Ryan Lochte, Michael Phelps, and Missy Franklin have garnered much of the spotlight in London this week. As a former swimmer myself, I enjoy watching the swimming competitions almost as much as any other sport in the Summer Olympics. I think most people realize how hard these elite swimmers have trained throughout their careers, but many people are surprised by how common swimming injuries occur.

A recent article in the journal Sports Health provides some interesting data regarding injuries among elite swimmers.

Swimming injuries and tips to prevent them

  • Elite swimmers often swim up to 9 miles per day during training. This distance requires more than 2500 shoulder revolutions in each training session.
  • Injuries in competitive swimmers are actually very common. A study of NCAA swimmers found an injury rate of 4.00 injuries for 1000 hours of training for male swimmers. Female swimmers had an injury rate of 3.78 injuries for 1000 hours of training.
  • Shoulder pain is the most frequent orthopaedic injury among swimmers. A recent study showed that 91% of elite swimmers age 13 to 25 reported at least one episode of shoulder pain.
  • Knee injuries are the second most common source of pain in elite swimmers. According to one study, 86% of competitive breaststroke swimmers had at least one episode of knee pain related to swimming breaststroke.
  • Low back pain is a common injury in swimmers too. One study shows incidence rates of low back pain as high as 50% for butterfly swimmers and 47% for those swimming breaststroke.

Fortunately there are some steps that swimmers can take to stay healthy during this rigorous training.

  • Pay extremely close attention to stroke technique. If coaches or the swimmer notice any change in mechanics, correct them before pain begins. Also once a swimmer develops pain, such as shoulder pain when she pulls her hand through the water, she might change her technique ever so slightly. This change in mechanics can exacerbate the problem. Focus tremendous attention on proper technique to try to stay healthy.
  • Incorporate traditional rehab exercises into prevention strategies. Learn and perform exercises to strengthen the abdominal muscles, rotator cuff muscles, muscles around the shoulder blade, lower back muscles, and quadriceps and hip muscles to try to decrease the chance of suffering overuse problems.
  •  Let the appropriate people know that you are experiencing pain. Tell your coach and your parents that you are having pain during training. Depending on the severity and the location of the pain, appropriate measures (adjusting training in the pool or dryland training, seeing an orthopaedic surgeon, etc.) can be taken.

A swimmer swimming laps in a pool.

References:
1. Wanivenhaus F, Fox AJS, Chaudhury S, Rodeo SA. Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers. Sports Health. 2012;4(3)246-251.
2. Pink MM, Tibone JE. The painful shoulder in the swimming athlete. Orthop Clin North Am. 2000;31(2):247-61.
3. Wolf BR, Ebinger AE, Lawler MP, Britton CL. Injury patterns in Division I collegiate swimming. Am J Sports Med. 2009;37(10):2037-2042.
4. Sein ML, Walton J, Linklater J, et al. Shoulder pain in elite swimmers: primarily due to swim-volume-induced supraspinatus tendinopathy. Br J Sports Med. 2010;44(2):105-113.
5. Rovere GD, Nichols AW. Frequency, associated factors, and treatment of breaststroker’s knee in competitive swimmers. Am J Sports Med. 1985;13(2):99-104.
6. Drori A, Mann G, Constantini N. Low back pain in swimmers: is the
prevalence increasing? In: The 12th International Jerusalem Symposium on
Sports Injuries; 1996; Tel Aviv.