SR Swim Clinic

Swimming Biomechanics
& Treatment Approach
UW Health Sports Rehabilitation

Beth Chorlton, MA, LAT
3/11/2011
Competitive Swimming Prevalence
US Swimming
Population:
100-120 million
250,000+ registered with
USA swimming.
38,000+ US Masters
Swimming members
5 million+ participate in
HS and summer
swimming
Kammer et al, 1999
Training Load
Freestyle is most common training stroke

Pool Work
Competitive swimmers train 10,000-20,000 yds/day.
40,000 shoulder rotations/per arm/per week
Stroke technique is critical
Dry land Work
Strength training
Dry-land conditioning
Cross-training (circuits, running, cycling)
Swimming Injury Epidemiology
Shoulder
Knee- breastrokers
Back-DDD,
Spondylolysis,
Spondylolisthesis
Swimming Injury Epidemiology
Prevalence of shoulder pain in elite

swimmers
3% in 1974 Swimmers Shoulder

42% in 1980
40-69% in 1994
47% lifetime incidence of shoulder injuries in
collegiate swimmers and 48% in masters
swimmers
Sein et al, BJSM, 2010
Shoulder Pain Epidemiology
Pink et al (2000): survey of 233 collegiate

swimmers on pain location.
Anterior-Superior: 44%
Diffuse pain: 26%
Anterior-Inferior: 14%
Posterior-Superior: 10%
Posterior-Inferior: 4%
Biomechanical Demands of Swimming
Outside humans natural environment

Specific actions needed for breathing
No firm surface against which to generate
forces.
Propulsion by upper limbs
Negative effects of water drag
Biomechanics of Freestyle
4 Phases of Freestyle
Entry/Catch
Early Pull/Pull
Push
Exit/Recovery
Entry/Catch
Hand entry in line with

shoulder and at wrist level
Slight IR pitch to hand ~ 40,
open hand
Elbow straightens to get long
glide
Elbow bends slightly and
remains on the surface for
catch and preps for pull
Opposite arm pull on entry
Opposite leg kick
Early Pull/Pull
High shoulder and high

elbow position
Elbow bent for pulling
and IR
Forearm vertical at mid
pull
Body rotation continuous
Pulling body past a
stationary arm, NOT
pushing water back.
Push
From vertical forearm

position to hip
Power thru core and
axial rotation
Need > 40 rotation to
clear the hip
Arm continues to
accelerate
Elbow exits first
Exit/Recovery
Elbow exits first, then

5th digit
Trunk rotation
necessary to avoid
horizontally abduction
beyond bodyline
Elbow leads
recovery, then hand
leads elbow
Kick
Power and propulsion

from hip and knee
extension
Efficient kick takes
stress off shoulder
Ankle PF
Stabilize core
2 beat/4 beat/6 beat
Head Position/Breathing
Slight cervical
extension vs. neutral
Alignment of
head/trunk/hips
Breathe at beginning
of recovery
Bilateral breathing
Freestyle
Common Freestyle Mechanical Changes Caused

by Fatigue, Soreness and Pain
Freestyle Stroke Flaw

Thumb First Entry
Over developed IR
Weak/fatigued ER
Coached to improve
catch/early pull
Poor motor program

Crossover at Entry
Poor scapular control

Poor trunk rotation
GH hypermobility
Poor motor
control/proprioception
Swimming flat
Poor motor program

Poor core strength
Poor kick
Anterior pelvic tilt
Excessive IR in
Recovery
Weak ER
RTC fatigue
Posture
Coached for high elbow
or finger tip drill
Poor Timing
Poor core strength

Poor balance in water
Poor motor program
Good Timing of Freestyle stroke
The Question...
Why has this swimmer
have this injury
at this time?
Etiology of
Shoulder Pain in Swimmers
Intrinsic Factors
Scapular dyskinesis
Muscular imbalance
Joint mobility (hyper/hypo)
Posture/increased thoracic kyphosis
Core stability
Inflexibility (pecs, lats, hip flexors)
Etiology of
Shoulder Pain in Swimmers
Extrinsic Factors
Training load- absolute and sudden increase

Stroke flaws/error
Stroke specialty
Sprinter/Mid/Distance
Training environment (pool/dryland/Xtrain)
Research Updates
Research - Impingement
4 areas of impingement recognized in the literature

Subacromial
Posterosuperior Internal
Anterosuperior Internal
Coracoid
Subacromial impingement: compression and

abrasion of bursal side and subacromial structures
between the humeral head and coracoacromial arch
Mechanical impingement occurs 25% of

freestyle stroke cycle in swimmers
(Yanai & Hay, 2000)
40% of impingement occurs at entry

40% during recovery
20% during the pull
(Pink & Timone, 2000)
Research - Muscle activity
Normal muscle activity during freestyle
15-20% of a muscles maximal voluntary contraction is

the highest level at which sustained activity can occur
without fatigue (Monod et al, 1985)
Pink et al, AJSM, 1991
EMG study on 12 muscles in 20 swimmers w/o shoulder

pain
Subscapularis and Serratus Anterior are constantly fire
at more than 20% of the maximum
Research - Muscle activity
Abnormal muscle activity during freestyle
Scovazzo et al, AJSM, 1991

EMG study of 12 shoulder muscles in 14 swimmers with
shoulder pain
During pulling, significantly less activity in SA and more in
rhomboids.
Research Muscle Activity
Research Joint Laxity
Many authors have examined GH laxity in

swimmers and concluded that swimmers
have great GH laxity and general joint laxity
Jobe described the instability complex
Borsa et al, AJSM 2005
42 NCAA Div 1 swimmers

44 age matched controls
US imaging of GH laxity
No difference in GH laxity between swimmers
and age matched controls
No difference in GH laxity between painful and
non-painful swimmers
Sein et al, BJSM 2010
80 elite swimmers (13-25

yo)
Training questionnaire,
PE, laxometer, MRI
91% complained of
shoulder pain
84% impingement sign
69% SSPS tendinopathy
Inferior glide
Sein et al, BJSM 2010
All swimmers with SSPS thickening had a

+ impingement sign and SSPS tendinopathy
++ correlation between SSPS tendinopathy and # of
hours swum each week (> 15 hours/week)
SSPS tendinopathy in swimmers is induced by large
training loads
Shoulder laxity has only a minimal association with
shoulder impingement in elite swimmers
Summary
Muscular fatigue and training load appear

to have a greater influence on shoulder
pain than joint laxity based on new
research
Key is to get swimmers in early, eval/treat
impairments, swim stroke analysis, modify
training as needed
Looking Forward
More research is
needed on age group
and high school
swimmers
Is there a place for
yardage count for
younger athletes

SR Swim Clinic

Uploaded by

Copyright:

Available Formats

SR Swim Clinic

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

SR Swim Clinic

Uploaded by

Copyright:

Available Formats

What are some of the biomechanical demands of swimming?

What are some of the biomechanical demands of swimming?

What are the phases of the freestyle stroke?

What are the phases of the freestyle stroke?

Swimming Biomechanics

& Treatment Approach

UW Health Sports Rehabilitation

Competitive Swimming Prevalence

Kammer et al, 1999

Freestyle is most common training stroke

Swimming Injury Epidemiology

Swimming Injury Epidemiology

Prevalence of shoulder pain in elite

3% in 1974 Swimmers Shoulder

Shoulder Pain Epidemiology

Pink et al (2000): survey of 233 collegiate

Biomechanical Demands of Swimming

Outside humans natural environment

Hand entry in line with

High shoulder and high

From vertical forearm

Elbow exits first, then

Power and propulsion

Common Freestyle Mechanical Changes Caused

Freestyle Stroke Flaw

Freestyle Stroke Flaw

Poor scapular control

Freestyle Stroke Flaw

Poor motor program

Freestyle Stroke Flaw

Freestyle Stroke Flaw

Poor core strength

Good Timing of Freestyle stroke

Training load- absolute and sudden increase

4 areas of impingement recognized in the literature

Subacromial impingement: compression and

Mechanical impingement occurs 25% of

(Yanai & Hay, 2000)

40% of impingement occurs at entry

(Pink & Timone, 2000)

Research - Muscle activity

Normal muscle activity during freestyle

15-20% of a muscles maximal voluntary contraction is

EMG study on 12 muscles in 20 swimmers w/o shoulder

Research - Muscle activity

Abnormal muscle activity during freestyle

Scovazzo et al, AJSM, 1991

Research Muscle Activity

Research Joint Laxity

Many authors have examined GH laxity in

Jobe described the instability complex

Research Joint Laxity

Borsa et al, AJSM 2005

42 NCAA Div 1 swimmers

Research Joint Laxity

Sein et al, BJSM 2010

80 elite swimmers (13-25

Research Joint Laxity

Sein et al, BJSM 2010