Page 8 - Summer 2020

TEAM PHYSICIAN’S CORNER

Risk Factors, Evaluation, and Treatment to resist repetitive forces on the spine. undulating motion of the hips and low
Additionally, degenerative disc changes back during butterfly and breaststroke
Unlike breaststroke, backstroke and
freestyle employ a flutter kick which have been shown to be more common may lead to pain by increasing lumbar
5,11,33,34
1,30
can lead to anterior knee pain from in swimmers than non-swimmers. In lordosis due to extension forces. A
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patellofemoral overload. Similar contrast to recreational swimmers, the physical therapy program that includes
symptoms may occur due to improper training intensity, duration, and distances video swim stroke analysis to identify body
swum by competitive swimmers has been
roll angle measurement and initiation of
block starts or repetitive explosive kicks shown effect the rate of disc degeneration this movement with core (not shoulders
off of the wall creating a mini-squat in elite swimmers. 31 nor hips), along with an extensive core
position during flip turns. Thorough strengthening program is recommended
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evaluation for patellar maltracking, Risk Factors, Evaluation, and Treatment for treatment and prevention of
patellar instability, decreased quadriceps recurrence. Instruction on appropriate
and gluteal strength and flexibility, and When training surpasses the endurance use and activation of the transverse
ligamentous laxity should be part of the of core abdominal musculature, the hip abdominus and maintenance of neutral
evaluation of swimmers who present flexors increase lumbar lordosis and spine position in the aquatic environment
with knee pain. As with the shoulder, a may precipitate disc degeneration, bony while coordinating a diaphragmatic
1,25
physical therapy program that includes stress injuries, musculotendinous strains, breathing pattern are the critical
video swim stroke analysis along with spondylolysis, and spondylolisthesis. 4,5,32 components of the trunk stability. 27,37,38,39
strengthening of the quadriceps, vastus For competitive swimmers, body
medialis obliquus, and core stabilizers positions for starts and turns expose the Conclusion
1,4,13
is recommended for treatment and back and neck to repetitive strains.
prevention of recurrence. 4,5,28 The streamline position loads the posterior Swimming has long been and continues
structures of the vertebrae placing to be a popular recreational activity and
athletes at risk for spondylolysis and competitive sport. It is a low risk activity
Spine Injuries and Conditions
spondylolisthesis. Strokes such as for serious injury due to its low impact
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Neck and back pain occur commonly butterfly and breaststroke in particular, nature. Overuse injuries may occur in
among recreational and competitive place swimmers at an even higher risk competitive athletes, those who specialize
swimmers with a reported injury for reporting low back pain, with butterfly in one particular stroke, and in those with
incidence rate ranging from 22–50 reporting the highest incidence. 35,36 Similar genetic and biomechanical risk factors. In
percent. 35,36 It is crucial to assess hyperextension forces may occur during general the cardiovascular fitness benefits
and ensure proper start and stroke training with the use of fins, kick boards, of regular participation in swimming
mechanics from an early age in order and pull buoys. Additionally, the greatly outweigh the risk of injury.
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 6 SPORTS MEDICINE UPDATE | Summer 2020, Issue 3