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Promoting Performance Through Injury Prevention
By Wayne Goldsmith | In Performance Science
By Peter Blanch, Australian Institute of Sport Physiotherapist and Co-author Wayne Goldsmith
Author, Peter Blanch, is a physiotherapist with the Australian Institute of Sport. He assisted with the preparation of a number of Australian National Teams with whom he travelled which included the teams for the 1994 Commonwealth Games in Victoria, Canada, and the World Championships in Rome. He has a strong conviction in regard to the prevention and management of injury. Together with ASI Sports Science Co-ordinator Wayne Goldsmith this article provides 10 simple tips to promote performance through injury prevention.
Injury prevention is an important part of the training plan of every coach. The best-planned and periodised training program is of little use if the swimmer is always injured and unable to train.
Due to the high repetition involved in swimming training, the injuries that are most common are of the overuse variety. This is where the cumulative effect of repetitive actions … like pulling or stroking … cause tissue breakdown and inflammation, (microtrauma). Regardless of the type of injury, learning to minimise injuries is far better than learning how to treat them!
Here are 10 simple tips to promote performance through injury prevention that all coaches can use.
- Develop a Network of Sports Medicine/ Science Specialist: Get to know your local sports physiotherapist, sports MD, sports massage therapist, podiatrist, etc. It is important to develop a network of reliable, suitably qualified, sports medicine backup personnel who know and understand swimming and who you can send your swimmers to with confidence in times of injury. Don’t underestimate your role as a coach in this network! Not all health professionals fully understand the demands of swimming and swimming training. The coach should work closely with the doctor/physio to determine an effective rehabilitation strategy for injured athletes. Imaginative rehabilitation programs can be co-operatively planned and structured into a modified training schedule. This will help ease the frustration that both coach and athlete feels during times of injury.
- Screening: Prevention is better than cure! Have your local sports physiotherapist screen your squad for possible problems. Have them look for flexibility limitations, movement patterns, body symmetry, etc., before starting hard training. A 10-minute screening by someone who knows what to look for may save a lot of pain and frustration later in the season. For example, a limited range of motion (R.O.M.) in a shoulder may eventually lead to shoulder pain. A lack of symmetry in the upper back may lead to an uneven stroke and pain and spasm in the neck.The coach’s role in injury prevention is essential. If biomechanical deficiencies are identified and rehabilitative programs are suggested, the coach needs to reinforce these as part of the overall training schedule.Finding a skilled professional may not always be easy, but there are standard screen protocols available through the State Directors of Coaching and the A.I.S. that your local sports medicine professional may find useful.
- Stretching: Stretching has many roles. We tend, as coaches, to just consider the aspect of stretching during warm-up for injury prevention. However, stretching has an important role in performance! Increasing the range of motion of different joints will make for a more efficient swimmer. For example, in the early part of the freestyle armstroke, most of the propulsive force is generated through internal shoulder rotation. If a swimmer is able to exert force through 40 degrees instead of 20 degrees, they are able to generate power through a greater range (there are of course upper limits to this increase in range of motion).The body’s joints move through the path of least resistance. If one joint is limited in its ability to perform a motion, this task will be passed along the chain to a point where the movement will occur. Take the swimmer who kicks with tight hips. If the hips can’t supply the motion, the body will compensate by increasing the amount of motion through the lower back. This is not only inefficient, but potentially injury causing.Attention to better stretching technique will ensure better results in increases in the range of motion. Many swimmers perform stretches incorrectly, believing that leaning against a wall with their arms over their heads is enough to reduce injury risk and enhance performance. Most stretches need to be performed with a strong, stable trunk. We are looking to increase mobility around the peripheral joints whilst maintaining stability in the core.
Stretching gives the swimmer the range of motion to efficiently execute the skills of swimming.
- Strengthening: Not in the Arnie Schwarzennegger sense, but a program designed to strengthen the body to limit and reduce injuries. The weights program should be periodised to compliment the overall training program design and the compatibility of strength and endurance needs to be considered – i.e. gains in maximum strength levels in the gym may not be as effective during the general preparation (aerobic endurance) phase of pool training owing to the physiological complications of training strength and endurance concurrently.Skilful swimming requires quite a deal of strength. There is valid argument that suggests swimming itself is sufficient strength work for swimming – i.e. to get strong enough to swim, you swim. However, there are specific benefits that a swimmer can gain from doing specialised strength work. Muscles that stabilise the trunk and scapulae (shoulder blades) can be better worked in the controlled environment of the gym or pool deck.It is important to perform all stabilisation exercises correctly and with an emphasis on control rather than on lifting the maximum weight possible. The aim should be to develop the ability to produce force at the body’s extremities whilst maintaining a strong stable trunk.
- Technique: Swimming techniques have been developed over along time to effectively increase force production and minimise resistance. Generally speaking, strokes performed with correct technique are less likely to cause injury because the movements are more efficient. Technique needs to be reinforced and stressed for all swimmers at all levels at all times, and particularly when the swimmer is feeling fatigued.It should be noted that training develops not only the cardiovascular and musculo-skeletal systems, but also the nervous systems. It is important to maintain good control of movement patterns regardless of physiological fatigue.In the case of the tired swimmer continuing to swim in a fatigued state with poor technique, the gains in cardiovascular conditioning may be offset by the decreased stroke efficiency reinforced in the nervous system – i.e. the poor technique is reinforced – and the increased likelihood of injury.
- Backstroke & Kicking: As well as being a competitive swimming stroke, backstroke has an important role in injury prevention. Butterfly, breaststroke and freestyle are all strokes which place a lot of strain on the muscles which rotate the arm inwardly. This continually inwards rotation causes stress and sometimes the condition called “rotator cuff tendonitis” (swimmer shoulder) eventuates. Using backstroke works other muscles between long fly and freestyle sets and helps reduce the load on the muscles and tendons of the shoulder. For example, instead of 20×50 Fly on 1:00, try 2x(10×50) Fly on 1:00 with 200 easy back every 10.Instead of straight overdistance freestyle (1000’s, 2000’s, etc.), try 100 back every 500 free.(Note: Backstroke also works inward rotators during the pull phase.)
Coaches have also used kicking in the past to reduce training stresses on shoulders and arms. It is important, if using kicking sets between swim sets to give the shoulder a rest, that swimmers using boards cross their arms on the board or don’t use a board at all. Kicking with the arms straight out in front only increases the strain on the point of the shoulder … the very thing the kick set is supposed to be relieving!
- Parental Education: Parents can be the frontline in injury prevention and management strategy. Regularly hold parent education sessions where experts such as physiotherapists, nutritionists, doctors, etc., come in and teach parents the basics of injury management and prevention. Topics such as “Eating to Win” and “The R.I.C.E.D. Technique” or “Recovery Techniques for Competitive Swimmers” may help parents understand the important role they play in the preparation of a swimmer.
- Massage: Massage is extremely useful in three forms:
(1) Professionally done i.e. massage therapists or physiotherapists working directly with swimmers.
(2) Swimmers massaging themselves.
(3) Parents massaging swimmers. It only takes a few sessions with your local sports massage person or sports physiotherapist to educate your swimmers on the benefits of self-massage. Swimmers can be easily taught to massage problem areas – e.g. neck, upper back, triceps, and shoulders – if pain or soreness presents. Similarly, parents can be taught the basic of massage and can work with swimmers to massage out spasms in back, neck and shoulders.We are not suggesting that parents can take the place of an experienced, qualified physical therapist (unless one or both of them has spent five years at University studying to be one), but it is not always possible to get in to see a professional immediately the spasm or injury presents. Parents and swimmers, using simple injury management techniques, can keep pool time lost to injury to a minimum. (But as the Panadol ad says … if pain persists, see your family doctor!). - First Aid, Medical Kit, Ice: The fundamental responsibility of ALL coaches and teachers is the safety of the swimmers under his or her control. An important part of this responsibility is having a well maintained and up to date medical kit close by at all training sessions (not locked in the club cupboard), and at all swim meets and being able to administer basic first aid in case of emergency. Check regularly to see if all medicines, preparations and medications in the first aid kit have not gone past the use-by date. A current first aid certificate (St Johns or similar) is a vital part of being prepared for the first line in injury management. Ice should be available at all sessions and meets as part of your injury prevention and management strategy.
- Coach Education: It is vital that all coaches keep up to date with current injury prevention strategies and injury management techniques. Make it a priority to read up on injury prevention and to discuss the issue with sports science/sports medicine professionals at every opportunity. It is difficult (impossible?) to have a 100% injury free squad program. Swimmers are working hard, pushing themselves to the limits to achieve their best and injuries are an ever-present danger. However, injuries can be minimised and controlled with a sensible injury prevention and management strategy, which is at the heart of your training plan.
Hopefully these 10 tips will help you develop a sensible, safe and effective training program.
Wayne Goldsmith
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