Injury Prevention Focus on swimmers shoulder Darren Wigg Bsc (Hons) Physiotherapy

Introduction Darren Wigg Sports Physiotherapist specialising in swimming Former Senior GB International swimmer and British record holder for 200 and 400 I.M Consultant Physiotherapist for City of Newcastle Swimming Club Physio to the North East Beacon squad in Sunderland Member of the GB swimming Physiotherapy team

What are your goals as coaches? To get your swimmers to achieve their full potential? To have the best program in the region or country? To coach an Olympic medal winning athlete?

How do you achieve those goals Effective coaching Motivational skills ? Facilities Management skills

STAY INJURY FREE!!

Swimming Injuries....... Is it a dangerous sport? Swimming is a relatively safe sport regarding injuries The most common problems are due to repetitive strain injuries of the shoulder and knee Swimmer ‘s Shoulder is a repetitive strain injury which accounts for about 40% of injuries in competitive swimming Swimmers are exposed to the injury due to the unusually high number of shoulder rotations performed by competitive swimmers each year Have a guess how many per arm? ....................................

.............. 1.32 million!

The anatomy of the shoulder The main shoulder joint is the glenohumeral joint (ball and socket) and is inherently unstable There are 4 main stabilising muscles around the shoulder joint They are called the rotator cuff (RC) muscles They all originate from the scapular

Function Their main function is to provide stability to the joint along with the joint capsule The RC is predisposed to injury because of the bony anatomy of the shoulder complex

How does it occur As the arm is elevated past 70 degrees the space available for the RC tendons is significantly reduced If there is not good rotator cuff control the tendons can become impinged between the head of the humerus below and the acromion above causing RC impingement As the cuff has a poor blood supply healing is difficult and a vicious cycle of repetitive impingement begins

How does it occur? Swimming predominantly uses the muscles at the front of the shoulder and chest This can cause those muscles to become overactive and short pulling the shoulder forwards. The muscles at the back become underactive, weak and long A forward shoulder posture is common amongst competitive swimmers and is another contributing cause of swimmers shoulder

How does it occur Poor frontcrawl technique can predispose a swimmer to RC impingement Insufficient trunk rotation with a pull that crosses the mid line of the body is the main causative factor Poor core stability in the water can also contribute to the problem

Can we prevent it? Yes! Through an exercise programme which focuses on: Improving RC control and endurance Restoring muscle balance around the shoulder girdle by strengthening the underactive, weak muscles and stretching the overactive tight ones Improving your general spinal and shoulder girdle posture

Can we prevent it? Stroke analysis and attentive coaching will help to avoid the common mistakes which contribute to swimmers shoulder The common faults in technique that reduce efficiency also increase risk of injury

How do we manage it if it occurs? As coaches you can help minimise time out of the water through early identification and intervention by looking out for common signs and symptoms Catching pain in the shoulder and upper arm Usually worse with frontcrawl or butterfly First line treatment should be ice and non steroidal anti-inflammatory drugs(e.g ibuprophen or volterol)

How do we manage it if it occurs? Avoid aggravating activities – be flexible with training Referral to sports physiotherapist ASAP Ensure you liaise as closely as possible with them to ensure your swimmer’s optimum recovery

How do we manage it? Physiotherapy may involve the following: Prescription of RC and scapular conditioning exercises Postural advice and exercise Advice regarding modification of training Manual therapy Electrotherapy

Summary Staying injury free is extremely important in competitive swimming The most common injury in competitive swimming is caused by impingement of the RC It is an overuse injury caused by poor RC and scapular control Poor posture and technique are also contributing factors We can reduce the risk of injury through incorporating a RC and scapular setting programme into our land sessions, improving our posture and working with our swimmers to improve their stroke

Any Questions?

Contact Details Darren Wigg Physiotherapy Ltd Bsc (First Class HONS)Physiotherapy darrenwiggphysiotherapy@hotmail.com Clinic : 0191 5200066 Mobile: 07752693464