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Thread: Swimming Injuries - Solutions?

  1. #1
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    Swimming Injuries - Solutions?

    Swimmers... particularly Masters Swimmers... tend to develop unique injuries. It is really hard to find information and solutions for these problems outside of the aquatic world. I would appreciate it if folks who have overcome shoulder/elbow injuries (or other swimming related problems) could post information on what your injury was, and how you solved it.

    My selfish reason for this new thread? I've been dealing with "swimmer's shoulder" for about 6 years (I'm 32). I'm trying to find a non-surgical solution that will allow me to continue to swim (relatively pain-free?). I swim everything from sprints to open-water marathon swims -- and my shoulder pain (which has spread to my neck and elbows) is making it less enjoyable.

    Looking forward to hearing some success stories. Thanks!

    Duncan

  2. #2
    Very Active Member emmett's Avatar
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    Be sure to read the book "The 7-Minute Rotator Cuff Solution" by Horrigan and Robinson.

    We do a set of exercizes at every practice that are derived predominantly from that book. This, coupled with proper "neutral shoulder" technique, has virtually eliminated shoulder problems in our program.

    I've got an article on my site www.H2OustonSwims.org that gives details - "Hops, Whirlpools, Shoulder Thangs and Stretches"
    Coach Emmett Hines - ASCA Level 5
    Gulf LMSC Top10 Chair
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    Active Member GZoltners's Avatar
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    I've had shoulder, knee, hip and elbow problems in my years of swimming. If it hurts, and it is not muscle soreness, stop right away. Pushing it too far can mean a year off to recover. Take the time to find out what motions and situations are causing the joint pain. Are you warmed up enough? Is it a technique issue? Some joint problems are due to bad technique, but probably not all of them. I had good breastroke technique and weak quadriceps, and got knee problems. This problem rarely bothers me anymore, but I am very careful warming up, and my quads are much stronger.

    I found for my elbow (medial epicondylitis) that traditional therapeutic exercises irritated the injury rather than helped. Also, the traditional "can of soup" weights are silly since I was doing wrist curls with 35s before I got injured. I did a lot of kicking and "invented" my own exercises to strengthen the forearms. I liked juggling with weights (exerballs) because it was more of a weight bearing exercise than a flexing exercise. This was a masters injury. I also stopped swimming all the strokes that irritated it.

    For me, the real issue is body awareness. I've gone over the edge enough to know when I'm overtrained and prone to injury, and I know what bursitis and tendonitis feel like when I get them. Run away to fight another day when you get the warning signs.

    My shoulder injury was as an 18 year old, just plain sprinting without enough warmup. I was probably 1000 yards and 8x50s build short of enough warmup for the speed we did and the level I was training at. Now, of course 1000 and 8x50 might be the whole practice. Ha! I learned that bench press/pushups/dips are very dangerous for the kind of injury I had. I also learned my freestyle technique was weak.

    Try to see a sportsmedicine doctor that has experience with swimmers. Ask around, college coaches might know someone.

    Swim fast,
    Greg

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    Duncan,
    I've successfully treated many cases of "swimmer's shoulder" over the years. As a non-surgical option, I suggest you find a competent chiropractor to help with the biomechanics of the thoracic spine/scapula/shoulder structures. I'm happy to "consult" with any doctor you get hooked up with if contacted by e-mail. Being a swimmer, having daughters who were all swimmers and being a chiropractor gives me a unique perspective on this particular problem and I don't expect that the ordinary DC out there will have the same background to know how to approach treatment; nor would I expect most MD's to be open minded enough to consider another view. Let me know if you need my help.

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    Thumbs up

    Greg, Greg, and Emmett -- Thanks for your replies! I'll follow your suggestions.

    Emmett -- can you provide a quick description of "neutral shoulder" position? My recent focus has been on entering the water with the fingers straight ahead (a little bit "pinky first"), instead of thumb-first as I learned. Besides body roll and high elbow catch, is there anything else in particular I should be concentrating on to keep a "neutral shoulder" position?

    Thanks again!

    Duncan

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    Very Active Member Bert Petersen's Avatar
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    Dear Duncan.........

    As one who has suffered several swim injuries, my advise would be to back off anything that causes pain. Seems obvious, yet I am surprised to see people with sore shoulders continuing to use those garbage-can sized hand paddles. About two months ago, my coach chastized me for not doing enough bi-lateral breathing on freestyle. I get lazy sometimes. So I began doing a lot of left side breathing for compensation. Sure enough, pectoral and triceps pain developed on the right side - so severe that I could only swim one-armed. We finally figured out that it was the way I turned my head that was causing undue pressure on those areas. When I changed that, the problem went away. So: bottom line - check your stroke and experiment around some......... Bert

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    Very Active Member emmett's Avatar
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    Never allow the elbow to venture behind the body plane. This is most common when trying to do a "high elbow" recovery with insufficient body roll. Pulling the elbow behind the body plane even slightly can be very hard on the shoulder - especiall in ballistic recoveries in sprinting.

    Another action the puts detrimental stress on the shoulder is pressing down on the water in front of you with your extended arm.
    Coach Emmett Hines - ASCA Level 5
    Gulf LMSC Top10 Chair
    http://H2OustonSwims.org
    emmett@usms.org

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    Participating Member moognut's Avatar
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    Cool a swimmer's plan for adapting workouts to shoulder injury

    I have a shoulder injury from last summer that has not gone away despite physical therapy, icing, and anti-inflammatory medications. Resting is helpful but in large doses has not proved beneficial; my shoulder often hurts more after I've been away from the water for a few days or even a couple of weeks. My coach and I also spent an entire season revamping my freestyle technique to mitigate stress on my shoulder.

    Recently we have worked out a solution to my shoulder pain that I am comfortable with and that seems to be (gradually) decreasing the overall level of pain. Of course, this would not work if I did not continue to ice my shoulder and do shoulder exercises.

    First, since I'm the kind of swimmer that feels "out of shape" if I take 2 days in a row off, I swim 6 days a week BUT I take a mandatory easy day one day a week (usually Thursday). So I get in a good workout M, T, W; go easy on Thursday (and focus on technique... and have fun!!!); then a good workout on Friday and Saturday.

    Second, if there are long freestyle sets (which always aggravate my shoulder), I consult with my coach and we change the routine a little. I started off not allowing myself to do more than 100 freestyle at a time; so I would do 75 free, 25 no free; 75 free, 25 no free. This was great because it challenged me to keep up with other swimmers who were doing all freestyle!!

    I have been gradually adding the amount of freestyle I can do in a row (usually adding a 25 every 1-2 weeks). Currently, I do 200 free, 25 no free.

    Third, I never pull. The pull buoy puts my shoulder in immediate pain. Sometimes if others are wearing paddles, I will wear short positive drive fins and then concentrate on using my core strength and my kick to help my arms.

    I'm really not an expert and this isn't necessarily "the solution" - It's just an approach I'm trying out, and so far, I'm happy with it. The most important thing for me is to come up with a plan tailored to my needs that will allow me to continue improving. Because of the systematic and consistent nature of this plan, it's much better than just getting out of the water when I feel pain in my shoulder, and feeling terrible about missing a workout or getting out earlier.

    The systematic approach to easing back on the things that hurt and finding other ways to keep the fun and challenge in swimming also prevent me from feeling "mentally guilty" about having to pull back from the full routine.

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    Participating Member LAnderson's Avatar
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    Talking

    I started swimming with Masters a couple of months ago - very out of shape. A couple of weeks ago I experienced very sore shoulders as my Monday morning workout progressed. I felt very "bound" up, finding extreme difficulty in upper body/shoulder movement. Needless to say, I was very worn-out when the workout was over (more than normal). Very sore shoulders and neck. While in the showering after practice, I was still experiencing stiff shoulders - it was difficult to raise my arms up to wash my hair.

    In a split second, I realized the problem - I had my daughters swim suit on - which had to be ATLEAST 3 sizes smaller than mine! Now, at 5:30am, I double check to make sure that I have my own swimsuit in my bag.

    Just thought I would throw in this "shoulder" humor..........

    Loreta
    Eugene, Oregon

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    Participating Member USNAVYGUNNER's Avatar
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    Glucosamine HCI and Glucosamine Sulfate. BEST JOINT REPLENISHING ANGENT ON EARTH. I have swimmers elbow, and even though it is chronic I can swim 1000's of meters pain free. When it does act up, I take about 3 days to rest and support it with either an ace bandage or an elbow support device. Works for me, but I am still young. (No offense meant, but I really am just a baby at 24, compared to most of the swimmers that I talk to)

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    Swimming Injuries - Solutions

    I'm entering this thread late, but hope I can still be heard. I want to second Vermont Swimmer's suggestion that there be a special area for the injuries we Masters swimmers sustain. The last time I wrote in it was because of a shoulder injury. The solution my coach came up with was for me to kick for two whole months. Now I am swimming full strokes again and we are working on correcting my stroke and easing me back into my previous workout patterns. Those two months were long ones, but my kick is now much more effective and I come off the wall faster. But equally important to my recovery was the input and support of other masters swimmers on this list. So I'd very much like to see a forum for discussion of injuries.
    Lanelubber

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    I have been doing competitive swimming since I was 9 (I am now 37). About 5 yrs ago I suffered a major shoulder injury during workout. After about a 1 1/2 yrs of trying different things, I ended up having surgery. I am finally able to swim without pain, but it's been a major learning experience. The key here is maintaining strong rotator cuff muscles so that your shoulder joints remain in their correct position to a fraction of a mm. So here's what I would do:

    1. You should, under no circumstances, swim through the pain. This will only excacerbate your injury, causing chronic and perhaps permanent damage. You should lay off for at least 6-8 weeks. This will allow a possible tear to heal. You should not get back in until you can swim without pain! You may have to be out of the water for as long as 3-6 months, or even a year.

    2. At the same time, you should try to strengthen your shoulder rotator cuff. For me it really works to do external rotation and straight arm exercises (standing up) with surgical tubing. Start out easy, maybe 3 sets of 10 with little resistance. Do the excercises slowly. Eventually you should build up to 3 sets of 18. Stop if it hurts. Not strengthening your shoulder will cause your shoulder problems to continue. You should go to a physical therapist to get more excercises. You can also look at the USA swimming web site (www.usa-swimming.org), which at least until recently had really good articles on shoulder strengthening excercises.

    3. Take ibuprofin for your pain when you are out of the water. The swelling causes further damage with shoulder movement and should be treated.

    4. If you can not get rid of the shoulder pain through rest, physical therapy, and ibuprofin, you should definitely see a doctor! You may at first get a steriod shot in your shoulder, which may succeed in reducing swelling and pain, and allow you to heal. In my case this did not work (the pain did not subside for more than a day!) and I had to have orthroscopic shoulder surgery. It is not the end of the world. Eventually I was able to get back in the water and now I can do regular workouts. I still do my shoulder excercises every day before I swim, and this keeps my shoulder feeling great. I also don't use paddles (and you shouldn't either).

    Hope this helps.

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    Post

    I am new to this board, and definitely a newbie to swimming for exercise. However, I grew up almost swimming before walking (recreationally) and really love the exercise I get from swimming now. But that is beside the point.

    I am a family practice physican with a bit of sports medicine training (I am NOT board certified for sports medicine, however). I have also had more than my fair share of sports related, chronic injuries from various activities.

    I do have a few recommendations, but take them with a grain of salt since I have not had the chance to examine you, and mostly these are general recommendations.

    1. You should, under no circumstances, swim through the pain. This will only excacerbate your injury, causing chronic and perhaps permanent damage
    Very very true. Sad, and bad news if you think about it, but things WILL get worse with any chronic tendonitis (which it sounds like you have)

    You should lay off for at least 6-8 weeks
    Hard to say for sure, but if this has been persistent or even intermittent for 6 years, 6-8 weeks is not long enough to rest your shoulder.

    2. At the same time, you should try to strengthen your shoulder rotator cuff.
    Also true. Many chronic sports related injuries are at least in part caused by muscle imbalances across a large joint (examples: knees, shoulders, the low back). Here is the difficult part: it is nearly impossible to recover on your own. The shoulder muscles and its motion is perhaps the most intricate and complicated joint in the human body. I would say that you need either an awesome trainer or physical therapist to work with your shoulders to evaluate its motion and relative strengths of the rotator cuff muscles. If you continue on the path now, you will probably have chronic pain and/or instability of that shoulder.

    It's all about balance of strengths and mechanical forces. I don't see an easy answer to this one. A physical therapist well versed in sports medicine combined with avoidance of re injury, and knowing you are in for a long (but not impossible, I suspect) recovery are key.

    And now that my first post to this board is so preachy, please forgive me when I ask some questions that may sound dumb in the future

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    Active Member Kipp's Avatar
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    Things I have seen

    Duncan
    I am a college coach and we get many damaged goods that come to our team. Ahh, the benefits of years of hard work! We have found (mostly our trainers have found) that shoulder problems stem from lack of stabilizing muscles in and under your scapula.. maybe the reason we are all slouching as we read this.

    1st solution: Sit and stand up straight. Our mothers were right, posture affects everything and you can begin strengthening those stabilizing muscles just by standing tall. Try it for five minutes to see what I am talking about.

    2nd solution: talk to a sports trainer or somebody in the rehab industry and find a way to start a rehab/prevention program. A good program should require no more than 15 minutes a day, but here is the trick. You have to stick to it for the rest of your life if you want to keep swimming, better yet, pick up your kids.

    3rd solution: try to start a lifting program, preferebly with someone who knows what you are trying to do. Many shoulder problems also stem from too much flexilbility. Yes, too much can cause other related problems. Yes, lifting is hard and takes time, but 30 minutes maybe two days a week could make an improvement.

    4th; like everyone else has said, listen to your body. if it hurts then stop. try kicking the rest of practice or put fins on. Technique change is difficult especially if you are trying to change an already weak area, plus you are ignoring the prblem by placing blame on technique. Fix the shoulder not the form.
    Good luck
    Kipp
    Jeremy Kipp
    UCSB Swim Coach

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    Very Active Member gull's Avatar
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    Those are great points. Six months ago I began a rehab program intended to strengthen the muscles which support the scapula. This has made a significant difference. I read somewhere that we should think of it as staying fit to swim, rather than swimming to stay fit.

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    I have had many sports related injuries over the years as well as some pretty severe damage from a car accident. I workout daily including a swim session at least 4 times a week. I have found that a combination of medical professionals seems to provide the best maintenance for my lifestyle. I do visit a Chiropractor once a month for lower back and shoulder/neck/arm adjustments. I also go to a certified massage therapist every 3 weeks. This is essential for me and has also been a great help to may daughter who is a collegiate swimmer. Additionally I consult an MD and Physical Therapists when I have a new injury. I would say that the Massage Therapist is the most indespensible. He is able to keep my muscles and entire body in balance and pain-free. Look for one who is certified for deep muscle massage and/or neuromuscular therapy. Not the type of massage you get on a cruise ship or a tanning spa.

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    Thumbs up

    Thanks for all of your replies. I'm going to make it my New Year's Resolution to act on your suggestions. Thanks!

  18. #18
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    Cool May I Suggest Total Immersion

    I would definitely focus on proper stroke. I have taken a few Total Immersion clinics, and my previously "problematic" shoulder is giving me no trouble at all. I do not use paddles and limit my pull buoy use. I also have mastered the art of bi-lateral breathing, therefore destressing my left shoulder. I focus more on my body roll and making my body longer to swim faster, as opposed to pulling harder with my arms. I really do suggest checking out Total Immersion, it has done away with shoulder pain and has made me much more efficient. TI focuses more on the core of your body doing the work (torso) instead of the small muscles of your arms.

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