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Injury Prevention in Swimming

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Presentation on theme: "Injury Prevention in Swimming"— Presentation transcript:

1 Injury Prevention in Swimming
Mr Kevin Boyd FRCS(Tr&Orth) FFSEM (UK) DipSportsMed Consultant Trauma & Orthopaedic Surgeon Chairman British Swimming Medical Advisory Committee

2 Swimming is Unique ! Outside of man’s natural environment
Specific actions to allow breathing No firm surface against which to generate forces Propulsion by the upper limbs Negative effect of water drag

3 Injuries in Sport and Exercise
Survey of in England & Wales 19.3 million new sporting injuries/year 9.8 million substantive injuries/year Injury risks: Rugby /1000 occasions Soccer 19.3/1000 occasions Hiking 4.2/1000 occasions Swimming 2.3/1000 occasions Nichol et al BJSM 1991

4 Human Performance Continuum

5 Causes of Sports Injuries
INTRINSIC Age, sex, body composition Muscle weakness/imbalance Flexibility Malalignment Poor nutritional state

6 Causes of Sports Injuries
EXTRINSIC Training methods Surfaces Equipment Environment Nature/rules of sport Training Load

7 Training Load POOL WORK 70 km/week = 1400 lengths/week
36 strokes/length 48-50 weeks/year 1.25 million strokes per arm per year Duration 8-10 years

8 Training Load

9 Training Load LAND WORK Weights Swimbench / pulleys Flexibility
Cross-training Circuits / Running / Cycling

10 Training Cycle Training Recovery INJURY Remodelling Adaptation
Stress to the system involved Excess or insufficient Recovery INJURY Tissue Breakdown

11 Acute Injuries Overuse Injuries

12 Education & Discipline
Acute Injuries TRAUMATIC Head & C-Spine Diving Correct technique Fingers / Feet Falls Wet Environment Drowning Education & Discipline

13 Shoulder Problems Aetiology
Tendinopathy Impingement Instability Fatigue Secondary Impingement Syndrome due to functional instability

14 Research - Impingement
Impingement 25% stroke time (range 4-56%) Increased impingement with: - reduced shoulder tilt at catch ‘breathing side’ - late initiation of ER in recovery - large IR in insweep Yansai & Hay MSSE 2000 4 trials 2 speeds +/- paddles All swimmers impinged 15% in water 10% in recovery Stroke technique not consistent Overhead activity greater demands than what shoulder is designed for Impingement increases in quality not quantity in paddles

15 Research – Muscle Imbalance
Prospective, controlled trial 31 elite age group swimmers/20 controls Initial 2/12 18/12 ER/IR ratio 1:1.96 1:1.78 1:1.47 Controls 1:1.47 Pain Instability Holz Biomech Med Swim VII 1996

16 Research – Joint laxity/Pain
40 elite swimmers Laxity Score ± Apprehension Pain group 15/16 cf No Pain group 9.8/10.7 Significant correlation (p<0.05) between shoulder laxity and interfering shoulder pain McMaster AJSM 1998

17 Shoulder Instability Spectrum of Instability
Acute traumatic v Multi-directional Functional/Dynamic instability Imbalance Fatigue +/- Generalised Joint Laxity Chronology v direction

18 Knee Problems Chronic MCL sprain Patellofemoral Plica syndrome
external rotation of ‘whip’ kick Patellofemoral Maltracking CMP Instability Plica syndrome Meniscal tears

19 Back Problems Postural Ligament strains / Muscle sprains Spondylolysis
Pars stress injury Butterfly / Breaststroke

20 Prevention Education Progressive training loads
Athlete / Coach Progressive training loads In-build Recovery periods Limit non-sport demands Minimise psychological stressors Ensure optimal nutritional status Responsive to Change

21 Prevention Correct postural / muscular imbalances
Muscle / Ligament Length Endurance Optimise Core Stability Attention to technique / biomechanics Stretching *BEWARE*

22 Summary Swimming is a safe sport Demands of elite Swimming are large
Individual ability to cope Primary prevention is the priority Swimmer, Coach and Therapist working together in the pool

23 Thank You

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