
Advice to improve your movement, fitness, and overall health from the world's #1 in orthopedics.
Swimming Overuse Injuries and How to Prevent Them
It may be a low-impact sport, but swimming can still cause problems from the repetitive motions it requires. Find out more about how to prevent swimming-related injuries from a USA Swimming team physician.
Advice to improve your movement, fitness, and overall health from the world's #1 in orthopedics.

But because swimming requires a series of repetitive movements, overuse injuries do occur. Scott Rodeo, MD, an orthopedic surgeon at Hospital for Special Surgery and a team physician for USA Swimming, shares details about the most common swimming-related ailments and how to prevent them.
Swimmer’s shoulder. This is the most common swimming injury, with reports of incidence of disabling shoulder pain in competitive swimmers ranging from 27% to 87%. It’s caused by the repetitive overhead motion required of almost every type of stroke, from freestyle to butterfly, which puts stress on the tissues around the shoulder. The rotator cuff, which allows you to raise and rotate your arm, becomes inflamed and tender, making it difficult or painful to move.
Low back pain. This occurs most often in those who do the butterfly and the breaststroke. Because these strokes require the head to lift while the hips and legs sink, swimmers often overarch their lower back to compensate, putting stress on the back muscles and ligaments.
Breaststroke knee. The mechanics of the stroke — facing the feet out while you extend and kick the legs — can cause the knees to externally rotate. This goes against the leg’s natural movement pattern, which can lead to knee swelling, inflammation and pain in the knees’ inner ligaments.
Foot and ankle tendonitis. This is a less-common overuse injury that affects the tendons in the front of the foot and ankle due to the repetitive kicking motion in butterfly, backstroke and freestyle.
Keep yourself healthy by always using the proper technique:
- Make sure your arm enters the water with your pinky finger first or your hand flat, avoiding rotating your arm. Entering the water with the thumb side down may increase the risk of shoulder pain.
- Don’t cross the midline of your body when your hand enters the water.
- Keep your hips toward the surface of the water to reduce drag.
- Move your body as one unit, with your head in line with your trunk.
- Breathe on both sides to distribute the load on your shoulders evenly.
- Roll your whole body to the side on which you are breathing in order to avoid excessive neck rotation.
- Keep your arm and leg movements smooth and clean, avoiding excessively wide or deep kicks.
You may also think about getting your technique analyzed by a coach who can take a look at your movement patterns and make sure you’re doing everything right. Sometimes even the most subtle change can help.
Outside of the pool, make sure you’re building strength in the muscles that support your stroke. In the weight room, focus on these three areas:
Published 7/30/2021