Injury Prevention for Swimmers Chrissy Becks, PT, DPT, OCS, ATC, CSCS Sarah Griffith, PT, DPT, OCS....
Importance of An Injury Prevention Program Swimming training: Repetitive motion High volume and intensity Long duration ***Predisposes to injury!*** http://www.theshoulderguy.com/shoulder-articles/shoulder-injurie s-in-competitive-swimming/#.wk5oirizors
Common Areas of Injury for Swimmers 1. Shoulders 2. Low back 3. Knees **Important to have stretching, strengthening, and endurance training program to prevent injury http://www.active.com/assets/active-family/620/race.jpg
What Causes Shoulder Pain? 1. Impaired posture 2. Altered stroke technique 3. Overuse and fatigue 4. Shoulder Scapula (shoulder blade) Upper back Core Laxity and shoulder instability 4
Impingement Injuries Repeated Trauma Repeated Pinching 5
Scapular Dyskinesis Dyskinesis = abnormal movement patterns Imbalance between muscles that control shoulder blade Increased fatigue of shoulder blade stabilizers increases shoulder instability Your form will worsen through the course of 1 practice due to fatigue. 6
Upper Trapezius Stretch Bend your ear to your shoulder so you feel a stretch on the side of your neck. Hold each for 30 seconds. Repeat 2-3 x on each side. 7
Levator Scapula Stretch Look down towards your armpit until you feel a stretch from the back of your head to your shoulder blade. Hold each for 30 seconds. Repeat 2-3 x on each side. 8
T-Y-Is (Scapular strengthening) Squeeze shoulder blades together and raise arms as below. Keep your shoulder blades away from your ears. START T Y I 9
Shoulder External Rotation Keeping wrist straight, turn your shoulder to the side by squeezing your shoulder blade to your spine and turning your arm outward. Slowly return to start. Repeat 2 sets of 10, work towards set of 20. Start End 10
Standing Rows Stand with elbows bent to 90 degrees. Squeeze shoulder blades together and pull back. Do not arch your back or lean back. Perform 3 sets of 10. Work towards 20-30 repetitions in a row.
W to Streamline Stand with your back against a wall with your arms in a W position. Keep back flat against the wall and move your arms to a streamline position.
Walkouts on a Stability Ball Start with your chest on the ball. Keep stomach tight and back straight and walk your hands forward until your knees or calves are on the ball. Do not let your lower back sag to the floor. Repeat 10 times.
Low Back Pain Who typically gets pain? Elite swimmers 33-50% of butterfly swimmers 22-47% of breaststroke swimmers http://www.swimminglesson.com.my/wp-content/uploads/20 11/12/butterflyphelps.jpg....
Causes of low back pain? Streamline position required for all 4 strokes Low back hyperextension + Training intensity and volume Long duration of repetitive training https://saycotest.files.wordpress.com/2011/08/streamline s1.jpg....
Hyperextension http://www.zwemza.com/wp-content/uploads/2013 /07/cover-fly-3.jpg Rhythmic wave-like motion of breaststroke and butterfly Repetitive nature of swimming = increased stress on low back region http://static01.nyt.com/images/2012/08/02/sports/olym pics/02soni_olyblog/02soni_olyblog-superjumbo.jpg....
Treatment and Prevention Swimming is an endurance sport Training core muscle strength... Helps avoid pelvic tilt Prevents excessive low back hyperextension https://www.linkedin.com/pulse/stre ngthening-your-core-using-medicin e-balls-stephanie-mizzi https://nydnrehab.com/blog/how-to-improve-core-s tability/....
Prone plank Prop up on your forearms and feet. Keep abdominals and glutes tight, back flat, and hips and shoulders in line. Hold for 30 seconds. Repeat 2-3 x.....
Prone plank with alternating leg lifts While keeping your abdominals and glutes tight, back flat, and hips and shoulders in line, alternate lifting right and lift legs. Perform 2 sets of 10 leg lifts on each side.....
Side plank Lying on your side, prop up on your right forearm and feet. Keep your elbow directly below your shoulder. Keep body in straight line. Hold for 30 seconds. Repeat 2-3 x on each side.....
Bird Dog Alternate lifting one arm and your opposite leg. Keep abdominals tight and back flat. Perform 2 sets of 20 repetitions.....
Bridge Slowly raise your buttocks from floor, keeping abdominals tight and squeezing your glutes. Progress to with feet on bleachers or physioball. Perform 2 sets of 20 repetitions.....
Opposite arm and leg lifts Alternate lifting one arm and your opposite leg keeping your core tight. Avoid hyperextending your low back. Perform 2 sets of 20 repetitions.....
Knee pain Second most common injury in swimmers Most prevalent in breaststroke swimmers (5x more likely) Risk factors: Poor hip strength Decreased flexibility Poor technique in pool and with dryland conditioning 24
Knee pain Anterior (front) knee pain: Common with kicking, wall push-off, and starts/turns, squats, running Girls ages 12-13 Medial (inside) knee pain: Common in breaststroke due to quickly bringing the legs in towards the middle 25
Leg stretches Hamstring Hip flexor/ Quadriceps Perform 2-3 sets of 30 seconds on each side. Calves
Clamshells Put a band around both knees and lay on your side with knees bent. Keep feet together and slowly raise your top knee towards the ceiling. Slowly lower back to start position. Perform 2 sets of 10 on each side.
Hip Abductor Straight Leg Raise Lay on your side and raise your top leg to the ceiling. Tips: Do not let your trunk roll backwards or let your leg come forward. Repeat 2 sets of 10 on each side. Work towards 15-20 repetitions.
Hip Adductor Straight Leg Raise Lay on your side with top leg crossed over the bottom leg. Raise the bottom leg to the ceiling and slowly lower back to the ground. Repeat 2 sets of 10 on each side.
When to Seek Medical Advice Pain is not a normal part of any sport. Consider seeking medical advice with any of the following: Pain that does not resolve after 48-72 hours of rest Pain that is constant Pain that increases with regular daily activities Popping or clicking with pain Low back pain that increases with backwards bending Pain impacting performance Numbness or tingling in upper or lower extremities 30
How to reach us... Sarah Griffith, PT, DPT, OCS 5680 Venture Dr. Dublin, OH 43017 P: 614-355-8752 sarah.griffith@nationwidechildrens.org Chrissy Becks, PT, DPT, OCS, ATC, CSCS 6499 East Broad Street, Suite 140 Columbus, OH 43213 P: 614-355-9757 christine.becks@nationwidechildrens.org Sports Medicine at NCH Scheduling: 614-722-6200