Science of Performance: Return to Swimming After Injury, Part IV

By G. John Mullen of and, Swimming World correspondent

SANTA CLARA, California, January 24. RETURNING to the pool guidelines are essential, but why not prevent injuries from the beginning? Remember, prevention is easier than rehabilitation.

Build the ship
The top athletes in the sport, such as Michael Phelps, Ryan Lochte, Federica Pellegrini and Grant Hackett, have all spent hours in the pool and taken millions of strokes throughout their careers, syncing their genetic and training potential. They synchronize their modifiable and innate characteristics for success. Building the ship looks at a modifiable characteristics and training.

So what makes them able to handle these volumes better than other swimmers? It comes down to being able to handle waves. Common stroke flaws are like waves in the ocean — you can hit a few along the way and still reach your destination safely, but hitting too many will cause damage and divert your course. The more robust your ship (or body), a modifiable characteristic, the less disruptive the waves, an unchangeable characteristic will be.

However, we should not detour all waves, as doing so could add unnecessary time to the journey. As no sea is completely tranquil, the ultimate goal is to handle waves with minimal effect on our ship.

Proper muscle strength, length, and timing make our ship a well-armored aquatic vehicle. Rarely (disregarding macrotrauma, read about macrotrauma here) does an athlete hurt himself or herself the first time they do a task. The athlete must keep their ship strong to float against recurrent waves and control the water. If an athlete has optimal muscle strength, length, and timing each time they hit the pool, their muscles will work properly, preventing shoulder injuries. Fewer injuries mean more consistent training, which leads to faster swimming and ample time for practice to synchronize genes to training.

Other Sports
Other overhead sports (tennis, baseball, etc.) provide adequate monetary compensation to help athletes assemble their ship. Unfortunately, the common elite swimmers are underpaid and barely able to support themselves while healthy. For some, a shoulder injury is tantamount to retirement, as any extended time out of the water can be financially crippling.

Due to low budgets, swim coaches are also spread thin and must wear numerous hats: sports psychologist, strength coach, rehabilitation specialist, and nutritionist. These articles and the upcoming COR Swimmer's Shoulder System will help these overworked coaches master two of these areas and keep their swimmers in the pool for longer times with less frequent injuries. It will also help the parent understand and support the coaches' efforts to prevent shoulder pain. Lastly, it will help the swimmer successfully perform the sport they love for a long time.

Muscle Length
In my opinion, muscle length is the most important aspect for shoulder health. I'm worked with many athletes who simply needed an improvement in muscle length for symptom alleviation. One athlete I saw had unrelenting shoulder pain, forcing her to discontinue swimming any stroke other than breaststroke. This switch worked at first, but eventually breaststroke caused her symptoms.

This swimmer exhibited the typical swimmer, Neanderthal posture: forward head, rounded shoulders, and rounded back. During breaststroke she said her symptoms occurred during the initial outsweep. Upon observation it was clear her shoulders remained protracted and rounded throughout the stroke, it was evident at this time her faulty posture and poor muscle length was preventing her from performing optimal stroke biomechanics for swimming success and injury prevention.

After talking, she indicated she had an initial injury which improved, but never resolved. It was determined her symptoms were perpetuated by compensations, impairing muscle length. Everyone has seen someone hurt their arm and then they hold it against their stomach to compensate. This is a good and bad reaction.

● Good: it prevents movement and more pain/injury to the area involved.
● Bad: it causes compensations and can lead to tight muscles.

Tight muscles lead to improper tone which is burdensome for many reasons: 1) poor positioning of a joint, 2) weakness (pseudoparalysis) to other muscles due to poor positioning, 3) poor movement patterns at the areas involved or surrounding muscles.

If a muscle lies in an inadequate position, it will be weaker and increase injury risk. For example, raise your arms overhead. Now, slouch and raise your arms again. I guarantee the second time you raised your arms you had less range of motion and potentially pain (unless you cheated and didn't hold a slouch, or you are already bent like Quasimodo). I didn't put a spell on your shoulder; slouching altered your muscle length and put your body at a biomechanically disadvantaged position…not fair!
Tight muscles will also inhibit other muscles from working properly. Another example, squeeze your finger as hard as you can.

Next, extend your wrist and squeeze your finger again.

If you did this correctly, you felt a significant decrease in strength when your wrist was extended. No I didn't put a hex on you, through your computer; I just changed the length/strength relationship between your muscles. Each muscle has an optimal firing position allowing maximal muscle firing.

Unfortunately, daily habits (posture, sitting, sports) or injuries put your body in suboptimal resting positions, causing impaired muscle firing. These impairments in muscle length not only cause weakness, but can cause symptoms.

Improvements in muscle length are essential for injury prevention and rehabilitation. This week, self soft tissue mobilization of the infraspinatus was demonstrated.

This exercise is one of many discussed in the COR Swimmer's Shoulder System being released in February. Stay tuned for the next installments on muscle strength and timing.

Dr. G. John Mullen is a Doctor of Physical Therapy and a Certified Strength and Conditioning Specialist. At USC, he was a clinical research assistant at USC performing research on adolescent diabetes, lung adaptations to swimming, and swimming biomechanics. G. John has been featured in Swimming World Magazine, Swimmer Magazine, and the International Society of Swim Coaches Journal. He is currently the strength and conditioning coach at Santa Clara Swim Club, owner of the Center of Optimal Restoration and creator of Swimming Science.