Swimming Injury Prevention

Written by: Larkin Grant, SPT

Now that we are in the swing of summer, I wanted to give everyone some pointers to reduce the risk of injury while swimming. Swimming is an excellent whole-body exercise that is a great option for people who want to get the cardiovascular benefits of aerobic exercise without high impact on their joints. 

The most common injury for swimmers is shoulder impingement. There are 3 main structures that can get pinched to cause shoulder impingement:

1.     Supraspinatus tendon/muscle – this is one of your rotator cuff muscles that sits between your collarbone and humerus.

2.     Bursa – a small fluid-filled sac in the same location which can get inflamed

3.     Biceps tendon – the tendon from the muscle of your biceps runs up into your shoulder joint.

No matter which one is impinged, the classic signs and symptoms are a “pinching” sensation when reaching overhead. This injury hits close to home, as I developed chronic shoulder impingement already by the time I was nine from so much swimming! From my two bouts of physical therapy and my current education in a DPT program, I have learned some very helpful pointers to avoid injury during swimming!


1.     Improve your posture

Swimmers are notorious for having poor posture. This is because the muscles you use when swimming tend to be the ones that rotate your shoulder inward. If your shoulder is not in its proper, upright position, it can pinch when you bring your arms overhead, making impingement more likely. Make sure you are sitting and standing with your shoulders back and down and your spine upright.

2.     When you swim freestyle, enter the water with your pinky finger first

Starting your stroke with your thumb first internally rotates (rotates towards your middle) your shoulder. This decreases the space between your shoulder and collarbone, which makes impingement more likely. If you externally rotate (rotate away from your body) your arm when you enter the water, your pinky will enter first and your arm will be in a position that makes impingement less likely. At the same time, try to rotate through your trunk with each arm cycle to lengthen your stroke.

3.     Breathe on both sides (one breath every 3rd stroke)

If you only breathe to one side during every lap, you will begin working one side of your neck muscles more than the other side, which can lead to imbalances that can cause neck and shoulder injuries later on. Even though you might have a preferred side to breathe on, normal breathing is every 3rd stroke, which also allows you to remember to breathe on both sides.

4.     Don’t forget to breathe in general

This may not be about impingement, but it sure is important! There is something called “shallow water blackout” that can cause death in competitive swimmers. When you hold your breath for long periods of time, the carbon dioxide can build up in your blood and make you forget to breathe. This can cause you to pass out underwater and could cause silent drowning. Don’t complete multiple lengths of underwater laps or laps without breathing unless you are closely supervised. To learn more go to http://www.shallowwaterblackoutprevention.org.

5.     Strengthen your rotator cuff muscles

Your rotator cuff seats your humerus in the correct position while you move your arms. If your rotator cuff is not strong, this can cause your shoulder to move more than is ideal during your stroke, which can cause inflammation and damage. Click here for pointers on how to keep your shoulder rotators strong (along with some hip exercises! :) ).


While you are keeping cool in the water this summer, don’t forget some injury-reduction tips. Make sure to call in to make a physical therapy appointment if your shoulder starts bothering you during swimming or outside the pool!