators- the muscles which raise the leg to the side and turn the thigh out.  When these muscles are weak, it allows the knee to fall into a position of genu valgum, also known as being knock-kneed.  Even when an athlete does not appear knock-kneed they could have weakness leading to malalignment at the knees which could lead to injury.  Weakness at the hips also decreases the overall stability of the hip and knee so when an athlete experiences a collision or lands awkwardly from a jump, they are less able to correct their position before an injury occurs. 

There are many factors that can lead to injury in a young and the ones discussed here are only the most common.  Proper evaluation and treatment from a licensed physical therapist can determine areas of weakness and/or tightness leading to an injury.  A therapist will then be able to create a personalized treatment plan to address these areas, restoring the athlete to health and allowing them to enjoy their sport for years to come.

Preventing Volleyball Injuries is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Whether the need is to improve strength, restore range of motion, promote soft tissue healing, reduce inflammatory conditions, or to improve body awareness one form of exercise or another can be used to facilitate changes. Here are some exercise facts:

• Exercise helps to reduce pain in joints because muscle balances normalize and improve the joint’s ability to move correctly and therefore reducing joint friction, stress and joint instability in dynamic activities.
• Exercise helps maintain bone integrity by reducing decalcification of bones in those individuals who find themselves less active or who were never athletically minded.
• Exercise helps improve the condition of all cells in the body, including the skin. The profusion of blood through all tissue has a restorative value. We encourage cardiovascular activity to promote the well being of the integumentary system.
• Bowel and bladder functions are greatly enhanced through the use of exercise of the trunk, hips and legs. Exercise of the pelvis and the lower trunk can help to improve elimination and the tone of musculature helps in management of conditions such as incontinence.
• Exercise helps strengthen the cardiovascular system, improves circulation and builds endurance, as well as reducing swelling that may be chronic in inactive individual lower extremities.
• Exercise aids in the prevention of atrophy of the muscles of the trunk muscles, and those of the upper and lower extremities.
• Exercise decreases muscle spasms and restrictions in mobility.
• Exercise helps to lessen the progressive effects of gravity, including poor posture, functional scoliosis and pain associated with the irritation of soft tissue.
• Exercise is very effective when used in the treatment of tendonitis and epicondylitis conditions such as tennis elbow through emphasis of eccentric or negative contractions.
• Unloading techniques using suspension devices, aquatic exercise and/or incremental weight bearing allows higher repetitions to promote accelerated return to normal and athletic activities.

These are ideas that provide natural, inexpensive means to achieve rehabilitation, prevention and wellness milestones

Exercise Cures Common Health Problems is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy

Impingement refers to mechanical compression and/or wear of the rotator cuff tendons. The rotator cuff is actually a series of four muscles connecting the scapula (shoulder blade) to the humeral head (upper part of the shoulder joint.) The rotator cuff is important in maintaining the humeral head within the glenoid (socket) during normal shoulder function and also contributes to shoulder strength during activity. Normally, the rotator cuff glides smoothly between the undersurface of the acromion and the humeral head.

How is Shoulder Impingement Treated?

The first step in treating shoulder impingement is eliminating any identifiable cause or contributing factor. This may mean temporarily avoiding activities like tennis, pitching or swimming. A The mainstay of treatment involves exercises to restore normal flexibility and strength to the shoulder girdle, including strengthening both the rotator cuff muscles and the muscles responsible for normal movement of the shoulder blade. This program of instruction and exercise demonstration may be initiated and carried out either by the doctor or a skilled physical therapist.

Source: American Orthopaedic Society for Sports Medicine

Shoulder Impingement is a post from: Physical Therapy Services in Arvada, Colorado ~ Accelerate Physical Therapy