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Guide to Prevention & Treatment of 5 Common Swimming Injuries

Common Swimming Injuries

Photo Credit: Brian Matangelo

Swimming is a great form of exercise and sports injury rehabilitation for all ages. It is widely recommended for its gentle low stress demands on the body as the water supports your weight while also giving a thorough workout by using most of the body’s major muscle groups.

With swimming and fitness it is certainly a case of what you put in you get back out. It can be used to relax, lose weight, and develop strength, flexibility and stamina.

While swimming is usually prescribed to help healing sports injuries there are a few common injuries the sport itself can cause, most of which are typically suffered by the professional or regular swimmer.

Injuries such as swimmer’s shoulder, muscle cramp, swimmer’s itch, general body and back pain and swimmer’s knee are all associated with swimming. And, depending on the level of participation and fitness of the swimmer, these injuries are more or less likely to be experienced.

This guide is aimed at the regular and elite swimmer and it explains each of these injuries and conditions with tips on diagnosis, prevention and recovery.

1. Swimmer’s Shoulder

Chances are if you swim regularly you will have experienced shoulder pain or discomfort at some point. The term ‘swimmer’s shoulder’ is used to describe overuse shoulder injuries in swimmers. Often poor stroke technique and muscular imbalance are the cause of injuries. Although not an exact diagnosis sufferers should look to seek further medical guidance from practitioners well versed in the mechanics of swimming. Because the shoulders and upper extremities help propel the body in water any small biomechanical problems can often accentuate the issue.

Symptoms of swimmer’s shoulder can include:

  • Pain that gradually increases while swimming.
  • Pain during periods of rest.
  • Overtime the shoulder may become painful to touch and aggravated during sleep.

Interesting Fact: The competitive swimmer can perform as much as 16,000 shoulder revolutions in a week while training.

What can you do to prevent swimmer’s shoulder?

As stated swimmer’s shoulder is an overuse injury so avoiding constant use of the shoulder is a good way to help the joint and muscles relax and recover. Front crawl and backstroke tend to cause the most discomfort when suffering from swimmer’s shoulder so if training note that breaststroke causes the least problems. You can also exercise the shoulder outside of the pool to strengthen and stretch the shoulder and back muscles. Using exercise bands and tubes are a great way to gradually build up flexibility and resistance.

What should you do if you suffer from swimmer’s shoulder?

Pain relief is the primary focus of treatment initially and swimmers will be advised to rest, stop exercise altogether or significantly reduce activities. Anti-inflammatory treatment in the form of cold therapy should be implemented, a cryotherapy cuff with cooler is an excellent option to utilise until the shoulder becomes pain-free. The next objective is to try and restore normal strength, usually by starting with very light mechanical exercises. Resistance bands are ideal for gradually increasing strength with functional movements.

In addition, pain management and inflammation reduction is key during this acute phase of rehabilitation and with the TENS Machine you have the benefit of being able to specifically target and retrain muscles while blocking the pain impulses, producing pain relief.

However for a small percentage surgical intervention is the only option and during the recovery phase immobilisation is key to allow the capsule to heal adequately. An elbow and arm sling keeps your arm immobilised and prevents overuse of the shoulder. Maintenance is the final phase of rehabilitation and with the kinesiology tape you have a waterproof supportive accompaniment offering piece of mind during this tentative stage of the process.

2. Swimmers Knee

Swimming is often perceived as one of the safest sports to participate in, however there a number of common injuries and ailments associated with taking to the water. The primary cause of swimmer’s knee is the breaststroke which is why it is also known as breaststroker’s knee. During breaststroke the leg whips out helping to increase the speed of the body through water. As the tension increases during this kicking phase the force generated on the inside of the knee can cause problems to the medial collateral ligament (MCL).

Symptoms of swimmer’s knee are:

  • General knee pain
  • Inflamed and/or fatigued knee tissue
  • Swelling of the knee
  • A sharp pain when placing the knee under stress
  • Long term breaststroke swimmers may become knock-kneed

What can you do to prevent swimmer’s knee?

Improper technique has been cited as the common cause of swimmer’s knee. The repetitive nature of swimming places the joint under constant stress. In the first instance swimmers are advised to rest, but on return, and in addition to technical guidance from a coach to help improve the biomechanical factors associated with this injury, swimmers can undertake a number of injury prevention exercises.

What should you do if you suffer from swimmer’s knee?

As mentioned, exercise is a great preventative for swimmer’s knee but it can also form part of a recovery process. A prescribed rehabilitation programme from a medical practitioner will often involve leg strengthening and stretching exercises, focusing on but not solely the quadriceps and hamstrings.

Perform squats and lunges using a balance trainer or wobble board, not only will this increase the supporting muscles in the leg but it can also help improve proprioceptive qualities and core strength. Foam rollers are excellent for use within massage therapy as a pre-event (warming the muscles before exercise) or as a post event accompaniment to help prevent delayed onset muscle soreness (DOMS).

Pain management and the ability to minimise swelling is key during this phase of recovery and a knee cryotherapy wrap is a convenient application of cold therapy. On return to the pool swimmers may often choose a suitable support during those early stages for peace of mind and the neoprene knee support is an ideal low-cost option suitable for this type of environment.

3. Swimmer’s Back Pain

In many cases swimming is used as a way of keeping active when recovering from injury, but that’s not to say this low impact sport cannot be the cause of injuries itself. Lower back pain occurs when the back has been hyper-extended or stretched for long periods during front strokes (the crawl or breaststroke). In addition, the groin and neck region are often prone to injury. The repetitive nature of the strokes, high head position and the strain caused by the force required in the kicking motion to keep the hips and legs from dipping, result in a number of problems.

Symptoms of swimming and back pain are:

  • Muscle weakness
  • Pain while swimming and / or getting out of the pool

Interesting Fact: Ironically as well as being a cause of back pain swimming is highly regarded as a solution for relieving the symptoms of it.

What can you do to prevent swimmers back pain?

To help prevent this pain a swimmer must look to implement correct form and technique avoiding any awkward or unnatural movements, coaching and guidance from a qualified professional or a more experienced swimmer is recommended. In addition research has shown that strengthening, stretching and regular aerobic exercise will assist in maintaining a healthy back. Using an exercise roller will combine a shoulder, arm and abdominal workout while improving tone and core strength. Incorporating yoga into your routine can also help prevent back pain. Increasing flexibility, strengthening the ligaments, tendons and joints have long been the associated health benefits of Yoga.

What should you do if you suffer from swimmers back pain?

Pain management is essential and cold therapy has been proven to effectively ease mild cases of back and general body pain while helping to reduce any swelling. A back support will help you to manage your back pain by keeping the spine in the correct position and reducing strain on the muscles.

In more extreme cases back pain sufferers may like to consider a more high tech approach with a TENS Machine helping to stimulate the nerve endings which send signals to the brain, blocking the pain impulses and producing drug-free pain relief. If swimming continues to be painful then you must look to stop and seek further guidance from a healthcare professional.

4. Swimmer’s Itch

Cercarial dermatitis or ‘swimmer’s itch’ is a skin rash caused by an allergic reaction to the infection which is carried by certain parasites on birds and mammals. These microscopic parasites are released from infected snails, ducks or swans that swim in fresh and salt water, such as lakes, ponds, and oceans.

Swimmer’s itch is more common in the warmer summer months when the parasites might burrow into your skin, where they cause the rash. However humans are not a suitable host for them, so the parasites soon die while still in your skin. Although uncomfortable, swimmers itch is usually short-lived. The rash typically clears up on its own within a few days.

The symptoms for swimmer’s itch are:

  • Itchy skin
  • A rash of small reddish pimples that usually appears 12 hours after swimming in fresh or salt water
  • These spots can sometimes develop into small blisters

Interesting Fact: Swimmer’s itch cannot be spread from person to person.

What can you do to prevent swimmer’s itch?

The most obvious way to prevent swimmer’s itch is to stick to the pool, but if you intend to swim in lakes etc, then it’s worth bearing in mind that swimmer’s itch only affects exposed skin. This means areas which are not covered by swimwear or wet suits are at risk. Using compression wear for full body coverage is an option you may like to consider. Compression shorts and shirts not only help retain body heat and keep muscles more supple but they would counteract any parasite attack.

What should you do if you suffer from swimmer’s itch?

Diagnosing swimmer’s itch can be difficult, because the rash can look very similar to other skin problems, such as chickenpox, dermatitis or impetigo. There are no specific tests to diagnose swimmer’s itch so be sure to tell the doctor if your symptoms appeared after swimming.

The rash may appear up to 48 hours after swimming, but you may also experience itching without ever developing a rash. The symptoms of swimmer’s itch should only last a few days and you can control itching with over-the-counter or prescription medications. Secondary exposure can cause the rash to become more severe and if the rash lasts more than one week or the site develops ‘pus’ you are advised to contact your doctor.

5. Muscle Cramps

At some point almost everyone has suffered from cramp. Incidents can last from as little as a few seconds or up to 15 minutes, sometimes longer and can reoccur multiple times until the problem is finally resolved. Leg and arm cramps when swimming are commonplace and happen when a muscle is involuntarily contracted and does not relax. If a muscle contracts into a forceful and sustained spasm it becomes cramp which involves a visible hardening of the area, tenderness to the touch and pain.

Symptoms of muscle cramp are:

  • Sudden stiff and tight muscles
  • Pain in the affected area
  • Restricted or difficult movement in affected area

Interesting Fact: Around 95% of people will experience muscle cramp in their lifetime.

What can you do to prevent muscle cramp?

There are a number of triggers from the excited nerves that stimulate the muscles to dehydration. You may be particularly prone after injury, have low blood levels of calcium, magnesium, or potassium or from certain medications.

Cramps can affect children and adults alike whilst performing rigorous exercise, strenuous physical activities or even when sitting or lying in an awkward position. Therefore the best forms of prevention are to stay well hydrated and always warm up and cool down before and after exercise.

What should you do if you suffer from muscle cramp?

Most muscle cramps will typically resolve themselves, however if they continually occur then it is advised to seek further medical guidance. If you experience a cramp while swimming then keep moving and exit the water as soon as possible.

Once out of the water the primary treatment involves stretching followed by massage. Finally, apply warmth to the affected area. Always try to incorporate an adequate warm-up and cool-down phase as part of your training session and maintain adequate levels of hydration before, during and after your workout. Fuel your body and replace lost electrolytes to help prevent and alleviate cramps.