Search

Background There are 2.8 million youth competitive swimmers in the United States (US), and shoulder pain is the most common complaint among swimmers. Purpose To determine prevalence of shoulder pain, disability, and dissatisfaction in youth competitive swimmers. A secondary purpose was to determine influence of age, competitive swimming experience, and previous history of shoulder pain or injury on shoulder pain, disability, and dissatisfaction, and finally to determine if sex, geographic area, and participation in a second sport relate to shoulder pain, disability, and dissatisfaction. Study Design Multi-site cross-sectional design Methods Six-hundred and seventy-one swimmers aged 9--17 years from six states in the US completed surveys which included demographics, the Penn Shoulder Score (PSS), and the Disability of Arm Shoulder Hand (DASH) Sports. Independent t-tests were used to compare pain, disability, dissatisfaction, the influence of age, sex, participation in second sport, geographic region, and history of shoulder pain. Linear regression analyses were performed to determine the interaction of these variables with reported pain and disability. Results Forty-nine percent of swimmers had shoulder symptoms. Greater shoulder pain and disability were reported in 15 to 17-year-olds compared to 9 to 10-year-olds (pain and disability: p<0.001), in swimmers with greater versus less years of experience (pain and disability: p<0.001), and in swimmers from eastern versus western states (pain: p=0.001, disability: p=0.0014). Swimmers not participating in a second sport had higher shoulder dissatisfaction (p=0.002). History of prior shoulder pain/traumatic injury was the best indicator of increased pain, disability, and dissatisfaction (p<0.001). Conclusion Almost half of swimmers surveyed had shoulder pain, with a higher prevalence found in older age groups, those with greater experience, and in those with prior shoulder pain or traumatic injury. Further research should investigate shoulder pain prevention programs, and surveillance methods are recommended to identify symptomatic swimmers who may benefit from referral to prevent further pain and disability. Level of Evidence III [ABSTRACT FROM AUTHOR]

Background: Glenohumeral impingement is one of the common clinical conditions among the overhead athletes. Elite swimmers develop impingement at the glenohumeral joint due to overuse injuries. This type of impingement is due to lack of muscle strength, demanding training session and altered flexibility. Muscle energy technique and positional release therapy are two different manual therapy interventions that may improve joint range and glenohumeral function. Aim: The aim of the study is to compare the effectiveness of positional release therapy and muscle energy technique on glenohumeral impingement among the elite swimmers. Methods: The study included about 40 elite swimmers in which group A (n=20) received positional release therapy with strengthening exercise and group B (n=20) received muscle energy technique with strengthening exercise. The intervention was given for the duration of 4 weeks and the outcome measures used were numerical pain rating scale, range of motion of the glenohumeral joint and the shoulder pain and disability index. Results: The results of the present study were analyzed using Mann Whitney U test and Wilcoxon signed rank test. The pre and post-test values were taken. The results from analysis shows both groups shows statistically significant improvement but group A show highly significant improvement in reducing pain, improving range of motion and shoulder functional ability comparing to group B, 'p' value < 0.05 Conclusion: The study concluded that positional release therapy was effective clinically and statistically shows significant improvement in reducing pain, improving Glenohumeral range of motion and shoulder function. [ABSTRACT FROM AUTHOR]

Background: Anconeus compartment syndrome is a rarely reported compartment syndrome in the anconeus muscle compartment of the forearm. It has anatomic and pathophysiological associations with posterolateral rotatory instability (PLRI) of the elbow. Purpose: To present the history, management, and outcomes of 4 patients with anconeus compartment syndrome. Secondary aims were to (1) establish normative anconeus pressures and (2) measure the volume of this compartment with and without PLRI in cadavers. Study Design: Case series; Level of evidence, 4. Methods: Four patients with clinical signs of anconeus compartment syndrome (2 gymnasts, 1 swimmer, and 1 footballer/weightlifter) were identified over a 3-year period (2015-2017 inclusive). Patient history, sporting activity, physical examination, anconeus compartment pressures, and treatment outcomes were recorded. Manometry of the anconeus compartment in 2 healthy male controls was performed to establish normative compartment pressures. Anconeus volumetric anatomy and the effect of creating PLRI on compartment volume was investigated in 4 cadaveric elbows. Results: All 4 patients had microtraumatic PLRI, and 2 patients had anconeus hypertrophy. Anconeus compartment pressures at rest and at 2-minutes postexercise were median 28.0 and 67.5 mm Hg, respectively, in the patients and mean 16.5 and 18 mm Hg, respectively, in the controls. Simultaneous fasciotomy and PLRI reconstructive procedures were performed in 2 patients, with outcomes showing full return to competition. Fasciotomy alone was performed in 2 patients to allow return to competition, with both requiring later reconstruction to address PLRI. Cadaver dissection revealed that the anconeus compartment was extremely small and that creation of PLRI reduced the direct volume of the compartment and increased the distance between the anconeus origin and insertion. Conclusion: Our case series demonstrated that anconeus compartment syndrome can occur in upper limb-dominant athletes in the presence of PLRI and anconeus hypertrophy. Pain is relieved by fasciotomy, but definitive treatment of the underlying instability prevents further symptomatology. [ABSTRACT FROM AUTHOR]

Context: The definition of an "overuse injury" had some ambiguity until recent publications . It is unknown whether the improved definition of "overuse injury" has been applied to epidemiology studies that examine high school-aged athletes. This population may be predisposed to overuse injuries due to several factors. Clinical Question : Is there more consistency in how the term "overuse injury" is being used, and has the rate of overuse injuries in high school-aged athletes epidemiology studies changed since Roos and Marshall's 2014 systematic review on overuse injury definitions? Clinical Bottom Line: Since Roos and Marshall's systematic review. more studies are recognizing "overuse injuries as needing a specific mechanism of injury: however, several studies failed to differentiate "overuse injuries" from "noncontact injuries." The rate of overuse injuries does not appear to have changed significantly. [ABSTRACT FROM AUTHOR]

The article tells about the Model Aquatic Health Code (MAHC) as a tool and resource for implementation at the local level. An overview of the MAHC Network at the National Association of County and City Health Officials (NACCHO) is provided. It informs about the reference guides published by the NACCHO on the safe operation of splash pads and floatation tanks. It also cites the journey of the Pueblo Department of Public Health and Environment in Southeast Colorado in adopting the MAHC.

BACKGROUND Swimming is enjoyed by athletes of all ages, and shoulder pain is a common problem. Clinicians identify impairments which impact shoulder pain and these impairments may differ depending on the swimmer's age competition level. PURPOSE The purpose of this study was to investigate objective measures utilized to assess swimmers and assess the relationship of test values to shoulder pain in distinct age groups/competition levels. A secondary aim was to report normative/expected values for these tests. DESIGN Systematic review METHODS PRISMA methodology was employed to assess studies evaluating clinical tests and measures associated with shoulder pain for swimmers in varied age competition levels. The Methodological Index for Non-Randomized Studies instrument was used to evaluate the quality of the included studies, and a qualitative synthesis of findings was conducted to determine the strength of the evidence in four age competition levels for nine objective measures. Distinct cut points for proposed measures were identified. RESULTS Twenty-seven studies were included in the analysis and the majority were of moderate quality in adolescent/adult swimmers. Youth swimmers had limited evidence for the development of shoulder pain associated with scapular position/dyskinesia, weakness of periscapular muscles, low endurance of core muscles, and moderate evidence for shoulder pain associated with laxity and altered range of motion (ROM). Adolescent/ adult swimmers demonstrated limited evidence for a positive association between developing shoulder pain if there is a low eccentric ER:concentric IR ratio, and moderate evidence for pectoralis minor tightness and glenohumeral laxity. There were limited studies regarding masters swimmers to derive conclusive evidence. Cut points were identified from the included studies but these have not been validated in other studies. CONCLUSION Swimmers of various ages may have different objective clinical tests and measures associated with the risk for developing shoulder pain. More studies are needed to fully understand risk factors for shoulder pain in the masters swim competition level, and to validate recommended cut points for various tests and measures. Key level of evidence 3, Systematic review of mostly Level 3 studies [ABSTRACT FROM AUTHOR]

Swimming analysts aid coaches and athletes in the decision-making by providing evidence-based recommendations. The aim of this narrative review was to report the best practices of swimming analysts that have been supporting high-performance athletes. It also aims to share how swimming analysts can translate applied research into practice. The role of the swimming analyst, as part of a holistic team supporting high-performance athletes, has been expanding and is needed to be distinguished from the job scope of a swimming researcher. As testing can be time-consuming, analysts must decide what to test and when to conduct the evaluation sessions. Swimming analysts engage in the modelling and forecast of the performance, that in short- and mid-term can help set races target-times, and in the long-term provide insights on talent and career development. Races can be analysed by manual, semi-automatic or fully automatic video analysis with single or multi-cameras set-ups. The qualitative and quantitative analyses of the swim strokes, start, turns, and finish are also part of the analyst job scope and associated with race performance goals. Land-based training is another task that can be assigned to analysts and aims to enhance the performance, prevent musculoskeletal injuries and monitor its risk factors. [ABSTRACT FROM AUTHOR]

Aim: To synthesize and assess the literature for shoulder pain and injury risk factors in competitive swimmers. Design: Systematic review with best‐evidence synthesis. Data Sources: CINHAL, SportDiscus, Scorpus, PubMed, and Embase databases from 1966 to April 30 2022. Search and Inclusion: Cohort, cross‐sectional, and case–control studies investigating shoulder pain or injury risk factors in competitive swimmers were included. Quality of eligible studies were assessed using a modified Newcastle–Ottawa scale. Risk factors were divided into four categories: modifiable‐intrinsic, modifiable‐extrinsic, non‐modifiable, and other/secondary. Results: Of 1356 studies identified, 24 full texts were evaluated for methodological quality, 22 met the criteria and were included in best evidence synthesis. There was no strong evidence supporting or refuting the association between 80 assessed variables and shoulder injury or pain. The swimmers' competitive level (nondirectional), and shoulder muscle recruitment profiles (e.g., increased activity of serratus anterior) exhibited moderate evidence supporting an association. Conversely, internal and external range of motion, middle finger back scratch test, training frequency, specialty stroke, height/weight, sex, and age all had moderate evidence opposing an association. Limited evidence was found for 58 variables, and conflicting for 8. The highest quality study (n = 201) suggested high acute‐to‐chronic workload ratio and reduced posterior shoulder strength endurance are associated with injury. Conclusions: Due to the paucity of high‐quality studies, future prospective studies are needed to reevaluate known risk factor associations over exploring additional potential risk factors. Swimming practitioners should be aware of the nondirectional association of a swimmer's competitive level and pain, as squad changes could impact injury incidence. Moreover, swimmers experiencing shoulder pain may show increased activity in shoulder stabilizers during specific movements. Importantly, shoulder strength‐endurance may be the most clinically relevant modifiable intrinsic risk factor. [ABSTRACT FROM AUTHOR]

Elbow pain (EP) in overhead sports is a common phenomenon. Swimming is classified as an overhead sport, but a lack of attention regarding EP in swimming has created a gap in the knowledge around elite freestyle swimming in Tianjin, China. The purpose of this study was to identify the distribution and prevalence of EP among elite freestyle swimmers in Tianjin, China. The methodology involved a total of 311 qualified participants who volunteered to undertake all measurements. The main findings showed that 183 of the elite freestyle swimmers in this study had EP (accounting for 58.84% of the total 311 participants), with 147 in slight pain and 36 in critical pain. The characteristics of a heavier body weight, taller height, longer left/right forearm length, and longer weekly average training hours serve as contributing factors to the occurrence of EP issues. Gender, age, weekly average training hours, and left/right forearm length are the primary factors correlating with and influencing the assessment scores. In conclusion, swimmers with longer weekly training hours, older ages, heavier bodyweight, and longer forearm lengths should receive greater attention in relation to EP. Regular assessments at a high frequency serve as a means to identify the risk of EP. [ABSTRACT FROM AUTHOR]

Objective: Using data from a longitudinal national sports injury surveillance program, this study aimed to calculate injury rates and describe injury patterns across high school swimmers and divers. Design: Descriptive Epidemiological Study. Athletic trainers (ATs) from participating high schools reported injuries from swimming and diving programs for the High School Reporting Information Online system. Setting: Convenience sample of high school boys and girls' swimming and diving injuries during the 2008 to 2019 school years. Patients or other Participants: High school boy and girl swimmers and divers (aged ∼14-18 years). Independent Variables: Exposure data on gender, location of injury (practice vs competition), mechanism of injury, and sport (swimming vs diving). Main Outcome Measures: Injury rates, rate ratios (RRs) with 95% confidence intervals, and other descriptive statistics were performed. Results: 563 swimming and diving injuries occurred during 2 171 260 athlete exposures (0.26 per 1000 athlete exposures). Girls had higher injury rates than boys overall (RR 1.57, P < 0.05), in practice (RR 1.53, P < 0.05), and competition (RR 1.81, P < 0.05). In swimmers, most injuries were to the shoulder (48.6%), associated with the freestyle (67.3%), and classified as overuse/chronic (58.0%). Among divers, most injuries were to the head/face (36.6%) and from contact with the playing surface (68.3%). Conclusions: Girls had statistically significantly higher injury rates than boys. The shoulder and head/face were the most injured body parts in swimmers and divers, respectively. Swimming injuries were most frequently of an overuse etiology, whereas diving injuries were more likely traumatic. Coaches and ATs should be aware of these findings to develop targeted strategies for injury prevention. [ABSTRACT FROM AUTHOR]

Objective: Artistic swimming is a highly challenging discipline, requiring physical skills and creativity. There are almost no published data on trauma. We aimed to assess the incidence and the nature of injuries in artistic swimmers. Design: An 11-year retrospective single-center cohort study. Setting: Department of Sport Medicine of a University Hospital. Patients: One hundred and twenty-four elite female artistic swimmers aged 12.9 ± 1.6 years. Interventions: The cohort was divided into 3 groups according to the competition categories (from 9 to 12 years old called "future", 12-15 years old called "youth", 15-19 years old called "junior"). Main Outcome Measures: Injury rate per season and per athlete was assessed. Results: The injury rate was 0.95 injuries/season/athlete and 1.05 injuries/1000 hours of practice. The most frequent injuries were rotator cuff tendinopathy (13.6%), acute low back pain (13.6%), and patellofemoral syndrome (11.9%). Swimmers in the youth and junior categories had significantly more injuries than those in the future category (P = 0.009), possibly because of more training hours (P < 0.001). Twelve major injuries occurred, all in the same group of youth swimmers. Conclusion: This is the first study investigating trauma during artistic swimming practice. A better knowledge of the main injuries is necessary for the physician to provide optimal care for athletes and to develop prevention. Attention should be particularly paid to the swimmers' shoulders and knees. [ABSTRACT FROM AUTHOR]

Introduction: Despite progress in the field of water safety, Poland has been experiencing much higher mortality due to drowning than in other countries of the EU region. The main aim of the paper is to examine the changes in drowning frequency and their causes. Material and methods: All available sources of data on drowning in Poland were analysed. Crude and age-standardized mortality rates due to drowning were calculated. A jointpoint regression model was employed in the analysis of long-term trends in annual mortality rates. Results: In total, 7350 persons died due to various types of drowning (ICD-10 codes: W65-W74, V90, V92, X37-X39, X71, Y21) in Poland in the years 2013-2021. The most frequent type of registered drowning was a drowning in natural waters - 3990 (54.3% of registered cases). The second cause of death due to drowning were falls into the water - 914 (12.4% of cases). Age-standardized death rates of males due to drowning in the years 2013-2021 dropped from 4.3 to 2.7 per 100,000. Among females the age-standardized rate decreased from 0.8 to 0.6 per 100,000. The annual percentage change of mortality (APC) in Poland was -4.0%. The downward trend of mortality was only significant among males (APC = -4.4% vs. APC = -2.6% among females). Mortality reduction was especially high among the youngest age groups: 0-14 years old (APC = -7.9%) and 15-29 years old (APC = -6.5%). Conclusions: There is a need to properly address drowning prevention tailored to groups with risk factors in Poland such as males, elderly people, and people with low socio-economic status. [ABSTRACT FROM AUTHOR]

Injuries are inevitable during swimming. The main goal of athletes especially competitive ones and coaches is to do the most mechanically effective movement patterns. In this case, biomechanical assessments could be beneficial in the management and prevention of injuries and pain in swimmers' vulnerable joints. As the upper limb in swimming causes the highest propulsive force, the arm is exposed to more injuries. A skeletal model with 5 degrees of freedom is developed to simulate the swimmer's arm during front crawl swimming. This model includes shoulder and elbow joints with all of their degrees of freedom. An adaptive integral sliding mode (AITSM) controller is employed to track the desired joint trajectories during swimming. This controller can converge the tracking errors to zero in finite time. For tuning the controller gains regardless of the upper bounds of the system uncertainties, an adaptive controller is applied. The results demonstrate the performance of the AITSM strategy in tracking the desired trajectory of an underwater arm model during swimming. During the down sweep to catch phase, arm movements cause more stress in the shoulder than the elbow. The applied moment at the shoulder is almost triple of the elbow's moment. Therefore, the most vulnerable joint is the shoulder. By considering shoulder strength, the injury risk is predicted about 10% for the considered swimmer. Highlights The human upper limb during front crawl swimming is simulated. A 5-DOF skeletal model is considered to simulate the arm. An adaptive integral sliding mode (AITSM) controller is employed to track the desired trajectory. The results show that the controller has the proper performance to track the desired motion. The most vulnerable joint is the shoulder and higher moments are induced at this joint. [ABSTRACT FROM AUTHOR]

Introduction: Swimming is a sport that often involves various injuries, which can cause pain that can last for a lifetime. The aim of the study was to assess the impact of past injuries on basic movement patterns in amateur swimmers. Material and methods: Sixty amateur swimmers (32 women and 28 men) completed the Functional Movement Screen (FMS) test and a questionnaire on past injuries. The mean age of the respondents was 37 years (SD = 12.7), body weight 72 kg (SD = 13.7) and body height 175 cm (SD = 10). All subjects were adults, practicing amateur swimming for at least two hours a week. Any participant with injuries that had occurred in the previous four weeks was excluded from the study. Results: Among the respondents, 62% reported suffering injury: 78% being a traumatic injury, 35% an overload injury and 14% both types. The FMS test indicated an increased risk of injury in 20% of respondents, based on a result lower than or equal to 14 points. The mean score in the FMS test was 16 points. Additionally, 5% reported pain in the lumbar spine in the trunk stability push-up test. All other tests were passed by all study participants. No significant difference in global FMS score was found between injured and non-injured swimmers. Conclusions: The FMS score obtained by amateur swimmers does not appear to be influenced by previously experienced injuries. Most of the respondents had suffered injuries in their lives, and these were mainly traumatic injuries. [ABSTRACT FROM AUTHOR]

Shoulder pain is pervasive in swimmers of all ages. However, given the limited number of prospective studies, injury risk factors in swimmers remain uncertain. To determine the extent to which the risk factors of previous injury, poor movement competency, erroneous freestyle swimming technique, and low perceived susceptibility to sport injury were associated with noncontact musculoskeletal injury in collegiate swimmers. Prospective cohort study. College natatorium. Thirty-seven National College Athletic Association Division III swimmers (21 females, 16 males; median age = 19 years [interquartile range = 3 years], height = 175 ± 10 cm; mass = 70.0 ± 10.9 kg). Participants completed preseason questionnaires on their previous injuries and perceived susceptibility to sport injury. At the beginning of the season, they completed the Movement System Screening Tool and the Freestyle Swimming Technique Assessment. Logistic regression was used to calculate odds ratios (ORs) with 95% CIs for the association between each risk factor and injury. Eleven of the 37 participants (29.7%) sustained an injury. Univariate analyses identified 2 risk factors: previous injury (OR = 8.89 [95% CI = 1.78, 44.48]) and crossover hand positions during the freestyle entry phase (OR = 8.50 [95% CI = 1.50, 48.05]). After adjusting for previous injury, we found that a higher perceived percentage chance of injury (1 item from the Perceived Susceptibility to Sport Injury) decreased the injury odds (adjusted OR = 0.11 [95% CI = 0.02, 0.82]). Poor movement competency was not associated with injury (P >.05). Previous injury, a crossover hand-entry position in freestyle, and a low perceived percentage chance of injury were associated with increased injury odds. Ascertaining injury histories and assessing for crossover positions may help identify swimmers with an elevated injury risk and inform injury-prevention strategies. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate maximum voluntary contraction through surface electromyography in stabilizer shoulder muscles, as well as the clinical evaluation of shoulder injury in the pre, post, and detraining stages of specific training in child swimmers. Twelve competitive swimmers volunteered for this study. Anthropometric measurements, clinical examination, electromyography (with Delsys® data acquisition system), and pain intensity levels were performed. Clinical examination and EMG data were compared using repeatedmeasures ANOVA with Bonferroni correction pre, post, and after detraining. The intervention program lasted for 12 weeks. The pain group presented higher pain intensity values compared to the post-intervention program. Most of the tests presented lower values at the detraining compared to the baseline. After the intervention, pain levels significantly decreased in five tests. Muscle strengthening work is highly recommended because it improves the swimmer's shoulder performance, reducing injuries and decreasing pain intensity after 12 weeks of intervention. [ABSTRACT FROM AUTHOR]

Background: Drowning is a leading cause of unintentional injury-related death for toddlers within the USA. Keeping toddlers within arm's reach while swimming is recommended, yet many caregivers do not. Possibly, caregivers' attitudes are shaped by their expectations about whether they could quickly save a child. The aims of this study are to 1) explore caregivers' views of arm's reach pool supervision in various scenarios and 2) understand whether perceptions of arm's reach pool supervision are impacted by the caregiver's self-reported capability to swim the length of a standard pool. Results: Caregivers generally showed agreement with arm's reach pool supervision; however, arm's reach supervision was viewed as less necessary when a toddler was in shallow water, wearing a flotation device, or with an older child or teen. There was a significant effect of caregiver swimming capability on perceptions of arm's reach pool supervision, with non-swimmers and the strongest swimmers showing more positive perceptions of arm's reach pool supervision than caregivers reporting poor swimming capability. Female caregivers showed significantly more agreement with arm's reach pool supervision compared with male caregivers. Grandparents and parents showed significantly more agreement with arm's reach pool supervision than siblings. Conclusions: Caregivers' views about what constitutes appropriate supervision are impacted by gender, the relationship to the toddler, and the caregiver's swimming capability. Findings suggest that a caregiver's ability to offer close supervision or respond in an emergency may influence their attitudes about what constitutes appropriate supervision. Caregivers may view arm's reach pool supervision as less necessary when additional layers of protection are in place. [ABSTRACT FROM AUTHOR]

There is a lack of quantitative assessments of athletes' functional strength and dynamic balance following labrum repairs. To compare the upper extremity strength and dynamic balance among pre-injury baseline and approximately 3 and 4 months after labrum surgeries in collegiate athletes to identify critical values to inform rehabilitation. Fifteen male and one female collegiate athletes between 18 and 22 years old were tested at pre-injury baseline (n = 14) and 2.7 (n = 16) and 3.8 months (n = 12) after labrum surgeries. Strength was assessed using the peak forces produced in a maximal push-up test. Dynamic balance was assessed using the reaching distances in a reaching test. The injured side's peak forces significantly decreased from the baseline to the 3-month post-surgery and then significantly increased between the 3-month and 4-month post-surgery assessments but remained significantly less at the 4-month post-surgery compared to the baseline (p ≤ 0.024; Cohen's dz ≥ 0.75). Peak force asymmetries were greater at the 3-month and 4-month post-surgery assessments than the baseline (p ≤ 0.005; Cohen's dz ≥ 1.02). With a relatively small sample size, the results support the use of objective functional assessments for rehabilitation and return-to-play decisions among collegiate athletes following labrum repairs. [ABSTRACT FROM AUTHOR]

Background: Shoulder problems are common in swimmers. Previous research has focused on elite swimmers. Our research questions were: 1) what is the prevalence of shoulder problems among Ontario age group swimmers and 2) how does prevalence relate to age, sex and years of experience? Methods: A cross sectional survey was administered to youth swimmers from two Ontario clubs. Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC) was used to assess four-week prevalence of shoulder problems. Prevalence (%) with 95% confidence intervals (95% CI) was constructed and prevalence across age, sex and years of experience was investigated using cross-tabulations and chi-square tests. Results: There were 83 surveys completed (response rate 50%). The 4-week prevalence of shoulder pain was 35% (95% CI 25%, 45%). Shoulder problems were not significantly related to age, sex or years of experience. Conclusion: These results can inform future studies on injury prevention and risk mitigation strategies in swimmers. [ABSTRACT FROM AUTHOR]

Context: Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers., Evidence Acquisition: From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms "swimming," "low back" or "lumbar," and "injury" or "injuries.", Study Design: Narrative review., Level of Evidence: Levels 4 and 5., Results: The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments., Conclusion: Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention., Strength of Recommendations: B. Recommendation based on limited quality or inconsistent patient-oriented evidence., Competing Interests: The authors report no potential conflicts of interest in the development and publication of this article.

Our purpose in this study was to examine the effects of using goggles and snorkel during a learn-to-swim program on the aquatic skills of young non-swimmers with fear of water. 40 children volunteered to participate in the study and were randomly divided into two groups: one that used goggles and snorkel (GS) and one that did not (NGS). After four weeks (five sessions per week) of learn-to-swim interventions, both groups improved aquatic skills, but improvements in water entry, back gliding, and prone swimming were greater for the GS than for the NGS group. In contrast, the intervention effect on a blowing bubbles skill was smaller for the GS than for the NGS group. Thus, the use of goggles appears to be more beneficial in a learn to swim program for young swimmers with a fear of water than not using goggles for all lessons other than blowing bubbles. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Objective: The shoulder is the most common injury in swimming, followed by the knee and spine. The repetitive nature of swimming training may predispose a swimmer to injury. Several risk factors have been previously identified, but the level of evidence and level of certainty that these risk factors predispose a swimmer to injury risk has yet to be evaluated critically in a systematic review. Design: Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data Sources: Data were obtained through PubMed, Cochrane, and Google Scholar. The database search was limited to articles that were published between January 1980 and December 2019. Eligibility Criteria for Selecting Studies: Level I, II, and III studies were included in this review. All studies must have been conducted in swimmers or swimming, a description of the specific pathology and provide at least one identified risk factor with an association (P < 0.05). Results: A total of 19 critically appraised articles identified 28 potential risk factors for musculoskeletal injuries in swimmers. The risk factors were grouped by the anatomical region: neck and back, pelvis and hip, and the knee. Only 2 risk factors were appraised at a moderate level of certainty, both occurring in the knee. The remaining 26 identified risk factors were appraised at a low level of certainty. There is a clear lack of research surrounding nonshoulder injuries in swimmers. [ABSTRACT FROM AUTHOR]

Antigravity treadmilk are being used in rehabilitation programs but have not been used consistently with posthip labral repair arthroscopy surgeries. The purpose of this study was to review the posthip labral protocol used by eight National Collegiate Athletic Association Division I collegiate athletes Call ages 18-21) from multiple sports that used the antigravity treadmill as a bridge between "no running" and 'on-ground running." The authors found that athletes who did this returned to play between 4.5 and 7 months. had a better overall functional status. and had no re-injuries. This is the first known study of its kind available in the literature. [ABSTRACT FROM AUTHOR]

Background Para swimming has experienced increased participation in recent years. Injury and injury prevention research on Para swimmers is lacking compared to swimmers without impairment. Purpose This study aimed to gather data in Para swimmers on typical injuries, injury prevention programs, and attitudes toward injury and injury prevention in this population. Study Design Cross-sectional, mixed-methods design evaluating injuries, injury management, and injury prevention in elite Para swimmers in United States (U.S.). Methods Para swimmers on the U.S. Paralympics Swimming National teams at multiple competition levels were invited to complete an online survey. Qualitative interviews with six U.S. Paralympics National team Para swimmers were conducted to provide detail on athlete experiences with injury and prevention. Results Twenty-one of 56 surveys were returned: 11 of 21 participants (52.4%) reported experiencing an injury that altered their weekly training. All (21/21) reported participating in strength training and 19 of 21 (90.5%) reported incorporating stretching into their training regimen, although strengthening/stretching regimens included routines that may not have been specifically targeted toward injury prevention. Six of 21 (28.6%) reported participation in an injury prevention program. Qualitative interview themes included the impact of swimmers' compensated body mechanics on injury risk, the value of individualized injury prevention programs, and the importance of knowledgeable coaching and rehabilitation staff. Conclusions Injury prevention programs are important components in Para swimming training although they are underutilized based on responses in this study. These programs should be individualized to address swimming biomechanics and athlete-specific impairments. Increasing coaching knowledge and access to individualized programs may reduce injury prevalence among this at-risk population. [ABSTRACT FROM AUTHOR]

Objectives: To identify evidence-practice gaps regarding shoulder injury risk factors in competitive swimmers., Methods: We gathered insights from 27 swimming experts including elite swimmers, coaches, high-performance staff and applied researchers using Concept Mapping. Participants brainstormed, sorted and rated (from 1 (least) to 10 (most) important and modifiable) their ideas of shoulder injury risk factors in competitive swimmers. Proposed risk factors rated above the grand mean for importance (6.2±0.4) or modifiability (6.5±0.5) ratings were considered highly important/modifiable. Expert opinions were then juxtaposed with systematic review findings to identify overlaps or convergences., Results: Brainstorming generated 126 proposed shoulder injury risk factors for competitive swimmers, subsequently refined to 61 unique proposed risk factors by removing duplicates and combining similar responses. The participants sorted the 61 risk factors into seven distinct clusters. Experts perceived 36/61 proposed risk factors as highly important, of which 6 were supported by literature, 6 showed no association with injury, 2 had conflicting evidence and the remaining 22 have not yet been investigated, suggesting an evidence-practice gap. Three proposed risk factors 'inconsistent training load', 'poor stroke technique' and 'low posterior shoulder strength-endurance' exhibited high perceived importance, high perceived modifiability and supporting evidence., Conclusion: An evidence-practice gap was identified for 28 proposed risk factors perceived as highly important by swimming experts despite either (1) no relevant empirical research (n=22), or (2) no association with injury (n=6) from synthesised evidence. Greater collaboration between researchers and practitioners is needed to effectively address shoulder injury risk factors in competitive swimmers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events., Competing Interests: Disclosure The authors have no commercial or financial conflicts of interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Aim: The aim of this study is to study the frequency of sudden death in sports from the year 2004–2020 in the city of Kashan, Iran. Materials and Methods: This case series research included fatal sports injuries from the years 2004 to year 2020. Anecdotal data were collected by interviewing different sports organizations and close relatives of the victims. Result: The result of descriptive analysis of collected data showed that 17 cases of sudden sports death occurred during the years 2004 until 2020. The highest frequency of the cases occurred in mountain claiming with 9 (52.9%), followed by swimming with 3 (17.6%), and handball with 2 (11.8%), horse riding 1 (5.9%), basketball 1 (5.9%), and martial arts 1 (5.9%). All the analysis was performed using the SPSS: pc version 21. Conclusion: Fatal sports injuries are rare; however, they occur incidentally due to poor knowledge and education of the sport participants. It was concluded that nearly all fatal incidents were preventable. [ABSTRACT FROM AUTHOR]

Collegiate- and elite-level swimmers can see extraordinary volumes in training throughout a season. Consequentially, injury and dysfunction in the shoulder are common in competitive swimmers. This study investigated whether preseason Kerlan-Jobe Orthopedic Clinic Questionnaire scores could identify collegiate swimmers who sustained a shoulder injury during an athletic season. A Kerlan-Jobe Orthopedic Clinic Questionnaire score of ≥81 was able to identify swimmers who did not sustain an injury versus those who did. The receiver operating characteristics demonstrated an area under the curve of 0.820, p <.004. A Kerlan-Jobe Orthopedic Clinic Questionnaire score of 81 had a sensitivity of 1.00 and specificity of 0.333. The current findings suggest that selective preseason patient-reported outcome measures could be utilized as a preparticipation screening tool to investigate athlete readiness to compete. [ABSTRACT FROM AUTHOR]

Context: Youth- through masters-level competitive swimmers incur significant shoulder pain. Risk factors associated with shoulder pain include high swimming yardage, a lack of cross-training, decreased shoulder strength and reduced core endurance, and limited posterior shoulder and pectoral length. Since training, swimming exposure, and physical-performance measures have all been associated with shoulder pain, the methods used to train swimmers may influence the development of shoulder pain, yet studies delineating training methods are lacking. Objectives: To identify in-water and dry-land practices among youth- through masters-level swimmers in the United States (US) and describe the potential effects of training practices on swimmers' shoulders. Design: A Web-based survey was developed to identify common training practices in 5 areas: quantification of swimming and dry-land training and in-water techniques such as kicking drills, upper-body stretching, shoulder and core strengthening, and cross-training. Participants: 156 swim-team coaches or captains of youth, high school, and college swim teams and 196 masters swimmers participated (N = 352). There was geographic representation from across the US. Results: Responses indicated diverse training practices. However, most respondents used kicking drills, which may provoke shoulder pain due to prolonged poor positioning. High yardage swum by high school and college teams increases their risk of shoulder tendinopathy. Stretching and strengthening exercises and dosages commonly used were inconsistent with current research recommendations and lacked specificity in terms of addressing typical mobility restrictions and muscle weaknesses described in the swimming literature. Core strengthening and cross-training are frequently performed. Conclusions: Several areas of in-water and dry-land practice were identified that may put swimmers' shoulders at risk for injury. Further research regarding the safety and efficacy of training programs is recommended to determine optimal methods of injury prevention and performance enhancement. [ABSTRACT FROM AUTHOR]

Introduction. Swimmer’s shoulder syndrome (SSS) is the most common overuse injury affecting swimmers and surfers. Core stability is crucial to prevent SSS. The study investigated the effect of isokinetic core strength of trunk flexors and extensors and core endurance on shoulder stability in adolescent swimmers with SSS. Methods. The study involved 30 swimmers, assigned to 2 equal groups. The experimental group (A) suffered from SSS; the control group (B) included healthy swimmers with no history of shoulder pain or instability. The mean values of age, body mass, and height were 12.86 ± 1.59 years, 41.73 ± 3.99 kg, and 142.0 ± 3.96 cm, respectively, in group A and 13.2 ± 1.56 years, 42.66 ± 3.9 kg, and 142.26 ± 4.39 cm, respectively, in group B. Isokinetic peak torque (PT) for trunk flexors and extensors was measured with a Biodex isokinetic dynamometer. Four functional tests assessed core endurance: side bridge endurance test, static back endurance test, ball bridge test, and unilateral bridge test. Results. There was a statistically significant between-group difference in mean PT of trunk extension at both angular velocities: 60°/s, 180°/s. No significant differences were detected in mean PT of trunk flexion. All functional core stability tests revealed a greater endurance time in group B. Conclusions. Weak core inhibits shoulder muscles, which is a major risk factor for shoulder instability and SSS. It is crucial to incorporate core stability training into the rehabilitation plan to provide proximal stability for obtaining safe and proper distal mobility across the shoulder joint. [ABSTRACT FROM AUTHOR]

The number of women's swimming and diving teams sponsored by the National Collegiate Athletic Association has increased over the last 5 years. Routine examinations of women's swimming and diving injuries are important for identifying emerging temporal patterns. Exposure and injury data collected in the National Collegiate Athletic Association Injury Surveillance Program during the 2014–2015 through 2018–2019 athletic seasons were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. The overall injury rate was 1.78 per 1000 athlete-exposures in swimmers and 2.49 per 1000 AEs in divers. Shoulder (33.0%) injuries accounted for the largest proportion of all swimming injuries; most injuries were classified as overuse (51.3%). Head or face (29.4%) and trunk (20.2%) injuries accounted for the largest proportions of all diving injuries. Findings indicated that shoulder and trunk injuries, as well as injuries resulting from overuse mechanisms, warrant further attention in swimming. Given the low in the National Collegiate Athletic Association Injury Surveillance Program observed across the study period, the need for greater participation in sports injury surveillance is also apparent. [ABSTRACT FROM AUTHOR]

The National Collegiate Athletic Association (NCAA) has sponsored men's swimming and diving since 1937. Routine examinations of men's swimming and diving injuries are important for identifying emerging injury-related patterns. Exposure and injury data collected in the NCAA Injury Surveillance Program during the 2014–2015 through 2018–2019 academic years were analyzed. Injury counts, rates, and proportions were used to describe injury characteristics, and injury rate ratios were used to examine differences in injury rates. The overall injury rate was 1.56 per 1000 athlete-exposures (AEs) for swimmers and 1.52 per 1000 AEs for divers. Shoulder (27.0%) injuries accounted for the largest proportion of all swimming injuries, and most injuries were attributed to overuse mechanisms (42.6%). Shoulder (23.3%) and trunk (23.3%) injuries accounted for the largest proportion of all diving injuries, and most injuries resulted from surface contact (32.6%). Findings were consistent with existing literature on swimming and diving. The need for continued surveillance, coupled with more robust participation by swimming and diving programs was also highlighted. [ABSTRACT FROM AUTHOR]

The majority of research on competitive swim start safety has focused on the maximum head depth (MHD) attained during execution of the start and the head velocity at that depth. But when assessing start safety as a means of stratifying risk, the horizontal distance from the start wall at MHD (DIST) must be considered as well. USA Swimming and the Fédération Internationale de Natation (FINA) require that minimum water depth for executing competitive starts be maintained for distances of 5 and 6 m from the wall, respectively. The purpose of the present analysis was to evaluate if these distances are appropriate. To do so, we reexamined data from studies that reported DIST for competitive swimmers executing starts. We found that 16.5% and 2.9% of the 715 starts had DIST in excess of 5 and 6 m, respectively. Since MHDs during starts have been observed at distances exceeding the mandated distance at which minimum water depth is to be maintained, swim start rules must be revised such that minimum depth is measured at a greater distance from the wall. [ABSTRACT FROM AUTHOR]

Abstract: Swimming is one of the most popular sports in the world with open-water swimming (OWS) gaining more and more prominence since being featured in the Federation Internationale De Natation World Aquatics Championships in 1992 and the Olympic Games in 2000. The aim of this review is to analyze the existing literature on heat injury in OWS. Relevant literature was located via computer-generated citations during November of 2020 through online computer searches of multiple major databases. Athletes participating in OWS are exposed to environmental conditions that place them at risk for unique medical conditions such as heat injury. Clinicians providing care for OWS athletes should be educated and trained to recognize these conditions and minimize risks to optimize athlete safety. This article identifies medical challenges related to heat injury in OWS while investigating water temperature recommendations, physiological effects of hyperthermia, risk mitigation strategies, and treatment measures. [ABSTRACT FROM AUTHOR]

Artistic swimmers (AS) are exposed to repeated apnoeas in the aquatic environment during high intensity exercise provoking specific physiological responses to training, apnoea, and immersion. This study aimed to evaluate the changes in lung diffusing capacity in AS pre-, mid- and post-training in a combined session of apnoeic swimming, figures and choreography. Eleven elite female AS from the Spanish national team were the study's participants. The single-breath method was used to measure lung diffusing capacity for carbon monoxide (DLCO) and one-way repeated measures ANOVA was utilized to evaluate the statistical analysis. Basal values of DLCO were higher than normal for their age and height (33.6±4.9 mL·min−1 ·mmHg−1 ; 139±19%) and there were a significant interaction between DLCO and AS training (ŋ2p =0.547). After the apnoeic swimming (mid-training) there was an increase in DLCO from basal to 36.7±7.3 mL·min−1 ·mmHg−1 (p=0.021), and after the figures and choreography (post-training) there was a decrease compared to mid-training (32.3±4.6 mL·min−1 ·mmHg−1 , p=0.013). Lung diffusing capacity changes occur during AS training, including a large increase after apnoeic swimming. There were no differences in lung diffusing capacity from pre- to post-training, although large inter-individual variability was observed. [ABSTRACT FROM AUTHOR]

Background: Knowledge of predictors for shoulder pain in swimmers can assist professionals working with the athlete in developing optimal prevention strategies. However, study methodology and limited available data have constrained a comprehensive understanding of which factors cause shoulder pain. Purpose: To investigate risk factors and develop and internally validate a multivariable prognostic model for the prediction of shoulder pain in swimmers. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 201 pain-free club- to international-level competitive swimmers were followed for 2 consecutive seasons. The cohort consisted of 96 male (mean ± SD age, 13.9 ± 2.2 years) and 105 female (13.9 ± 2.2 years) swimmers. Demographic, sport-specific, and musculoskeletal characteristics were assessed every 6 months. Swim-training exposure was observed prospectively. Shoulder pain interfering with training was the primary outcome. Multiple imputation was used to cope with missing data. The final model was estimated using multivariable logistic regression. We applied bootstrapping to internally validate the model and correct for overoptimism. Results: A total of 42 new cases of shoulder pain were recorded during the study. Average duration of follow-up was 1.1 years. Predictors included in the final model were acute:chronic workload ratio (odds ratio [OR], 4.31; 95% CI, 1.00-18.54), competitive level (OR, 0.19; 95% CI, 0.06-0.63), shoulder flexion range of motion, posterior shoulder muscle endurance (OR, 0.96; 95% CI, 0.92-0.99), and hand entry position error (OR, 0.37; 95% CI, 0.16-0.91). After internal validation, this model maintained good calibration and discriminative power (area under the receiver operating characteristic curve, 0.71; 95% CI, 0.60-0.94). Conclusion: Our model consists of parameters that are readily measurable in a swimming setting, allowing the identification of swimmers at risk for shoulder pain. Multivariable logistic regression showed the strongest predictors for shoulder pain were regional competitive swimming level, acute:chronic workload ratio, posterior shoulder muscle endurance, and hand entry error. [ABSTRACT FROM AUTHOR]

Objective: To contrast unintentional fatal drowning in rivers with lakes to determine appropriateness for application of existing river drowning prevention strategies. Design: A total population retrospective cross‐sectional analysis using coronial data. Setting: Australia, 1 July 2013 to 30 June 2018. Participants: Children and adults (n = 342) who died from unintentional drowning in a river or lake. Main outcome measures: Incidence, crude fatality rates, relative risk (95% confidence interval) and chi‐square tests of independence for risk factors for unintentional fatal drowning. Subset analysis of land management for lake drowning locations. Results: Four‐fifths (82%) occurred in rivers. Lake drowning was more likely among 0‐ to 17‐year‐olds, Aboriginal and Torres Strait Islander people and when swimming or using watercraft. River drowning most commonly occurred following a fall into water and with alcohol involvement. Drowning risk in very remote areas was elevated for both lakes (relative risk = 18.34; 95% confidence interval: 1.61‐209.44) and rivers (relative risk = 15.89; 95% confidence interval: 5.56‐45.37) compared to major cities. Those responsible for land and water management at lakes were primarily local government (59%), water authorities (32%) and parks and wildlife authorities (7%). Conclusions: In contrast to a focus on adults and alcohol in existing river drowning prevention strategies, lake interventions must target children, Aboriginal and Torres Strait Islander peoples and recreational lake users. Fatal drowning rates are high for remote rivers and lakes, necessitating focused effort. There are opportunities to embed drowning prevention strategies within land and water management plans. Lake drowning prevention requires broader engagement with land and water managers and Aboriginal and Torres Strait Islander peoples. [ABSTRACT FROM AUTHOR]

Background: This preliminary report describes our experience using unmanned aerial vehicles (UAVs) to identify swimmers in distress at the 2018 Mont-Tremblant IRONMAN triathlon (Quebec, Canada). Methods: In a prospective pilot study, we sought to determine whether UAV surveillance could identify swimmers showing signs of distress quicker than conventional methods (i.e., lifeguards on the ground and on watercraft). In addition, we investigated the feasibility of using UAVs for medical surveillance at a triathlon event in terms of operations, costs, safety, legal parameters, and added value. Prior to the race, we screened participants for medical conditions that could elevate their risk of injury during the swim portion of the triathlon. Athletes deemed to be at increased risk were given a yellow swimming cap to enhance their surveillance by trained observers watching a live video feed from the UAVs. Results: On race day, a total of 3 UAVs (2 mobile, 1 tethered) were launched over Lake Tremblant and provided 3 observers with live video of the swimmers. Of the 2,473 race participants, there were 25 athletes with pre-identified medical conditions who wore a yellow cap during the swim. We did not detect any signs of distress among swimmers wearing yellow caps. Among the remaining 2,448 athletes, there were 5 swimmers who demonstrated signs of distress and required mobilization of water rescue boats; UAV surveillance identified 1 of these 5 distress events before it was seen by lifeguards on rescue boats. None of the athletes in the IRONMAN suffered an adverse event while swimming. Several technical and safety issues related to UAV surveillance arose including poor visibility, equipment loss, and flight autonomy. Conclusion: While our preliminary findings suggest that using UAVs to identify distressed swimmers during an IRONMAN race is feasible and safe, more research is necessary to determine how to optimize UAV surveillance at mass sporting events and integrate this technology within the existing emergency response teams. [ABSTRACT FROM AUTHOR]

The purpose of this study was to gain comprehensive understanding of athletes' social support experiences during the injury process, with a focus on social support networks, exchanges, and appraisals (Bianco & Eklund, 2001). Twelve university swimmers who recently experienced swimming-related injuries engaged in a semistructured interview. Findings indicate athletes had mixed experiences with their networks of social support (i.e., coaches, medical practitioners, parents, and teammates), with themes regarding exchanges and appraisals emerging in three categories: (a) Don't bring your negative energy to practice, (b) Show me you care, and (c) Provide me with some clear and appropriate direction! Participants reported coaches and teammates being in denial of their injuries, shunning them from the team, or pushing them to train through their injuries, resulting in athletes feeling uncared for, unsupported, and lacking direction. Athletes' sense of support stemmed from feeling cared for. Findings underscore the importance of comprehensively examining the multiple constructs of social support, while serving as a springboard for further investigations and important practical implications. [ABSTRACT FROM AUTHOR]

The article investigates the influence of head depth, speed, and distance associated to safety in backstroke starts. It examines whether these variables are a function of age or not. It finds out that older swimmers are more vulnerable to injury when performing backstroke starts in shallow water than their younger counterparts. It concludes that backstroke start's maximum head depth is not different than the other competitive strokes among the older swimmers.

From the perspective of swimmer safety, there have been no quantitative 3-dimensional studies of the underwater phase of racing starts during competition. To do so, 471 starts were filmed during a meet with a starting depth of 1.22 m and block height of 0.76 m. Starts were stratified according to age (8 & U, 9-10, 11-12, 13-14, and 15 & O) and stroke during the first lap (freestyle, breaststroke, and butterfly). Dependent measures were maximum head depth, head speed at maximum head depth, and distance from the wall at maximum head depth. For all three variables, there were significant main effects for age, F(4, 456) = 12.53, p < .001, F(4, 456) = 27.46, p < .001, and F(4, 456) = 54.71, p < .001, respectively, and stroke, F(2, 456) = 16.91, p < .001, F(2, 456) = 8.45, p < .001, and F(2, 456) = 18.15, p < .001, respectively. The older swimmers performed starts that were deeper and faster than the younger swimmers and as a result, the older swimmers may be at a greater risk for injury when performing starts in this pool depth. [ABSTRACT FROM AUTHOR]

Objective: To characterise the prevalence, incidence rate (IR) and burden of injuries in elite short-course triathletes over a 4-year training and competition period., Methods: Fifty elite Australian triathletes were prospectively monitored for injury during four consecutive seasons (2018-2021). Injuries requiring medical attention were prospectively recorded and further subcategorised according to time loss. The IR and burden (injury IR×mean injury severity) were calculated per 365 athlete days, with sex differences in IR compared using IR ratios (IRR) from negative binomial regression models., Results: Two hundred and sixty-six injuries were reported in 46 (92.0%) athletes, of which 67.3% resulted in time loss. The injury IR was 1.87 injuries per 365 athlete days (95% CI 1.70 to 2.80), and comparable between sexes (IRR 0.82, 95% CI 0.64 to 1.04, p=0.109). Most injuries (70.7%) were training related. The most frequently injured body sites were the ankle (15.8%), foot (12.4%) and lower leg (12.0%). Bone stress injuries (BSIs) were the most burdensome injury type with 31.38 days of time loss per 365 days (95% CI 24.42 to 38.34). Twenty athletes (40.0%) reported at least one bone stress injury (BSI) (range 0-3). The rate of BSIs in female athletes was three times greater compared with male athletes (IRR 2.99, 95% CI 1.26 to 7.07, p=0.013)., Conclusion: Two-thirds of injuries reported in elite short-course triathletes resulted in time loss, with the majority occurring during training activities. Foot, ankle and other lower leg injuries had the highest incidence, with BSIs carrying the highest injury burden. The considerably higher rate of BSI observed in female athletes warrants consideration for future prevention strategies in female triathletes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: To assess the prevalence of shoulder injuries and ultrasound findings in elite Portuguese swimmers and their association with symptoms and personal or training-related factors., Methods: This cross-sectional study was conducted at the Portuguese Open and Youth Swimming National Championships between 27 and 30th July 2022. Each athlete entered details regarding personal and training history into a questionnaire and underwent a physical and ultrasound shoulder examination., Results: A total of 102 swimmers out of 662 Portuguese athletes were included in the study. Shoulder pain experienced during the previous season was reported by 42% of the athletes. A high prevalence of shoulder structural abnormalities was noted, specifically supraspinatus tendinosis (91%), tears (29%), and subacromial bursitis (29%). Specific training for injury prevention was associated with higher rates of infraspinatus tendinosis ( p  = 0.047), and supraspinatus tears were linked to greater swimming distances per week ( p  < 0.001) and practice ( p  < 0.001), more years of practice ( p  = 0.018), shoulder pain at the time of evaluation ( p  = 0.023), a higher number of missed competitions ( p  = 0.041), and shoulder injections ( p  = 0.009). Subacromial bursitis was associated with shoulder pain at the time of evaluation ( p  = 0.002) and during the previous season ( p  < 0.001), missed competitions ( p  < 0.001), and requirement for physical therapy ( p  = 0.006)., Conclusions: A high prevalence of shoulder morphological changes was found in surveyed swimmers and there were several associations with training load, regardless of individual characteristics of each athlete. It is essential to understand the true impact of current injury prevention programs and to develop effective measures to protect swimmers' health.

Background: Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies. This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes., Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting health problems (injury and illness) in triathletes (all sexes, ages, and experience levels) training and/or competing in short-course distances were included. Six electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, APA PsychINFO, Web of Science Core Collection, and SPORTDiscus) were searched. Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale. Two authors independently completed data extraction., Results: The search yielded 7998 studies, with 42 studies eligible for inclusion. Twenty-three studies investigated injuries, 24 studies investigated illnesses, and 5 studies investigated both injuries and illnesses. The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures, and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days. Injury and illness prevalence ranged between 2%-15% and 6%-84%, respectively. Most injuries reported occurred during running (45%-92%), and the most frequently reported illnesses affected the gastrointestinal (7%-70%), cardiovascular (14%-59%), and respiratory systems (5%-60%)., Conclusion: The most frequently reported health problems in short-course triathletes were: overuse and lower limb injuries associated with running; gastrointestinal illnesses and altered cardiac function, primarily attributable to environmental factors; and respiratory illness mostly caused by infection., (Copyright © 2023. Production and hosting by Elsevier B.V.)

Introduction: Water-related recreational activities, including swimming and diving, are widespread. However, they carry a significant risk of craniofacial injuries. Despite the popularity of these activities, comprehensive data on injuries beyond drowning remain scant. This study addresses this gap by providing valuable epidemiological insight into the nature, prevalence, and demographic patterns of craniofacial injuries related to water sports activities., Methods: The authors queried the NEISS database for craniofacial injuries related to swimming, diving, and water sports from 2013 to 2022. Data were analyzed for demographics, anatomic locations of injuries, and the activities leading to these injuries., Results: Between 2013 and 2022, a total of 952,111 craniofacial injuries were associated with swimming and water sports. Of these, 510,706 (53.6%) were male patients, and 441,405 (46.4%) were female. This indicates that males were 1.16 times more likely to sustain such injuries. The age groups most affected were 0 to 9 and 10 to 19 years. Anatomic locations impacted were as follows: ears (58.1%), head (16.8%), face (13.9%), neck (4.8%), eyeballs (4.4%), and mouth (2%). Leading causes were identified as swimming and water sports activities (66.5%), swimming pools and equipment (28.2%), diving or diving boards (4.7%), and scuba diving (0.5%). Notably, 89.2% of patients with diving-related injuries and 99.1% with swimming-related injuries were not admitted to the hospital., Conclusions: This study offers critical epidemiological data to supplement targeted prevention strategies and resource allocation in managing craniofacial injuries associated with water activities. The findings highlight the urgent need for specialized care and serve as a foundation for future preventive initiatives., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Consistent prescriptions for event-specific training of swimmers are lacking, which points to likely differences in training practices and a potential gap between practice and scientific knowledge. This study aimed to analyze the distance-specific training load of elite swimmers, derive a consistent training sessions' description and reflect on the current recommendations for training and recovery. The individual training regimes of 18 elite British swimmers were documented by surveying four swim and two strength and conditioning (S&C) coaches. The annual and weekly training load and content were compared between swimmers competing in sprint, middle and long-distance events. Thematic analysis of the surveys was conducted to identify key codes and general dimensions and to define a unified classification of the swimming and S&C training sessions. Weekly training loads and content of the swim (η² - effect size; p = 0.016, η² = 0.423) and S&C (p = 0.028, η² = 0.38) sessions significantly differed between the groups. Long-distance swimmers swam significantly longer distances (mean ± SD; 58.1 ± 10.2 km vs. 43.2 ± 5.3 km; p = 0.018) weekly but completed similar number of S&C sessions compared to sprinters. The annual swimming load distribution of middle-distance specialists did not differ from that of long-distance swimmers but consisted of more S&C sessions per week (4.7 ± 0.5 vs. 2.3 ± 2.3; p = 0.04). Sprinters and middle-distance swimmers swam similar distances per week and completed similar number of S&C sessions but with different proportional content. Whereas all coaches reported monitoring fatigue, only 51% indicated implementing individualized recovery protocols. We propose a consistent terminology for the description of training sessions in elite swimming to facilitate good practice exchanges. While the training prescription of elite British swimmers conforms to the scientific training principles, recommendations for recovery protocols to reduce the risk of injury and overtraining are warranted. [ABSTRACT FROM AUTHOR]

Several studies report that psychological factors, especially stress, are related to sports injuries, and while stress management techniques have often been found to facilitate sport performance, these reports have not included information about the effects of stress intervention on injury rates. This article reexamines two sport psychology programs by investigating the injury data collected by athletic training personnel before, during, and after two university varsity teams practiced progressive relaxation during team workouts. Major findings include a 52% reduction in injuries for swimmers and a 33% reduction in serious injuries for football players. Discussion focuses on methods of injury data collection by sport psychologists, questions about the nature of the stress/injury relationship, and possible interventions. [ABSTRACT FROM AUTHOR]