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Swimming is a sport in which there is a great diversity among participants. There are both recreational and competitive swimmers, ranging in age from preschool through college. Most swimming-related orthopedic injuries are related to overuse and are seen in competitive athletes. However, many injuries can be prevented. Use the following tips and guidelines to help keep your athlete safe.

Safety tips

The following are ways to help prevent swimming-related sport injuries:

  • Never swim alone. Make sure the area is supervised.
  • Don’t run on pool decks and wet areas. Abrasions and contusions (bruises) commonly occur from careless falls.
  • Don’t dive in shallow water. Avoid diving into shallow pools less than 3 feet deep. This will help prevent serious head and neck injuries.
  • Find out if the starting block is at the shallow end. Swimmers using starting blocks in the shallow end need to be instructed on proper technique.
  • Prepare for emergencies. Plan what you would do if a player is injured in or out of the water. Know how deep the pool is. Know where lifeguards and first aid stations are.
  • Wear the right gear.
    • Properly fitted goggles
    • Swim caps
    • Sandals in the pool area
    • Sunscreen as necessary

Use of physical therapy

Physical therapy often is useful to strengthen weak muscles and stabilize joints. It can also improve a swimmer’s endurance and ability to train. Physical therapy is necessary to treat all of the medical and orthopedic conditions listed below and should be prescribed by a doctor.

Medical conditions

The following is a chart of different treatments for common medical conditions affecting swimmers.


Condition What to do
Swimmer's ear Use tight-fitting swim caps. If symptoms of ear pain and/or drainage develop, see a doctor. Swimmer’s ear is usually treated with cleaning, antibiotic drops, and 3 to 10 days out of the pool. Acetic acid drops may help prevent swimmer’s ear.
Pinkeye See a doctor. Symptoms may be caused by irritation from chlorine and other chemicals, but viral and/or bacterial eye infections are highly contagious. Treatment includes prescription antibiotic eyedrops and 3 to 7 days out of the pool.
Athlete's foot and plantar warts Wear sandals on pool decks and locker room floors to help prevent foot infections. See your doctor if you have a cut on your foot.

Exercise-induced asthma

Swimmers with asthma vary greatly in their symptoms. Some do better in the warm, humid environment while others do not. Some find heavily chlorinated pools make symptoms worse. If difficulty breathing, cough, chest pain/tightness, or wheezing is present during swimming, then see a doctor. Every swimmer with asthma should have a personal asthma action plan. Swimmers should always have rescue medicine, such as an albuterol inhaler, on hand in case sudden symptoms occur.
Overtraining (excessive fatigue) This is common in swimmers because of year-round swimming and training. Treatment includes medical and nutritional evaluation and rest from swimming during noncompetition seasons.


Orthopedic conditions

Overuse injuries in swimming are related to repetitive stress to the swimmer’s body. Symptoms of an overuse injury usually include pain or discomfort, muscle weakness, alterations in stroke style, and the inability to keep up intense levels of training. Multiple factors must be considered for proper treatment. Workload, defined as either yardage or pool time, may need to be decreased during a time of injury. An evaluation of stroke technique may identify weaknesses, bad habits, or muscle-tendon imbalances that require correction. Lastly, the genetic predisposition to be excessively loose jointed, flexible, or stiff may require special consideration or treatment.


Condition Description


Swimmer's shoulder Is a compression or "impingement" of the rotator cuff tendons caused by repetitive overhead shoulder arcs. Overdevelopment of chest muscles and weak back muscles with progressive muscle fatigue can lead to this injury. Treatment is individualized and must address all contributing factors. Most treatment plans include some form of physical therapy to learn correct posture and exercises to strengthen shoulder blade muscles. Although common for swimmers to do, excessive stretching of the shoulder muscles is not recommended.
Low back pain Common in swimmers and caused by repetitive Rest, medicines, and physical therapy to
turns, rotations, and extended back positions. include core (abdominal, hips, and low back)
Common causes include muscle strains, joint strengthening exercises are the usual
irritation and, in rare cases, stress fractures. treatment.
Proper diagnosis by a doctor is essential to
ensure the appropriate treatment
recommendations are made. X-rays or other
testing may be needed.
Rest, medicines, and physical therapy to turns, rotations, and extended back positions. include core (abdominal, hips, and low back) strengthening exercises are the usual treatment.
Breaststroker's knee A chronic sprain of the medial collateral ligament (MCL) on the inside of the knee related to the frog kick in breaststroke. Kneecap pain (patellofemoral pain) is also common due to other forms of kicking. Treatment is to rest from these types of kicks.
Foot and ankle injuries Occur from repetitive flutter and dolphin kicking. This places the toes and ankle in an extreme pointed position that strains the top of the foot and causes pain. Treatment is rest, ice, medicines, and strengthening exercises.


Last Updated
Care of the Young Athlete Patient Education Handouts (Copyright © 2011 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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