1. Injury Prevention Focus on swimmers shoulder
Darren Wigg Bsc
(Hons) Physiotherapy

2. Introduction Darren Wigg
Sports Physiotherapist specialising in swimming
Former Senior GB International swimmer and British record holder for 200 and 400 I.M
Consultant Physiotherapist for City of Newcastle Swimming Club
Physio to the North East Beacon squad in Sunderland
Member of the GB swimming Physiotherapy team

3. What are your goals as coaches?
To get your swimmers to achieve their full potential?
To have the best program in the region or country?
To coach an Olympic medal winning athlete?

4. How do you achieve those goals
Effective coaching Motivational skills ?
Facilities Management skills

5. STAY INJURY FREE!!

6. Swimming Injuries....... Is it a dangerous sport?
Swimming is a relatively safe sport regarding injuries
The most common problems are due to repetitive strain injuries of the shoulder and knee
Swimmer ‘s Shoulder is a repetitive strain injury which accounts for about 40% of injuries in competitive swimming
Swimmers are exposed to the injury due to the unusually high number of shoulder rotations performed by competitive swimmers each year
Have a guess how many per arm?

7.
1.32 million!

8. The anatomy of the shoulder
The main shoulder joint is the glenohumeral joint (ball and socket) and is inherently unstable
There are 4 main stabilising muscles around the shoulder joint
They are called the rotator cuff (RC) muscles
They all originate from the scapular

9. Function
Their main function is to provide stability to the joint along with the joint capsule
The RC is predisposed to injury because of the bony anatomy of the shoulder complex

10. How does it occur
As the arm is elevated past 70 degrees the space available for the RC tendons is significantly reduced
If there is not good rotator cuff control the tendons can become impinged between the head of the humerus below and the acromion above causing RC impingement
As the cuff has a poor blood supply healing is difficult and a vicious cycle of repetitive impingement begins

11. How does it occur?
Swimming predominantly uses the muscles at the front of the shoulder and chest
This can cause those muscles to become overactive and short pulling the shoulder forwards. The muscles at the back become underactive, weak and long
A forward shoulder posture is common amongst competitive swimmers and is another contributing cause of swimmers shoulder

12. How does it occur
Poor frontcrawl technique can predispose a swimmer to RC impingement
Insufficient trunk rotation with a pull that crosses the mid line of the body is the main causative factor
Poor core stability in the water can also contribute to the problem

13. Can we prevent it?
Yes! Through an exercise programme which focuses on:
Improving RC control and endurance
Restoring muscle balance around the shoulder girdle by strengthening the underactive, weak muscles and stretching the overactive tight ones
Improving your general spinal and shoulder girdle posture

14. Can we prevent it?
Stroke analysis and attentive coaching will help to avoid the common mistakes which contribute to swimmers shoulder
The common faults in technique that reduce efficiency also increase risk of injury

15. How do we manage it if it occurs?
As coaches you can help minimise time out of the water through early identification and intervention by looking out for common signs and symptoms
Catching pain in the shoulder and upper arm
Usually worse with frontcrawl or butterfly
First line treatment should be ice and non steroidal anti-inflammatory drugs(e.g ibuprophen or volterol)

16. How do we manage it if it occurs?
Avoid aggravating activities – be flexible with training
Referral to sports physiotherapist ASAP
Ensure you liaise as closely as possible with them to ensure your swimmer’s optimum recovery

17. How do we manage it? Physiotherapy may involve the following:
Prescription of RC and scapular conditioning exercises
Postural advice and exercise
Advice regarding modification of training
Manual therapy
Electrotherapy

18. Summary
Staying injury free is extremely important in competitive swimming
The most common injury in competitive swimming is caused by impingement of the RC
It is an overuse injury caused by poor RC and scapular control
Poor posture and technique are also contributing factors
We can reduce the risk of injury through incorporating a RC and scapular setting programme into our land sessions, improving our posture and working with our swimmers to improve their stroke

19. Any Questions?

20. Contact Details
Darren Wigg Physiotherapy Ltd Bsc (First Class HONS)Physiotherapy Clinic : Mobile: