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Guest Blog: Swimming Â- making it to the start line Injury Free

TriBlogsby TriBlogsAug 9th 2013
Time for our latest guest blog and it's a fantastic article on injury prevention for swim training as part of any distance triathlon. This is the last in the series of Guest Blogs written by the experts at Six Physio: with specialist physios in all three triathlon disciplines, read on for injury prevention tips for Swimming.
My name is Daniel Boyd, and in January 2013 I decided to enter Ironman® Wales on September 8th (which is fast approaching!) This was always going to be ambitious, however it becomes borderline stupid when this is not only my first Ironman but my first triathlon, or even anything that relates to an endurance eventÂ... But I am always impressed when treating patients with such impressive training regimes that I thought I would try it myself.

I work In London for Six Physio, University College London Hospital and The Institute for Sport, Exercise and Health (ISEH) as a Senior Musculoskeletal Physiotherapist. My background is all sports related: having completed a BSc in Sports and Exercise Science followed by an MSc in Physiotherapy and a modest sporting background in football and boxing. My other Jobs have included working with Tottenham Hotspur and Colchester United Football Clubs.

I have encountered a few problems with injuries in preparation for the swim component of my race so most of this is speaking from experience and finding ways to prevent injury along the way so that I can keep training. The first and most important thing when swimming freestyle for any triathlon training is shoulder mechanics and movement. I have followed a few simple regimes three times per week: these are backed up by a fair bit of research, biomechanics and understanding of shoulder pathology.

Hip, Trunk and Core.

Dr Ben Kibler best describes the essential relationship between hip and trunk extension with regards to good shoulder mechanics. Happily this also contributes to enabling a good streamline swimming position in the water; correct swimming technique goes a long way to minimising injury and improving performance.

Hip and trunk extension patterns facilitate scapular control, and are essential in preventing a shoulder tendinopathy (one of the more commonly seen shoulder pathologies). I have followed the below programme around twice a week as part of a Â'coreÂ' session to prevent injury after feeling the beginnings of a shoulder tendinopathy.
Guest Blog: Swimming – making it to the start line Injury Free
Guest Blog: Swimming – making it to the start line Injury Free
As a side note to this, I completed my Pilates matwork course a few years ago to see what all the fuss is about, and going in a little sceptical I found my course tutor to have a really helpful understanding. I have to admit I was converted and if you have the time a good pilates group can help you out an awful lot.

The Cuff

IÂ'm sure most of you reading this are fully aware that the rotator cuff plays an important role in stabilising the shoulder and providing good, clean and powerful movement at the glenohumeral joint. Even knowing this I still ashamedly began my swimming training having done none of this using the classic excuse that some of my less motivated patients give me of Â"I have been to busyÂ". When the beginnings of shoulder pain began, for me in my early stages of training, I realised my mistake and where possible would do some simple isometric (static) exercises on my rotator cuff. Whenever I am in the gym I also use a simple set of rotator cuff exercises through movement to maintain integrity and prevent injury.
Guest Blog: Swimming – making it to the start line Injury Free

The Scapular (shoulder blade)

Optimal positioning of the scapula can minimise stress placed upon the glenohumeral joint by optimising your rotator cuff activation allowing smooth movement. As such specific closed chain exercises like the low row are great for keeping some important muscles around the scapula (lower fibres of trapezius & serratus anterior) in check that facilitate good scapula position. This is unfortunately something that is difficult to self assess and becomes more and more complex the more you look into it, as such this is something that if you are concerned, it is worth getting someone who knows what the are talking about to take a look for you.
Guest Blog: Swimming – making it to the start line Injury Free
Guest Blog: Swimming – making it to the start line Injury Free
Specifically within swimming (and to reference another Kibler study) fatigue of these muscles is very poignant within swimmers and cause a positional alteration of the scapular, as such, training of both high rep/ low weight, and low rep/high weight exercises are advisable to maximise endurance. Being aware of your training regime, incorporating recovery weeks and mixing up the intensity of your training is essential.

Thoracic Spine

Mobility of the thoracic spine is again essential not just for swimming but all triathletes because of the amount of time spent exercising and the invariable stiffness that you feel after a long cycle/run/swim session.

As such one of the simplest exercises I use is the rolled up towel techniqueÂ...
Guest Blog: Swimming – making it to the start line Injury Free
Easy to do and can save you untold trouble, particularly those of you that work in office environments for more than eight hours a day.

Make sure you have the available movement

Finally, mobility of the shoulder is essential, specifically internal rotation of the shoulder; having a limitation of this internal rotation is a pretty decent prognostic factor for people developing a shoulder problem. As such, donÂ't be part of a statistic and maintain your normal movement.

In Swimmers and throwers, training schedules and repetitive motions of this kind can cause you to lose this rotation, if you would like to read further about this loss of movement it has been conceptualised and is called Â'GIRDÂ' (Glenohumeral Internal Rotation Deficit)

I have followed the below exercise commonly called Â'sleeper stretchÂ' to maintain this movement:
Guest Blog: Swimming – making it to the start line Injury Free
If you have found the application of these exercises useful. If have any questions or would like a reference above that of which I have provided please donÂ't hesitate to get in touch.

Just to cover myself legally all of these exercises are just a documentation of what I have used as a decent injury prevention programme and should in no way be used as a treatment for any shoulder pain without consulting a professional first.
woodsey96by member: woodsey96, Aug 9th 2013 14:47
Good blog and something all athletes (not just triathletes) should bear in mind - these exercises are good for healthy mind, body and life, not just to improve swimming and shoulder based exercise.
On the flipside, the only way swimming repetitive motions will decrease the mobility in the shoulders is if you only do 1 movement (i.e. freestyle). By encouraging yourself to do backstroke or breaststroke, as part of a warm up, recovery, or even in an endurance aerobic set, you increase the range of motion available to the joint and muscles. As an extra, it assists with that elusive feel for the water and it breaks up the monotony of solely doing freestyle all the time!
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