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

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Presentation on theme: "Injury Prevention in Swimming Mr Kevin Boyd FRCS(Tr&Orth) FFSEM (UK) DipSportsMed Consultant Trauma & Orthopaedic Surgeon Chairman British Swimming Medical."— 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 29 000 in England & Wales 19.3 million new sporting injuries/year 9.8 million substantive injuries/year Injury risks: –Rugby 57.7/1000 occasions –Soccer19.3/1000 occasions –Hiking4.2/1000 occasions –Swimming 2.3/1000 occasions Nichol et al BJSM 1991

4 Human Performance Continuum PERFORMANCE OPTIMISED UK Swimming Population: 4.5 million HEALTH SUBOPTIMAL HEALTH OPTIMISED

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 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 LAND WORK Weights Swimbench / pulleys Flexibility Cross-training –Circuits / Running / Cycling

10 Training Cycle Training RemodellingAdaptation Tissue Breakdown Recovery INJURY

11 Acute Injuries Overuse Injuries

12 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

15 Research – Muscle Imbalance Prospective, controlled trial 31 elite age group swimmers/20 controls Initial2/1218/12 ER/IR ratio1:1.961:1.781:1.47 Controls1:1.47 Pain161 Instability228 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

18 Knee Problems Chronic MCL sprain –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 –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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