Spinal Musculoskeletal Injuries Associated with Swimming: A Discussion of Technique

Objectives: To review the biomechanics of the swimming stroke and examine common injuries which occur in swimming. A review of diagnosis and management strategies of these injuries is also performed. Background: Most injuries and complaints encountered in swimming athletes occur because of repetitive microtrauma or overuse, with many injuries originating from faulty technique and poor swimming biomechanics. As a result, assessment of an injured athlete requires the practitioner to have an understanding of the four swimming strokes and hydrodynamics. Methods: A Literature search of the MEDLINE and MANTIS databases was performed on all swimming related articles. Results: Twenty seven journal articles and 7 text books were chosen that satisfied the search criteria and related to the aims of this review. Discussion: The correct swimming technique is discussed and predisposing factors to injury in the stroke are identified. Specific injury sites are examined and pathologies to these areas are detailed. Conclusion: The shoulder, neck and back are the injuries considered in this review. These regions are considered in the total training program of the athlete to identify other factors, such as weight training or other dry land programs that may be contributing to injury. However, whilst rest or reduced training may be necessary for recovery, every effort must be made to keep the swimmer “in the water” as cessation of training may lead to a rapid detraining effect and loss of competitive advantage.