INJURY CLINIC WITH DOC MacLEAN Most injuries in swimming are down to overuse
IT has been a successful week at the World Aquatics Championships in Budapest with double gold winner and new world record holder Adam Peaty the standout for Team GB.
Scottish diver Grace Reid won silver with Tom Daley and we have had great performances from Ross Murdoch and Duncan Scott. Scottish swimming is maintaining its high profile and success in the wake of the Glasgow 2014 Commonwealth Games with an excellent programme at all ages backed up by the fantastic facility at Tollcross.
Swimming remains one of our most popular sports, both for competitive athletes and the non-elite, recreational swimmers. Swimming is fun and great for improving our cardiovascular fitness.
Swimming requires little in the way of equipment/clothing and importantly is relatively injury-free. Contrast the risk of musculo-skeletal injury in contact sports such as rugby, football and hockey.
With traumatic injuries relatively rare, most problems in swimmers are as a result of overuse. Not surprisingly shoulder, neck and back problems are most common with injury to the knee seen particularly in the breast stroke.
It has been estimated that an elite swimmer makes over one million strokes per arm over an average year. As a result overuse injuries to the shoulder are common. While the end result is pain on moving the shoulder through its normal range of movement it is particularly important to look behind the end result at the demands placed upon the shoulder by such a repetitive movement.
Many swimmers appear to have an increased range of shoulder movement – good to produce the necessary force to propel the athlete through the water but bad in that it can result in an increased incidence of instability injury and injury.
The shoulder is a relatively mobile joint – compared to the hip for example – but suffers for this as this mobility means the joint is less stable. This in part explains the relative frequency of dislocation of the shoulder.
It relies on the surrounding rotator cuff muscles to maintain stability. It is this group of muscles which are often damaged by the repetitive action especially if combined with poor technique.
The stability is a balance between these contributing factors, bones, muscles, tendons etc – when one element is injured the shoulder attempts to maintain stability by compensating through the other stabilisers. Initial treatment includes the usual ice etc but an early attempt is made to correct stroke dynamics and technique or re-occurrence is likely.
Knee pain is most commonly seen in those who do the breast stroke. This commonly involves the inside (medial) ligament of the knee or the patella (knee cap). This is most often due to the repetitive forces on the inside of the knee seen during the “whip kick” of the stroke.
Back and neck pain are not uncommon and again usually the result of poor technique and body position in the water. This may be the result of the desire to maximise the forward propulsion through the water.