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Swimming is one of the most popular forms of physical activity around the world. In England alone, prior to the Covid-19 pandemic, approximately 4.2 million of us swam at least two times a month making it the 8th most participated sport in the country; swimming is the most popular sport among children aged 5-10 years (ref).

With many of us using swimming as a primary form of exercise or as an alternative, due to injury or part of an injury rehabilitation programme, it is inevitable that injuries will occur.

The benefits of regularly swimming include

  • It's a form of exercise you can continue throughout your lifetime.
  • It's a life skill that can save your or someone else's life.
  • It gives you a total body workout, as nearly all of your muscles are used, toning muscle and building strength in the process.
  • It keeps your heart rate up whilst taking some of the impact stress off your body.
  • It builds your endurance and cardiovascular fitness.
  • Improves your core strength and flexibility which can help with controlling/preventing low back pain.
  • It can improve your mental health by reducing stress and anxiety and increasing self-confidence.

Common causes of swimming injuries

Swimming is unique in that it combines upper and lower body strength exercising with cardiovascular training all in a non-weight bearing environment. The highly repetitive nature of the activity +/- improper technique means that overuse musculoskeletal injuries account for the majority of swimming-related injuries. The most commonly injured sites are the upper limb, knees and spine.

Acute muscle strains can still happen from performing explosive actions like diving off blocks or kicking hard through the water. Also, we must not forget that in watersports that involve multiple participants (e.g. water polo) it is still possible to develop contact injuries similar to what is seen in land-based collision sports (e.g. concussion, contusions and facial injuries).

Common swimming injuries

Swimmer's shoulder

A broad term used to cover all potential causes of shoulder pain in swimmers. Pain which is usually located around the front of the shoulder can be caused by:

  •  Abnormal shoulder mechanics leading to rotator cuff impingement
  • Overuse fatigue of the muscles around the shoulder
  • Shoulder laxity resulting in instability
  • degenerative changes like a labrum tear, shoulder joint osteoarthritis or rotator cuff tear.

Treatment requires identifying the root cause of the problem in order to address it so the symptoms do not keep recurring.

Breaststroke swimmer's knee

The knee is the second most reported site of pain in regular swimmers with breaststroke swimmers at a 5x greater risk of developing knee pain.

Low back pain 

All swimming strokes require you to maintain hyperextension of the lower back to achieve a streamlined position; this position is exaggerated in the "undulating" nature of breaststroke and butterfly. The high intensity and repetitiveness of these two strokes load your lumbar spine, leading to an increased increase risk of damage.  Using training devices such as fins, kickboards, or pull buoys may worsen increase your risk of low back pain by increasing the hyperextension of the lumbar spine.

Medical conditions associated with swimming

In addition to musculoskeletal injuries, swimming poses a number of medical challenges due to the variety of environments it can take place.  Naturally occurring irritants and pathogens or chemical exposure commonly cause respiratory and skin conditions in swimmers. Conditions like:

  • Chemically or exercise-induced asthma
  • Rhinosinusitis
  • Chest infections
  • Ear infections
  • Skin infections and allergy

It is important you see a doctor if you are getting symptoms associated with swimming to ensure you get an early diagnosis and treatment so as not to affect your performance and your ability to enjoy your sport.

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