Chronic Overuse Injuries in Swimming: Causes, Prevention, and Practical Tips

Swimming is a sport known for its low joint impact, but the repetitive nature of the movements and the intensity of training can lead to chronic overuse injuries. These issues, which primarily affect the shoulders, knees, and spine, are often the result of poor training load management. So, how can we avoid and prevent them?


Training Load Management: A Fundamental Balance

Managing training loads means finding the right balance between effort and recovery. When the body is subjected to a sudden increase in the intensity or duration of training, the risk of overload increases. This is where the concept of the Acute – Chronic Workload Ratio (ACWR) comes into play. This ratio compares the recent load (e.g., the last week) with the long-term average load (e.g., the last 4 weeks).

  • A gradual increase in training load, with a balanced ratio, allows the body to adapt progressively without excessive stress.
  • Conversely, rapid or unplanned increases in load can cause cumulative microtrauma and injuries.

Areas at Higher Risk in Swimming

  • Shoulders: The “swimmer’s shoulder” is one of the most common injuries, caused by repetitive movements and muscle imbalances.
  • Knees: Especially in swimmers who practice breaststroke, lateral movements can strain the ligaments.
  • Spine: Poor posture or incorrect technique can lead to chronic lower back pain.

Practical Tips to Prevent Overuse Injuries

  1. Plan Your Training: Gradually increase duration and intensity, following the principle of progressive load. For example, do not increase your weekly training volume by more than 10% compared to the previous week.
  2. Strengthen Key Muscles: Training stabilizing muscles, such as the core and rotator cuff, helps prevent muscle imbalances.
  3. Don’t Neglect Recovery: Incorporate rest days and light training sessions into your program to allow tissues to recover.
  4. Work on Technique: Efficient strokes reduce stress on the shoulders and back. Consult a qualified coach to correct any technique errors.
  5. Listen to Your Body: Persistent pain or excessive fatigue may be signs of overload. In these cases, reduce the intensity and consult a specialist.

Conclusion

Preventing overuse injuries in swimming is possible through intelligent load management and a focused approach to training. Gradual increases, proper technique, and attention to recovery are the pillars of safe swimming and maintaining long-term physical health.

Dr. Marco Gastaldo
Specialist in Physical and Rehabilitation Medicine

Isokinetic Torino

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