Swimming and the Spine

Abstract

Swimming is a popular recreational and competitive sport for young athletes, ranking 8 and 10 for female and male youth sport participation in the USA. There are four main stroke types (freestyle, backstroke, butterfly, and breaststroke) and three kick types (flutter, whip, and dolphin) that create the swimming motion. Each stroke and kick has specific technical factors that can predispose an athlete to injury, with the spine being a vulnerable anatomic area for swimmers. Training in breaststroke and butterfly accounts for most of the spinal injuries seen in youth swimmers. The majority of spinal injuries in swimmers are overuse injuries and result from repetitive stress during practices rather than from acute trauma during swimming competitions. The adolescent swimmer is at particular risk due to rapid growth and maturation of the skeleton along with drastic increases in training volumes and introduction of new swimming techniques. A knowledge of swimming technique errors, intrinsic risk factors in each swimmer, and vulnerable spinal anatomic sites will assist in the assessment and management of the young swimmer with spinal problems.