A good swim workout includes a dry land program that incorporates exercise ball exercises to strengthen the core musculature.



The best swim workouts should include exercise ball exercises. I treat a lot of swimmers with the local aquatics club. The level of competition is fierce. They swim 6 days a week, often more than once a day with only 2 weeks off per year. With these high level swimmers occasionally exceeding 20,000 meters per day in training in addition to their dry land swim workout, it's no wonder overuse injuries frequently occur.


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 Why is Core Strengthening Important

A great number of swimmers work hard in the pool to achieve their best times but often hit a plateau. One factor contributing to this is fatigue in the core musculature and lack of core strength. Another is that they mindlessly just continue to train exactly the same way. It's not that they aren't fit or strong enough to improve, but their body has just accommodated to the routine and fails to improve.

You can shake up that routine with some new core strengthening exercises using the exercise ball in your swim workouts. New swimmers will often overlook this aspect of their training in favour of over working their shoulders or their kicking.

Without core strength the swimmer's form will quickly fall apart. Loss of core stability results
in poor streamlining, less efficient kicking, and ultimately repetitive strain injuries like breast stroke knees or swimmer's shoulder.
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 A Strong Core Minimizes Drag

A strong core will help you perform with better technique, longer, and with fewer injuries. No matter what your swim stroke, core stability is essential for good swimming technique. The freestyle and backstroke involve a rolling from one side to the other which is initiated in the core. A weak core means less rolling and more stress on the shoulders. A good swim workout that includes core strengthening will address this.

The cause of a painful shoulder in swimmers can be attributed to a myriad of stroke flaws.  A hand entry which crosses the midline will cause an impingement in the anterior shoulder at the biceps tendon and the supraspinatus.  This is further aggravated by a thumb first entry which stresses the biceps attachment to the labrum.  A crossover pull-through usually results from a crossover entry and increases the duration in the impingement position. A crossover entry is aggravated by an unstable core and can be addressed with a swim workout incorporating the exercise ball.

Proper body roll can resolve most of the impingement risks. (Provided the swimmer does not have a history of instability) Studies have shown that swimmers with painful shoulders had serratus anterior muscles that became less active or inactive. This is an important muscle in scapular stabilization (among others) and is easily addressed with swimming exercises using the ball.

The majority of  force produced during swimming comes from the trunk and shoulders. Like the spine, the shoulder must also be stable to transmit energy from the trunk to the upper extremity. There are also ball exercises that you can use in your swim workout to strengthen the scapular stabilizers.

You can see here that increased lateral trunk movement during the swim stroke can increase turbulence and drag. Core stabilization exercises done as part of your swim workout will help prevent that.
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 Exercise ball exercises as part of your swim workouts will help your speed:

Swim faster by including a ball in your dry land swimming exercises at home.
•Use fewer strokes to cover a given distance.
•Use smoother movements with less splash, and better coordination.
•Create better trunk control which gives the limbs a strong base from which to generate power.
•Improve trunk roll which helps reduce the incidence of shoulder injuries.
•Decrease drag during your stroke.
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Dry Land Training Should Include Exercise Ball Exercises - Part of a complete swimming workout

Core conditioning as part of a program of swimming exercises has been proven to improve muscular power, kinesthetic awareness, flexibility, posture and aid in injury prevention. Core stabilization on the ball as part of your swimming workout can help build trunk strength which will help you maintain streamlines off the wall, decrease drag during the stroke and optimize technique and form. The stronger the core, the better the hip turn and all motion during the stroke.

Core strengthening as part of your swimming workout provides the final link in the injury prevention plan. Lower abdominal strengthening should be emphasized in the dry land conditioning program for swimmers. The goal of abdominal strengthening is to develop increased control of the pelvis by avoiding excessive anterior pelvic tilt and lumbar lordosis. Ball exercises should be done with the pelvis in a neutral position and the spine in good alignment. Development of muscular endurance is also one of the goals of core strengthening, because swimmers must support their body in the water for long periods of time while training. Abdominal exercises to build core strength may be part of a separate strength training session or may be effectively accomplished without untoward risk of injury just prior to or just after swimming.
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The Swimmer's Exercise Ball Exercise Routine

Perform three sets of each exercise as described three times per week. If you find the exercises very easy, feel free to progress them as each exercise ball exercise description suggests.

Click on the links for full description and progressions.

Supine Back Extension Stretch

Supine Pec and Subscapularis Stretch

Supine Pec Stretch

Superman Takeoff

Alternate Shoulder Extension

Back Extension 3

Superman

Hand Walking

Reverse Bridge Leg Raise

Alternate Arm and Leg Raise

Ab Crunch 2

Oblique Crunch 3

Trunk Roll 1

Trunk Roll 2

Look at the Ceiling

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 Swimmer's shoulder - the mechanics of swimming

The complex design of the shoulder allows for the most degrees of movement of all joints in the body. The shoulder consists of  a very mobile glenohumeral joint and scapulothoracic joint, and the relatively immobile acromioclavicular joint and sternoclavicular joint. The support of the shoulder relies on a configuration of ligaments to offer primary support. A secondary support system consisting of the muscles which aid in its stability. This setup  allows the shoulder to perform complex movements yet be strong enough to withstand large forces.

Swimming requires the performance of several complex overhead movement patterns involving continuous circumduction of the humerus. A competitive swimmer can exceed 4000 strokes per shoulder in one workout; hence swimming has become a common cause of pathology in the shoulder. Shoulder pain is one of the most common complaints with swimmers with incidence ranging from 27% to 87%.
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Swimmer's shoulder - causes

Shoulder injuries in swimmers can be classified as "macrotrauma" or "microtrauma" based on how it started. An injury that results from one specific traumatic incident can be referred to as macrotrauma. A pain that develops gradually over time due to repetitive activity is considered a microtrauma. The cause of microtrauma is usually multifactorial and can be due to biomechanical problems.

Swimmer's shoulder is a manifestation of subacromial impingement of the rotator cuff tendons, biceps tendon, or bursa or a combination of the above.  This impingement can be due to tightness in the joint capsule but in swimmers who normally have excellent mobility it is usually due to  laxity or a degree of hypermobility. It is an inability to control this hypermobility that lends itself to impingement. Swimmers tend to develop a laxity in the structures on the front of the shoulder joint. This aids in the amount of external rotation required for the joint to go through over four thousand strokes per day. This increased range of motion however puts excessive strain on the rotator cuff and biceps to prevent impingement.

An inability of the rotator cuff and biceps to maintain joint stability leads to movement of the humeral head forward and up, causing a repetitive stretching of the tendons or compression of the tendons against the under surface of the acromion.

Fatigue in the serratus anterior can contribute to impingement. During a normal stroke the serratus anterior rotates the shoulder blade such that there can be room for the rotator cuff tendons however, with fatigue, this rotation will not occur leading to a narrowing of the subacromial space resulting in impingement. Symptoms can also result in a change in stroke mechanics. A swimmer will modify their stroke in order to avoid the movement patterns that are causing pain. An example of this is during the early pull through, the hand will normally enter the water near to mid line with elbow just above the water. The arm will then continue reaching forward under the surface toward mid line. If a swimmer has a painful shoulder the hand may enter the water further from mid line and the elbow dropping toward the water. A swimmer will use this  to avoid a position that causes impingement (full elevation with adduction and internal rotation). Another way of compensating occurs at the end of pull through as the hand is closest to the thigh and shoulder internally rotated. What happens instead is that the shoulder is externally rotated and the pull through phase is shortened in order to avoid the painful position.

Another problem with faulty mechanics and muscle fatigue is the "wringing out" of the supraspinatus tendon that occurs when the humerus is adducted and flexed. This causes a temporary avascular zone in the tendon approximately 1 cm from its insertion. Repeated "wringing out" can ultimately cause tendonitis, tendinosis, and tear.
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Swimmer's shoulder -treatment


Since it is not the purpose of this website to offer treatment advice, I will discuss prevention. If you are experiencing shoulder pain as a swimmer it is important to see your physical therapist. They will have a clear understanding of your impairment, functional limitations, and underlying soft tissue pathology. Knowledge of swimming mechanics, and training will guide your physical therapist in choosing the correct treatment plan for you or advise you on changes to your swim workout.

Common causes of swimmer's shoulder involve problems with posture. Maintaining adequate flexibility in soft tissues in the front and back of the shoulder will allow for full movement of the humeral head. While stretching, swimmers should beware of over stretching the front of the shoulder which can often occur with poor stretching techniques.

Scapular stability is essential as an unstable scapula will change movement patterns and place excessive demand on the rotator cuff muscles. Much of the exercise ball exercises listed help to address this scapular stability. It is important to be able to recruit the scapular stabilizers independent of the upper fibres of trapezius.

Rotator cuff strengthening can include isometrics in different positions, isotonic exercises and should include  a strong eccentric component given that this is very important in overhead sports. Resistance can be achieved through the use of bands or weights while lying prone or supine on the exercise ball.

Preventative exercise can be an important addition to a training program if done correctly. These exercises with the exercise ball may not be appropriate as treatment for swimmers who have a preexisting injury. Those swimmers should be evaluated by a physical therapist before they begin a rehabilitation program or swim workout which may or may not include exercise ball exercises depending on the nature of the injury. With the "new" freestyle techniques that emphasize body rotation and balance, scapular stabilization, appropriate stretching, and core strengthening become even more important for injury-free swimming and, ultimately more effective technique.

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