Injury PreventionInjury Prevention

Kevin Marberry, M.D.Assistant Professor Sports Medicine

Team Physician, University of Missouri Swimming and Diving

Kevin Marberry, M.D.Assistant Professor Sports Medicine

Team Physician, University of Missouri Swimming and Diving

Who Swims Anyway?Who Swims Anyway?

• 100 million participants

• One of the most popular sports internationally

• Becoming more popular locally

Who Gets Hurt?Who Gets Hurt?

• 150,000 swimming/diving related injuries annually.1

• 40-70% of competitive swimmers reports shoulder pain.

1. American Academy of Orthopaedic Surgeons, 2002.

What are the most common What are the most common injuries?injuries?

• Most are minor “bumps and bruises”.

• Injuries that interfere with ability to compete are musculoskeletal.

• Classified as overuse injuries.

Overuse InjuriesOveruse Injuries

• Swimmer’s Shoulder• Butterfly Swimmer’s Back• Breaststroker’s Knee

Swimmer’s ShoulderSwimmer’s Shoulder

• Shoulder Anatomy

Swimmer’s ShoulderSwimmer’s Shoulder

• What is it exactly?– Term coined in 1970 to describe anterior

shoulder pain during and after workouts.

– Rotator cuff tendinopathy

– Current understanding: combination of subacromial impingement and glenohumal instability

Impingement?Impingement?

What Causes It?What Causes It?

• Overuse.

• 2 hour sessions (4000-8000 yards), twice daily, 5 days a week, plus dry-land work

• 500,000 shoulder revolutions per year

When to get it evaluated?When to get it evaluated?

• May start as an irritation during exercise.

• Swimmer may change mechanics.

• Progresses to pain after exercise and then pain at rest.

Medical EvaluationMedical Evaluation

• Rotator Cuff Strength

• Shoulder Range of Motion

• Subtle Anterior Instability

How Is It Prevented?How Is It Prevented?

• Avoid overuse.

• Achieve balanced muscle strength.

• Maintain flexibility.www.usaswimming.org

Strengthening Strengthening RecommendationsRecommendations

• Rotator Cuff

• Muscles that stabilize the shoulder blade

• Muscles of the low back, abdominal, and pelvis that make up the “core” of the body – the abdominal and lower back muscles.

How Is It Treated?How Is It Treated?

• Avoid aggravating motion• Rest• Ice• Anti-inflammatory medications• Rarely surgery

Shoulder Arthroscopy

ConclusionsConclusions

• Swimmers are unfortunately prone to overuse injuries

• Swimmer’s Shoulder is common in competitive swimmers

• Prevention is the key to treatment

THANK YOUTHANK YOU