Swimming with Injuries? Ⓒ
11/10/2024
I am reading many posts with a similar theme asking whether you can swim with injuries. I thought it timely to say something.
In most cases you can modify your training so you can still get in the pool, which can be good for your mental health and to maintain fitness BUT most injuries should be rested to allow full recovery. So how do we manage that AND keep swimming?
Shoulder, elbow, wrist and hand injuries.
Good swimming technique may not prevent shoulder injuries because some high-performance swimming positions are not particularly good for you. If that were not the case, elite swimmers would largely be injury free. They are not, and their coaches spend hours in prehab trying to prevent injuries with specific strength training programs, or in rehab trying to fix injuries.
The main culprits for all strokes are any overhead movements that involves internal rotation of the shoulder. The high elbow vertical forearm which is performed in all strokes is particularly problematic, though it needs to be learned if you want to swim fast. Add to that an aging fitness swimmer with muscle imbalances or weaknesses, declining posture and flexibility loss, combined with thousands (if not millions) of revolutions of the shoulder over days, months and years of training and you can start to see the problem.
While streamlining with the classic tight shoulder shrug up to the ears is not internal rotation, it can cause issues as the shoulders are forcibly compressed to achieve this position. People with inflexible shoulders would be wise to not attempt this and to find a compromise. A looser streamline with elbows slightly bent will take the pressure off and unless you are competing at a high level will still be better than no streamline.
Some injuries still might allow you to swim the full stroke at slow speeds IF you modify the stroke.
Freestyle.
Experiment with swimming with your hand/s in a fist which will reduce pressure on palms and subsequently shoulders, during the pull. An exercise frequently performed in high performance squads is to swim 25m with left hand in a fist and right hand open; 25m with Right hand in a fist and left open; 25m with BOTH hands in a fist and 25m with both hands open. THis gives you the chance to compare hands and the pressure differences and to work on the vertical forearm and feeling pressure more on your inside forearm. However in an injuy setting you might just keep the injured hand/arm closed. THe surface area is not that greatly reduced yet the loss of power is remarkable. Your job is to try to get as
NOT breathing. When you ARE breathing you aim to look directly perpendicular to your body and slightly at or above the lane rope, with one goggle in the water and one goggle out giving you a ‘split screen’ effect. Again, you are trying to achieve a neutral spine. Head in the wrong position can exacerbate neck and lower back issues, which often refer into shoulder.
Backstroke
Lifesaving Backstroke
Sidestroke
Sculling drills
Single arm swimming
Swim single arm drills can be performed on ALL strokes. In most cases the injured arm should rest at your leg. This is a GREAT opportunity by isolating one arm, to improve your stroke. Work on your hand entry, your rotation, your timing of your breathing, your pulling pathway, and the coordination of your kick with your arm.
Kicking
If you have an injury to your upper body, you can include more kicking into your program and reap huge benefits. Generally speaking, using a kickboard places stress on shoulders and elbows and should be avoided when injured but if the injury is in one arm you can still use your good arm to hold a kickboard.
Kickboards are very bad if you have back or neck issues, but you could hold a kickboard if you use a snorkel and maintain a neutral spine. Fins are a fantastic way to maintain your mileage during injuries but be warmed, the more you use them the more dependent you will become on them and the more challenging you will find it to swim or kick without them. The irony is that in small doses they can improve your kick but in large doses they can ruin it.
NEVER do more than 50% of a workout with fins. Kicking does not need to be boring as you will see by the variety suggested below.
Aquacise
This is a fabulous opportunity to explore other movement patterns in the water. You might find some arm movements are ok to do gently and might actually be good for your injury. I can do most of my rotator cuff exercises in water similar to those done with the theraband, just using the water resistance. You might still be able to do bicep curls as they are below the shoulders. There are plenty of utube videos to guide you here and you are only limited by your imagination. Almost anything you can do on land can be adapted to water. Just try them and find out what works and what doesn’t.
Hip, Knee Ankle injuries
Using a pull-bouy can usually keep anyone swimming who has hip, knee or ankle injuries. You may need to modify your turns or push off walls with the good leg only. Best strokes are Freestyle, Backstroke and Lifesaving Backstroke. For anyone who likes to swim Breaststroke but has knee, ankle or hip issues, you can do Breaststroke with either a single dolphin kick, or with flutter kick. Both will give you a very different experience, but by mixing it up you can gain insight and make improvements to your stroke.
THE MORE VARIETY YOU HAVE THE BETTER YOU BECOME AS A SWIMMER!
Lower back injuries
Swimming long axis strokes with good body rotation is often ok. Avoid short axis stroke Butterfly and Breaststroke and do not use a kickboard which hyperextends the back. Lifesaving Backstroke is a wonderful stroke. If your legs sink, use a pull-bouy. Sculling on your back is also a great one as your spine can remain in neutral. Learn the art of sculling in different directions depending on where your fingertips point. It might be slow, but you will develop a better feel for the subtle pressure fluctuations on your hand which elite swimmers are highly attuned to.
As always talk to your physio or specialist to see if there are any contraindications to maintaining some exercise in water while you are injured. I am not a physician, so this is intended as general advice only.
I would love to hear your thoughts and training sets or modifications you have successfully used to keep swimming in the comments below. If you have any questions please ask and I will endeavor to answer if I am able.
In most cases you can modify your training so you can still get in the pool, which can be good for your mental health and to maintain fitness BUT most injuries should be rested to allow full recovery. So how do we manage that AND keep swimming?
Shoulder, elbow, wrist and hand injuries.
Good swimming technique may not prevent shoulder injuries because some high-performance swimming positions are not particularly good for you. If that were not the case, elite swimmers would largely be injury free. They are not, and their coaches spend hours in prehab trying to prevent injuries with specific strength training programs, or in rehab trying to fix injuries.
The main culprits for all strokes are any overhead movements that involves internal rotation of the shoulder. The high elbow vertical forearm which is performed in all strokes is particularly problematic, though it needs to be learned if you want to swim fast. Add to that an aging fitness swimmer with muscle imbalances or weaknesses, declining posture and flexibility loss, combined with thousands (if not millions) of revolutions of the shoulder over days, months and years of training and you can start to see the problem.
While streamlining with the classic tight shoulder shrug up to the ears is not internal rotation, it can cause issues as the shoulders are forcibly compressed to achieve this position. People with inflexible shoulders would be wise to not attempt this and to find a compromise. A looser streamline with elbows slightly bent will take the pressure off and unless you are competing at a high level will still be better than no streamline.
Some injuries still might allow you to swim the full stroke at slow speeds IF you modify the stroke.
Freestyle.
- If you can identify a ‘catch’ point where the rotator cuff feels it is pinching, that helps to know if it is a technique issue in which case you might need a coach to assess your technique. It might be as simple as rotating more.
- If it is just after your hand enters and stretches forward, you might need to use a deeper catch.
- If it occurs mid-way through the arm pull, you might want to use a straighter arm pull.
- If it happens on the recovery, more body rotation, a straight arm recovery or even a wider arm recovery might allow you to do the stroke pain free.
- much pressure as possible on the fist hand to redress the balance.
Experiment with swimming with your hand/s in a fist which will reduce pressure on palms and subsequently shoulders, during the pull. An exercise frequently performed in high performance squads is to swim 25m with left hand in a fist and right hand open; 25m with Right hand in a fist and left open; 25m with BOTH hands in a fist and 25m with both hands open. THis gives you the chance to compare hands and the pressure differences and to work on the vertical forearm and feeling pressure more on your inside forearm. However in an injuy setting you might just keep the injured hand/arm closed. THe surface area is not that greatly reduced yet the loss of power is remarkable. Your job is to try to get as
NOT breathing. When you ARE breathing you aim to look directly perpendicular to your body and slightly at or above the lane rope, with one goggle in the water and one goggle out giving you a ‘split screen’ effect. Again, you are trying to achieve a neutral spine. Head in the wrong position can exacerbate neck and lower back issues, which often refer into shoulder.
Backstroke
- often uses the opposing muscle groups and may not be a problem IF you also have good body rotation which unloads your shoulders. Again, if you can identify the precise catch point you might also be able to modify the stroke accordingly. Make sure you hand exits the water thumb first to avoid your shoulders internally rotating.
Lifesaving Backstroke
- with either flutter kick or breaststroke kick is all performed below the shoulders and can usually be performed pain free. Although it is not a competitive stroke it is great to include in your general program and can be performed with either flutter or breaststroke kicks. Like Backstroke it stretches out your opposing muscle groups and opens up your chest and upper thoracic region, working your postural muscles. Great for warming up and down.
Sidestroke
- is another non-competitive stroke but can be performed with the good arm leading and pulling above the head and the injured arm pushing from below the shoulder. The kick is NOT Breaststroke kick but a split kick and could be a great new skill to learn during your rehab. Plenty of utube videos out there.
Sculling drills
- which develop your feel for the water, can be performed either on your front or back with a pullbouy or without, but with your hands anywhere below your shoulders. Again, nothing above your shoulders. Improving your sculling improves your ‘feel’ for the subtle pressure fluctuations on your palms which will greatly improve your preferred stroke.
Single arm swimming
Swim single arm drills can be performed on ALL strokes. In most cases the injured arm should rest at your leg. This is a GREAT opportunity by isolating one arm, to improve your stroke. Work on your hand entry, your rotation, your timing of your breathing, your pulling pathway, and the coordination of your kick with your arm.
- Freestyle - Don’t forget although you are swimming with one arm (on freestyle and backstroke) you need to rotate both shoulders, once has your hand enters, and once as your hand exits. If you MUST swim with the other arm outstretched you might find setting it deeper rather than at the surface, can be done pain free. Pain is your guide, it serves to warn you what you can and can’t do. For freestyle try breathing to your left on one lap and your right on the other. It will give you a different experience. Try to analyse it. If your left arm is resting at your leg, also try swimming with your right arm and breathing to your right side. You won’t be as balanced, but it is still a valuable exercise as it has a higher degree of difficulty.
- Backstroke resting hand on your leg. Make sure you are rotating in your long axis. If you normally pull with a straight arm, now would be a good time to teach yourself the bent arm pull. Use fins and balance a cup on your forehead to learn how to rotate AND keep your head still.
- Breaststroke single arm is best done with the other arm extended so this might not work for those with rotator cuff problems.
- Butterfly. Single arm drills are a staple in training. Resting arm in front or on your leg. Variations include breathing to the side or to the front.
Kicking
If you have an injury to your upper body, you can include more kicking into your program and reap huge benefits. Generally speaking, using a kickboard places stress on shoulders and elbows and should be avoided when injured but if the injury is in one arm you can still use your good arm to hold a kickboard.
Kickboards are very bad if you have back or neck issues, but you could hold a kickboard if you use a snorkel and maintain a neutral spine. Fins are a fantastic way to maintain your mileage during injuries but be warmed, the more you use them the more dependent you will become on them and the more challenging you will find it to swim or kick without them. The irony is that in small doses they can improve your kick but in large doses they can ruin it.
NEVER do more than 50% of a workout with fins. Kicking does not need to be boring as you will see by the variety suggested below.
- Kick a straight (insert your own distance) at comfortable speed with fins. Wear a snorkel. Keep both hands on your legs. Practice rotating in your long axis keeping your head still. Imagine your goal is to kick 1000m. Time it on day one. Let’s say you kick the 1000m in 20minutes at a comfortable speed, that is an average of 60 secs/50m. Now you have a road map for future sessions. By kicking a tiny bit faster, the same set can be broken into many different permutations such as
- 20x50m on 65 seconds this means you average 60 seconds and take exactly 5 seconds rest each time. With a bit of rest, you might be able to average 57 seconds. Once you can do this set averaging 55 seconds, move the interval to departing every 60 seconds.
- 10x100m departing on 2min 10 secs. Again, aim to repeat this set every now and again until you can do these every 2 minutes holding an average of 1min 50 secs.
- 5 x 200m on 4.15. Over time get these down to 4 minutes holding an average of 3mins 45 secs or less.
- Go back and re-test your 1000m time on occasions to see if you can improve it.
- Kick 10x 50m fins on your back with hands by side doing fly kick on the way down and coming back flutter kick. Gives a great ab workout. Have 10 seconds rest.
- Of course, doing kick WITHOUT fins is a great opportunity to improve your kick. Linley Frame a famous Melbourne Swimmer won the World Championships Breaststroke after she broke her wrist. She was in a cast in the months before and she just did kick work. Her kick improved so much she won gold. Start on short distances and build up.
- Breaststroke kick can be performed on your back with hands by your legs, or on your front with a drill we call ‘Heels to Hands’. Keeping your hands by your thighs, the aim is to touch your fingers to your heels on every kick. This also works the timing of the breathe. You breathe at the end of the glide just as the legs start to lift toward the butt.
- If you are already a great kicker, try adding a weight such as a drag suit or parachute, or wear sandshoes for variety.
- Do speed work with kick. 10 x 25s kick on your best stroke FAST with medium to long rest (30 to 60 seconds) is a great workout. The volume may not be high but it burns calories.
- Vertical kick. There are plenty of videos if you google them use fins if you are not a strong kicker, or without if you are. Fly or flutter kick can be done.
- Do Medley kick sets. Work on your worst stroke kick and you might find you improve.
- Eggbeater kick. Teach yourself how to do this if you don’t know how. Use this time to learn new skills. If you are already good at this try it with your hands at shoulder height.
- Mix kick with something else for recovery. For instance 10 x 50m Kick 25m fast / 25m scull or lifesaving backstroke with pullbouy so legs recover.
- Backstroke kick can be performed with or without a kickboard and with the hands in various positions from resting on the thighs, crossed over the chest to interlocked under the head. Streamline should be avoided unless the hands are open and elbows bent.
Aquacise
This is a fabulous opportunity to explore other movement patterns in the water. You might find some arm movements are ok to do gently and might actually be good for your injury. I can do most of my rotator cuff exercises in water similar to those done with the theraband, just using the water resistance. You might still be able to do bicep curls as they are below the shoulders. There are plenty of utube videos to guide you here and you are only limited by your imagination. Almost anything you can do on land can be adapted to water. Just try them and find out what works and what doesn’t.
Hip, Knee Ankle injuries
Using a pull-bouy can usually keep anyone swimming who has hip, knee or ankle injuries. You may need to modify your turns or push off walls with the good leg only. Best strokes are Freestyle, Backstroke and Lifesaving Backstroke. For anyone who likes to swim Breaststroke but has knee, ankle or hip issues, you can do Breaststroke with either a single dolphin kick, or with flutter kick. Both will give you a very different experience, but by mixing it up you can gain insight and make improvements to your stroke.
THE MORE VARIETY YOU HAVE THE BETTER YOU BECOME AS A SWIMMER!
Lower back injuries
Swimming long axis strokes with good body rotation is often ok. Avoid short axis stroke Butterfly and Breaststroke and do not use a kickboard which hyperextends the back. Lifesaving Backstroke is a wonderful stroke. If your legs sink, use a pull-bouy. Sculling on your back is also a great one as your spine can remain in neutral. Learn the art of sculling in different directions depending on where your fingertips point. It might be slow, but you will develop a better feel for the subtle pressure fluctuations on your hand which elite swimmers are highly attuned to.
As always talk to your physio or specialist to see if there are any contraindications to maintaining some exercise in water while you are injured. I am not a physician, so this is intended as general advice only.
I would love to hear your thoughts and training sets or modifications you have successfully used to keep swimming in the comments below. If you have any questions please ask and I will endeavor to answer if I am able.