The term "swimmer's shoulder" refers to the tendonitis of the biceps tendons. As the least stable joint, the
schoulder is the most vulnerable to injury in the overhead position. To keep up with the
continuous repeated demands made by swimming, the muscles of the rotator cuff may be required
to work excessively. With the cuff fatigue that results from this work, superior
migration of the humeral head may occur which in turn may be a factor that triggers the onset
of tendonitis. Treatment includes increase in both warm-up and warm-down times, particular
attention to prepracticed stretching, icing, correcton of external rotation weakness, decrease in work load
and temporary elimination of painful strokes. It is important that practice strokes be pain free.
Patellofemoral syndrome is an abnormal alignment of the extremity. The more severe syndromes
occur in club swimmers maybe due to improper execution of the kick. However, those with
inherent instability of the patellofemoral articulations may be precluded by reaching superior
levels of breaststroke swimming by the forces generated by the web kick. Communication among coach,
swimmer and physician is essential. Knee pain is more often easily controlled that shoulder pain
experienced by swimmers. A stretching program for the lower extremity must be taught as well as kept up.
Arm action in the breaststroke undergoes prevent change. This stress may cause a variety of low back problems including stress fractures or a mechanical low back pain from posterior irritation. These back complaints can also occur with the butterfly stroke where inefficient and improper mechanics are often the case. If low back pain is mechanical, hamstring stretching and abdominal strengthening playing are part of ongoing treatment. Prolong treatment includes nerve stimulation or repeated immobilizations to the effectvie area may be required in more resistant cases.