Sports Biomechanics

1. BIOMECHANICS OF SWIMMINGBiomechanics of swimming
Presented by:
Dr Nishank Verma
MPT-Sports
Jamia Millia Islamia

2. INTRODUCTION
Swimming is a movement through water using
one’s limbs and usually without artificial apparatus.
It is a full body sport and requires the coordinated
activation of muscles in legs, core and upper body.
One unique aspect of swimming mechanics is that
power comes from shoulder girdle.
In swimming, the body is being over the arms. Thus,
the arms are the propulsive mechanism and the
shoulders are quite vulnerable specially if the
scapula cannot act as a stable base for GH control.

3. In a survey of 532 collegiate swimmers, not only did
half of the swimmers have a history of 3 or more
weeks of shoulder pain that forced them to alter
their training, more than half of the injured
swimmers also had recurrence.

4.  Most of the injuries swimmers experience are chronic in
nature and are due to repetitive microtrauma or overuse
because of the repetitive nature of the swimming stroke. The
elite swimmer experiences higher injury rates than the
recreational swimmer primarily because training tends to
stretch the body to its limits of endurance.
 Site of pain:
• 44% swimmers: anterior superior region pain
• 26%: diffused pain
• 14%: antero inferior region pain
• 10%: postero superior region pain
• 4%: postero inferior pain

5. On Average, injury rate about 50%
• 10 strokes per 25 – yard pool (5 each arm)
• 320 laps per day (8,000 yards)
• 5 x 320 = 1,600 revolutions per arm each day!
• 8 x 1,600 = 12,800 revolutions per arm each week!
• 12,800 x 50 = 640,000 revolutions per arm each year!
• 640,000 x 15 (years) = 9,600,000 revolutions per arm each
age-group career!

7. Swimming Strokes
What is a Swimming Stroke?
• A swimming stroke is a method of moving
the arms and legs to push against the water
and propel the swimmer forward.

8. Types of Strokes
• Freestyle
• Butterfly
• Breaststroke
• Backstroke
• Medley

9. FREESTYLE
Arms follow the windmill motion with one hand going
into water when the other hand exits the water.
When hand in water pull through making an ‘S’ shape
Breathe when hand is out in front.
Kick with feet together moving up and down
Make sure you don’t lift head to high, because you want
to be in a streamline position.

11. Butterfly Stroke
 The most difficult and exhausting stroke.
 The body is in a prone position.
 Involves the dolphin kick with a windmill-like movement of both arms in
unison.
 Pull through the water making an S shape
 Make sure hands leave water at the same time.
•

13. Breaststroke
 The body is in a prone position.
 Involves frog kicking alternates with a simultaneous
movement of the arms from a point in front of the head to
shoulder level.
 Push inwards with hands into chest area.
 Then bring hands out to front again
 Kick is similar to a frog, bring feet up to behind and spread
outwards then kick with feet going together again at the end.

15. Backstroke
 Involves alternate over-the-head arm strokes and a flutter kick
in a supine position
 Keep head straight do not move it around.
 Move hands in windmill motion, while one hand is inside the
water the other hand is outside the water.
 When one hand is entering the water make sure the other
hand is exiting the water.
 You must enter the water with little finger first.

17. STROKES(biomechanical implication)
• The shoulder is the primary area of interest to clinicians working with
swimmers because of its vulnerability to injury. The visually apparent
mechanics related to potential shoulder injury in the freestyle, backstroke,
and butterfly strokes is that of humeral position relative to the axis of the
body.
• humeral hyperextension is defined as a combination of humeral
abduction and extension (i.e., the humerus is behind the long-axis of the
body while the arm is abducted).
• This position places stress on the anterior joint structures. Too much or
too little body rotation changes the position of the humerus relative to the
body axis, and thus is related to humeral hyperextension.

18. Humeral hyperextension
Freestyle style
Butterfly stroke
backstroke

19. FREESTYLE STROKE
 Phases: hand entry
forward reach
early pull-through
middle through
Late pull through
hand exit
Early recovery
middle recovery
Late recovery
 MECHANICS:
• 70% painful symptoms are identified
during the first half of pull-through.
• 18% identified during the first half of
recovery.

21. • The arm motion in this stroke is
reciprocal.
Hand entry-The hand enters the
water forward of and lateral to
head and medial to the shoulder.
• The elbow is flexed and positioned
above the hand so that fingers are
the first to enter the water.
Forward reach-The hand then
reaches forwards under the water
and palm begins to rotate down
and at maximal elbow extension,
hand initiated S-shaped pulling
pattern(early pull-through)

22. • EARLY PULL THROUGH PHASE: marked by the initiation of
the backward arm movement. The palm and forearm
should face the backward direction with the fingertips
pointing down
• MID PULL THROUGH PHASE: The point at which the
humerus is perpendicular to the body.
• LATE PULL THROUGH PHASE: The hand continues back
and passes next to the hip until it exits the water, leading
with the elbow.

23. HAND EXIT
RECOVERY PHASE: when the arm is swung above the
water to bring the arm into position to pull once
again.

24. Shoulder pain occurs in early pull through to mid pull
through and hand exit to mid recovery phase.(cause-
humeral hyperextension)
The lower extremities do a reciprocal diagonal sweep
called flutter kick.
Swimmers roll to left once the left arm reaches mid pull-
through and to the right when right arm reaches mid
pull-through.
Breathing pattern: roll the head to the side of dominant
arm as the arm exits the water. They prefer to breath
alternately on the right and left sides during every third
hand exit.

25. MUSCLE ACTIVITY
Three force couple
During hand entry and forward reach:
suprasinatus Anterior and middle deltoid
During early pull through phase:
pectoralis major teres minor
During late pull through:
lattiimus dorsi subscapularis

26. • During hand entry and forward reach , the upper
trapezius elevates the scapula while the rhombiods
retract it.
• The serratus anterior is active in order to protract and
upwardly rotate the scapula.(also stabilizer of the
scapula in a protracted position)
• this muscle action positions the glenoid fossa for the
humeral head as the arm is abducted and flexed by
supraspinatus and anterior and middle deltoid when
the hand reaches forward in the water.

27. • The pectoralis major is responsible for the initial and
powerful humeral adduction, internal rotation and
extension. Teres minor fires to provide an
antagonistic external rotation force.
• Lattisimus dorsi becomes the primary muscle of
propulsion after mid pull-through. Subscapularis
forms a force couple with the latissimus dorsi.
• Throughout the propulsive motions serratus anterior
is also active as it pulls the body over the arm and
through the water. It also maintains the scapula in a
position of upward rotation and also assists with
joint congruency of the humerus and glenoid.

28. • The posteior deltoid becomes active after the latissimus dorsi
reaches its peak, it contributes to final part of pulling.
• As the hand begins to exit the water, the group of muscles that
were active at hand entry once again begin to function.
• The muscles that function at hand exit continue with their activity
during recovery.
 In swimmers with normal shoulders, the serratus anterior
continually fires above 20% of its maximum. This muscle appears
to be stabilizing the scapula in a protracted position as the arm pulls
the body over itself. When a muscle continually fires above 20%, it
is susceptible to fatigue.
• in swimmers with painful shoulders, the serratus anterior
demonstrates significantly less muscle action during a large portion
of pull-through

29. • Although the serratus anterior diminishes its action during
pull-through, the rhomboids increase their activity . It may
be that, in an attempt to stabilize the scapula during the
absence of the serratus anterior, the primary muscles
available are the rhomboids.
• Decreased subscapularis activity during mid recovery.
• the primary “power” muscles of the shoulder during swimming
(the latissimus dorsi and the pectoralis major) demonstrate no
significant differences when comparing normal versus painful
shoulders. So it appears that these muscles may not be integral in
the prevention of injury.

30. EMG ACTIVITY DURING FREESTYLE
STROKE

32. COMMON FREESTYLE MECHANICAL CHANGES
CAUSED BY FATIGUE, SORENESS AND PAIN

33. NORMAL SHOULDER PAINFUL SHOULDER
HAND ENTRY
FORWARD REACH
PULL-THROUGH

34. HAND EXIT
AND
RECOVERY
ROTATION

35. Ways by which an injured swimmer can
reduce humeral hyprextension
CATCH-UP
When arm phases overlap slightly so that the recovery
arm is on to the late recovery while the underwater
arm Is still in the early pull through.
Reduces body rotation during the early to mid pull
through
Reduces the chances of humeral hyperextension

36. During the hand exit to mid recovery:
• Humeral hyperextension can be reduced by swinging
the arm wider and decreasing the elbow flexion.
• The recovery should be relaxed and controlled, and it
is acceptable to swing the hand around the side.
• Recovery phase should be led by the elbow.

37. BUTTERFLY STROKE
MECHANICS:
• The butterfly stroke is a bilateral activity. butterfly stroke typically
consisting more of an S –shaped pulling pattern and the upper
body pivoting up and down about the hips, instead of rotating
about the central axis as in freestyle and backstroke.
• No body roll in this stroke.
• Breathing occurs by lifting the head out of the water.
• Dolphin kick: legs move together similar to the tail of dolphin. The
legs move up then down for two cycles during each complete arm
cycle. When the arm begin the actual pulling, the legs kick upward.

38. The hands enter the water with the arms extended
forward and in front of the shoulder. The upper body
presses down at the same time the arms enter the
water to generate a more dynamic motion on entry and
support the swimmer’s forward motion.
The hands and arms should remain extended forward
during the upper body press, as opposed to aiming
downward.
There is potential for the humerus to be internally
rotated during the arm exit and early recovery phase.

39. MUSCLE ACTIVITY
• the rhombiods, upper trapezius, serratus anterior,
supraspinatus, anterior and middle deltoid all exhibit peak of
muscle activity during hand entry. But the peak is a little
later than in freestyle stroke. This later peak is due to wider
hand entry in butterfly stroke.
• Activity increases in pectoralis major and teres minor
• Decrease in activity of latissimus dorsi and subscapularis.
• Due to excessive scapular elevation needed to replace the lateral
body roll of freestyle and to clear hand above the water- more
activity in upper trapezius , deltoid and supraspinatus.

40. • Wider arm position, which produces an outward
rather than upward position of the elbow and an
increase in external rotation-more activity in
posterior deltoid and infraspinatus and less activity
in supraspinatus and subscapularis.
• At the end of the recovery phase, the teres minor
also exhibits decreased muscle activity in the
swimmer with a painful shoulder.

41. • In swimmers with painful shoulder, there is less activity
in the serratus anterior muscle.
• This muscle is not firing enough to stabilize the scapula
or to assist with the pulling of the body over the arm. The
decreased firing may be attributable to fatigue.
• With an unstable or “floating” scapula, the teres minor is
unable to control the humeral rotation caused by the
powerful pectoralis major.
• These two muscles which attach to scapula lacks
synergistic interplay to assist the propulsion ahead.

42. With a floating scapula during butterfly stroke, there is no stable base and
The teres minor and serratus anterior cannot function adequately

43. BACKSTROKE
MECHANICS:
• The backstroke is similar to the freestyle stroke in that the arms
stroke reciprocally and are supported by a trunk rotation and a
leg kick.
• backstroke is performed supine.
• diagonal flutter kick
• The face is above throughout the stroke, thus no specific
breathing pattern.
• The body rolls in the direction of the arm that is entering the
water in order to minimize the lateral motion of the legs and
hips.
 PHASES:
• Hand entry is by little finger leading towards water.
• The beginning of the pull-through is marked by the hand entry of
the swimmer with the arm extended above the head

44. • The mid pull-through phase begins when the humerus is
perpendicular to the body. The arm continues to move toward
the feet
• late pull-through, the elbow straightens out with a slight
downward press before lifting out of the water to start the
recovery phase.(it is important that hand exit the water with
the thumb first)
• recovery phase -The elbow is fully extended throughout and
travels straight over the top of the water and overhead to the
point of hand entry.

45. MUSCLE ACTIVITY-
• The muscles most active during the powerful pull-
through are the teres minor and the subscapularis.
• Positioners: the three heads of deltoid, supraspinatus
are responsible for placing the shoulder girdle in a
position for hand entry and hand exit.
• Pullers: latissimus dorsi, rhomboids, posterior deltoid,
subscapularis and teres minor are active during
propulsive phase.
• depressed activity in the teres minor in the backstrokers
with painful shoulders, the rhomboids also exhibit less
action.
• Supraspinatus demonstrates suppressed activiy toward
mid pull though in the swimmers with painful shoulder.

46. BREAST STROKE
MECHANICS:
it is unique in that the arms do not exit the water. the
legs are more of the propeller or power drivers than are
the arms.
This stroke uses a bilateral arm motion in which the arms
reach forward and then sweep outward (the beginning
of the pull-through), while the elbows begin to flex.
When the hands are in line with the mid-chest, the hands
move inward in a circular pattern until they meet in front
of the chest and are thrust forward (recovery) once
again.

47. the body motion in the breaststroke is centered
around the hips. Breathing is done by lifting and
lowering the head.
The kicking motion most frequently used in
competition is the whip kick, a symmetric, bilateral
action or frog kick.
The kick motion starts with the legs fully extended
horizontally. The knees bend and move forward as
the heels are brought as close to the buttocks as
possible. When the heels reach their highest point,
the feet rotate outward so that the toes point to the
side, and will also move wide of the knees.

48. • The knees and feet push backward and inward from that
position until reaching full extension with the legs together
again. Forward propulsion is generated primarily by the force
of the inside of the feet and lower leg pushing directly against
the water.

49. Muscle activity
• The pectoralis major is responsible for powerful humeral
adduction and extension to provide propulsion.
• Serratus anterior is active throughout pull through to
stabilise scapula and recovery to stabilize, protract and
upwardly rotate the scapula for the forward reach.
• The three heads of deltoid fires sequencially during
recovery in order to position the arms forward.
• Painful shoulder: breaststroke swimmers with painful
shoulders demonstrate an increase in activity in the
subscapularis and the latissimus dorsi.

50. • The increased subscapularis activity, along with a
decrease in the action of the teres minor, leads to a
relative increase in internal rotation. The increase in
latissimus dorsi action may assist with humeral head
depression to relieve the impingement. (during pull
through)
• Activity of serratus anterior also decreases during
pull through phase lack of stabilization and
upward rotation upper trapezius increaes its
activity in order to upward rotate the scapula and
relieve impingement
• During recovery: decreased middle deltoid activity
drop elbow to avoid impingement

51. BIOMECHANICAL IMPLICATIONS IN
PREVENTING INJURY
 A hand entry that crosses the midline of the long axis causes
mechanical impingement in the anterior shoulder, including the
long head of the biceps and the supraspinatus.
 This is exacerbated by a thumb-first entry that further stresses
the biceps attachment to the anterior labrum. A crossover pull-
through usually results from a crossover entry and increases the
time in the impingement position.
 Proper body roll, however, can resolve most of the
impingement risks, unless the athlete has glenohumeral
instability or anterior capsular laxity and concomitant anterior
subluxation.

53.  Asymmetric body roll or unilateral breathing may increase
impingement by causing a compensatory crossover pull-
through on the side with less roll or on the nonbreathing side.
Improper head position, forward-sloping shoulders, and
scapular instabilities are also implicated in arm, shoulder,
upper-back, and neck pain that may or may not be associated
with neurologic signs and symptoms.

54. Rotating on the axis
• The correct stroke pattern must be accompanied with equal body
rotation to avoid injury. The body must rotate at least 45° from
its long axis equally in both directions. The head position should
be neutral on the spine
PREVENTIONIMPROVING MECHANICS

55. Conditioning and flexibility
• Encouraging the young athlete to participate in a variety of
activities that help develop total-body conditioning, muscular
strength, and muscular endurance is essential.
Preventive Rehabilitation
• A preventive rehabilitation program should include
strengthening the scapular stabilizers, appropriate stretching,
and spinal stabilization with core strengthening

56. Strengthening exercises should focus on endurance
training of the serratus anterior, lower trapezius,
and subscapularis muscles.
• The four most widely accepted and effective
exercises used in clinical practice are scapular
elevation (scaption), push-ups with a plus, and press-
ups.
• These exercises can be incorporated into a dryland
training program for swimmers and should be
progressed to three sets done to fatigue.
• upper-body ergometry can greatly enhance the
endurance component of the strengthening of the
scapular stabilizers.

57. Muscles at risk during the swim sroke
and suggested exercises
stroke Muscles at risk Strength or
endurance
Suggested optimal
exercise
freestyle Serratus anterior
subscapularis
Strength
Endurance
Strength and
endurance
Push-up
Military press
Scaption
Boxing
Medial rotation
butterfly Serratus anterior
Teres minor
Strength and
endurance
Same
Lateral rotation with
low loads, more reps
backstroke Teres minor
Subscapularis
Rhomboids
supraspinatus
Strength and
endurance
Strength
strength
Retraction with an
isometric hold
flexion
breaststroke Supraspinatus
Upper trapezius
Strength
strength Shoulder shrugs

58. Serratus anterior
Teres minor
subscapularis
rhomboids

59. • Strength training is most effective when done as an isolated
workout session. Strengthening exercises done before swimming
can fatigue the rotator cuff and possibly increase the risk of
injury.
Stretching: Swimmers have selective tightness of certain
muscles, which may predispose them to anterior impingement.
Isolated stretches of the pectoralis major and minor, posterior
capsule, and latissimus dorsi are most effective. There should be
omission of anterior capsule stretching.
Core strengthening: facilitates total kinetic chain
transference and ultimately performance.

60. Stretchings a swimmer should NOT do(omission of anterior capsule strtching)

61. Back stretch
Hamstring sand back stretch
Dorsiflexor stretch
Pectoral stretch

62.  Warm up/Cool down :
• Warm up: To prepare all the muscles to be used later when
swimming for speed and conditioning, all strokes except the
butterfly should be incorporated into the warm-up. The
butterfly is too powerful a stroke to be considered warm-up
intensity(15-20 minutes).
• Cool down :
• rhythmic freestyle and backstroke laps are good choices,
avoiding breaststroke and butterfly because they are too
intense. A good cool down session will avoid strain on your
heart and will reduce muscle soreness.

63. Training and cross-training:
• Both dry-land and pool-based exercises should focus on
building strength and endurance of the muscles involved in
swimming as well as increasing core strength, cross-training,
and flexibility. Both aerobic and anaerobic training will reduce
muscle fatigue and increase endurance.
Technique : Proper swimming technique involving stroke,
kick, and breathing as well as overall form, force, and
streamlining greatly improve the ability to swim without
injury.

64. • Any position of the body angled from horizontal will increase
form drag. Wave drag is decreased in deeper pools and pools
using wave-dispersing lane lines.. Body hair, swim suit
materials, and swim caps all have an effect on frictional drag.
Some swimmers shave their bodies to reduce this force.
• Streamlining your stroke, reducing drag, timing of force so
that it’s at the portion of the stroke that utilizes it most
effectively, and directing force so that your effort efficiently
propels you in the direction you want to go are all important
factors not just in increasing speed, but reducing the
counterforces that fatigue body parts and lead to overuse
injuries.

65. Factors contributing to overuse
injuries
Physical factors joint alignment problems, muscle imbalance,
inflexibility, muscle weakness, and ligament
instability.
Nutritional factors During high-intensity workouts, glycogen levels
fall to low levels, and if depleted, the body
must break down stored fats; an inefficient
method of obtaining energy during high
energy demand which contributes to fatigue.
Stroke mechanics Poor stroke mechanics
Training factors There is increased stress to the joints if
technical stroke flaws exist. Training too hard
and too fast is likely to put the swimmer at risk
of injury.

66. Possible mechanisms of shoulder pain
in swimmer’s
TRAINING MUSCLE WEAKNESS DEFICITS IN
NEUROMUSCULAR
CONTROL
CAPSULAR
ABNORMALITIES
Faulty stroke
mechanics
•Early fatigue
•Abnormal loading of
soft tissues
Serratus anterior and
lower trapezius
•Abnormal loading of
GH joint and
surrounding soft
tissues
Temporal problems of
neuromuscular
dynamic stability of
ST jt cause
inadequate scapular
stabilization.
Posterior capsule
tightness creates
obligate translation of
humerus can lead to
impingement
syndrome.
Sudden increase in
training loads
•repetitive
microtrauma
•Inadequate time for
tissue recovery
Posterior rotator cuff
muscles
•Inadequate GH
dynamic stability
•Early fatigue
Temporal problems of
neuromuscular
dynamic stability of
GH jt cause
inadequate GH
dynamic stability.
Anterior inferior
hypermobility of GH jt
leads to
microinstability which
in turn can lead to
secondary
impingement
syndrome.

67. Lack of periodization in training
High level of swimming experience
Elite swimmers train near or at their threshold
of injury
High percentage of time training with the
front crawl stroke

68.  It is a condition that has a microtraumatic overuse onset.
 It has been described as an inflammatory condition caused by
the mechanical impingement of soft tissues against the
coracoacromial arch.
 Bak states that shoulder pain in swimmer’s has been regarded
as synonymous with coracoacromial ligament subacromial
impingement, that is, anterior shoulder pain due to rotator
cuff or long head biceps tendinopathy.
 He also concedes that concomitant glenohumeral instability
plays an additional role in creating signs and symptoms of
swimmer’s shoulder(secondary rotator cuff impingement due
to underlying instability)
SWIMMER’S SHOULDER

69. Sources of impingement
During pull through
phase of front crawl
stroke
During recovery phase
of front crawl stroke
•The shoulder is placed in a
position of horizontal
adduction that
mechanically impinges the
long head of biceps against
the anterior part of
coracoacromial arch.
•The fatigued muscles of
the rotator cuff act to
externally rotate and
depress the head of
humerus against glenoid
and they become less
efficient.
•Supraspinatus becomes
mechanically impinged
between GT and middle
and posterior portions of
coracoacromail arch.

70. Double squeeze phenomena(decreased subacromial space)
• Intraarticular compression by
– Antero superior glide of the humerus
– Position of shoulder during pull through
– Similar to provocative impingement tests-hawkins kennedy
and neer impingement: increased internal rotation at the GH
joint

71.  Stocker and coworkers state that more than 50% of swimmers
with shoulder pain in both impingement type groups
perceived that increased intensity or distance provoked their
shoulder pain. This finding is significant and illustrates that
fatigue may be a condition to avoid.
 A number of swimmers might also have a primary
impingement due to abnormal acromial morphology or a
selective hypomobility of posterior capsule.
 Electrical activity measured in 25 breaststroke swimmers
showed an increase in activity of the internal rotators muscles
in swimmers with painful shoulders. There was decreased
activity in the teres minor, supraspinatus and upper trapezius
muscles. These factors increased the risk of impingement

72. Classification scheme that divides the
swimmer’s shoulder into four phases based on
the severity of the symptoms
I. Pain only during workout; does not interfere with
performance.
II. Pain during and after workout, which resolves with ice and
does not affect performance.
III. Pain during and after workout, which affects performance.
IV. Pain severe enough to prevent competitive swimming.

73. Role of laxity in swimmer’s shoulder
• Shoulder stability is controlled by static and dynamic factors.
• Loss of static component requires greater contribution from the rotator
cuff, which can result in muscle overload and eventual muscle fatigue.
• The most common pattern of instability is anteroinferior.
• The risk of subluxation is increased in backstroke if the hand contacts
the wall for the turn with the arm in this position of abduction and
external rotation.
Thoracic outlet syndrome
• Freestyle, butterfly and backstroke all require a controlled
repetitive power motion at the very extreme of abduction and
external rotation of the shoulder. Tightness and pain about the
shoulder, neck and clavicle at the hand entry position should alert
the physician to the possibility of thoracic outlet syndrome.

74. The instability continum
Stretching of anterior fibres
microtrauma
Muscle fatigue or weakness
hyperlaxity
instability
subluxation
impingement
Rotator cuff
tear

75. Signs and symptoms of swimmer’s
shoulder
SIGNS SYMPTOMS
Altered and reduced arc of ROM Pain progression
Weakness of supraspinatus and
infraspinatus
Pain only present during and after workouts
Weakness of scapulothoracic stabilizers Pain present that interferes with
performance
Poor neuromuscular control of ST jt Pain prevents participation
Increased shoulder laxity anteroinferiorly Pain at rest or at night
Multidirectional instability Dead arm feeling
Trunk and abdominal(core) stability deficits Feelings of instability

76. In freestyle swimmers
Deviating the head from the
axis of rotation i.e. looking or
breathing forward
repetitively can cause
unnecessary neck problems
due to the neck adopting an
extended and rotated
position, which is known to
stress the neck
Poor body
rotation
results in over-
rotation of the
neck in order
to breathe
In backstroke swimmers
prolonged contraction of
the anterior neck to keep
the face above the water
line, a position, which may
predispose cervical spine
hyper flexion.
These muscles are prone
to fatigue and can result in
muscle soreness
afterwards.
In butterfly swimmers
A weak kick, poor body
strength, or a combination of
both may result in imperfect
clearance of the head and face
out of the water causing the
swimmer to hyperextend in
order to breathe
Cervical spine

77. LUMBO-PELVIC COMPLEX
• Torsional strain can occur when the body does not roll as a
whole unit during the stroke causing abnormal loading at the
point in the spine where the rolling stops.
• This predisposes the swimmer to overuse or acute injury or
both.
• Tight hip flexors can reduce hip extension resulting in
hyperextension of the lumbar spine and anterior pelvic tilt. In
addition, anterior pelvic tilting results in the pelvis assuming a
lower than normal position in the water, creating increased
drag.

78. • The hyperextension motion of the lumbar spine seen with
butterfly and breaststroke can predispose to facet joint
irritation, otherwise known as “Butterfly back syndrome”
• If this compression becomes repetitive and chronic, it may
progress to low grade joint inflammation, leading to reflexive
spasm of the back muscles and pain can occur. With
continued repetitive stress, low back problems like stress
fractures of the pars interarticularis (spondylolisthesis) can
occur.
• Scoliosis

80. BREASTSTROKER’S KNEE
• Most common in swimmers who swim a lot of breaststroke.
• Mostly due to the position of the knee during breaststroke
kick.
• The rotation in the kick affects
the medial collateral ligament,
which runs along the inner
side of the knee.
• If painful exercise does not
stop, it can lead to a MCL
tear.
http://www.nsmi.org.uk/articles/swimming
-injuries.html

81. REFRENCES
Athletic injuries and rehabilitation
James E. Zachazeuski
Spinal musculoskeletal injuries associated with
swimming
henry pollard, matt fernandez
Prevention and treatment of swimming injuries
Tamara mitchell
Swimming biomechanics and injury prevention
james N. johnson
Knee pain in competitive swimming
Scott A. Rodeo
Bilateral and antero-posterior muscular imbalances
in swimmers
Ted becker

82. THANK
YOU
THANK YOU