Blog guest: Mr Nedeljko Radomirovic – Injuries and swimming

How and when can swimming be treated as a part of rehabilitation for children and adults recovering from serious injuries? Based on his 12-year experience in work with sportsmen, for Swimming Dad as a #Blog guest, Mr Nedeljko Radomirović, Senior Sport Physiotherapist is telling us more about this. He is a dedicated and determined health professional with a strong clinical and sport background. He is currently living in Dubai (Zia Medical Center)

How can swimming contribute to faster recovery after an injury?

Swimming, like any other form of physical activity, can contribute to faster recovery after an injury if done with the respect to the injury itself. For example if the shoulder is injured, an athlete can use his legs in the pool with assistance of a floating device and if supervised by a professional. What are the mechanisms that contribute to faster recovery after an injury? Answer would be metabolic response to physical exertion. Let's put it this way, you will recover faster if you engage in modified physical activity rather than avoiding it completely. I have to underline that the above mentioned have to be taken in account in respect to the injury and the stage of recovery / rehabilitation that the individual is in. Make sure you are always cleared to engage into any form of physical activity by a licensed health professional.

When can swimming be part of rehabilitation?

Swimming can be a part of rehabilitation for a wide spectrum of different musculoskeletal injuries if the program is individually tailored to suit the subject. Of course, one has to be cleared by a health professional to engage into swimming and preferably coordinate with the swimming coach on a regular basis. Teamwork and communication are very important in these cases.

Are there cases when it's contraindicated and why?

Swimming cannot be a part of rehabilitation in acute stages of any pre existing or chronic musculoskeletal conditions. To make it simple, if your injury is recent, this is not a chronic condition, it's called acute. First steps would be diagnosing the injury and being assessed by a licensed medical professional.

One example from practise, a patient with pre existing/chronic (old injury) is having lower back pain and he's presenting in my office asking for advice if he can start swimming because he heard that swimming would be safe for him. On assessment he presented with pain and sensitivity in the lumbar area while performing trunk extension (part of basic range of motion

testing) therefore breaststroke swimming would be contraindicated for him due to the specific demands of the technique requiring him to be exposed to trunk extensions that may aggravate his condition. Other styles like backstroke and/or freestyle would be more suitable for him. The key here is individual approach. I hope this makes sense.

Can regular swimming reduce injuries and why?

Of course it can. We are coming back to the basics of physiology and metabolism. Basically the fitter you are, less likely you are going to be injured. One would be specific demands of techniques and variety of strokes that will strengthen practically your whole body and second is already mentioned metabolic response to physical exertion.

How frequent are injuries in swimming in comparison to other sports?

Swimming is a non contact sport and obviously done in water where your bones and joints are not exposed to the same type of load like for example playing football or weightlifting. Therefore one would think there are no injuries in swimming, right? Wrong. The forces that swimmers generate in water can cause overuse injuries, especially if an athlete is not energy efficient. Energy efficiency comes with good technique and good technique comes with years and years of repetition and training. That's where proper training comes into play with proper periodisation (rest and training load balance), proper recovery and nutrition. But that is a very complex subject, let me try to answer this question by comparing football and swimming injuries rate per 1000h of training:

Football: "The injury rate during competition ranged from 8.7 injuries to 65.9 injuries per 1000 hours of exposure, whereas the injury incidence during training ranged from 1.37 injuries to 5.8 injuries per 1000 hours of exposure." 1

Swimming: "A 5-year survey from the National Collegiate Athletic Association (NCAA) revealed that overall elite swimmer injury rates were 4.00 injuries per 1000 hours training for men and 3.78 injuries per 1000 hours training for women. Shoulder injuries are the most common injuries, with prevalence between 40% and 91%." 2

References:

1: Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review; J Athl Train. 2016 May

2: Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers; Sports Health. 2012 May