Swimming Injuries in Competitive and Leisure populations

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April 14, 2026

Swimming Injuries in Competitive and Leisure populations

Swimming is an excellent low-impact way to build cardiovascular fitness, strength and mobility. Alongside these benefits, swimming carries a meaningful risk of overuse injury due to highly repetitive movements, high training volumes and technical demands – particularly at the shoulder, knee and lower back12_15. Most swimming injuries develop gradually rather than from a single traumatic event, and early management is key to avoiding long-term problems.1_3 

This article summarises what to expect as a swimmer, and how your injury can be addressed to keep you in the pool.

INJURY PREVALENCE 

Shoulder pain is the most common swimming injury, reported in 30–70% of competitive swimmers.1_5 Leisure swimmers experience lower but still significant rates of shoulder, knee, neck and lower-back pain.3,14 Most swimming injuries are overuse-related which helps explain the risk factors below.2 

RISK FACTORS 

  • Rapid increases in training load2,6 
  • Poor stroke mechanics3,9 
  • Shoulder strength imbalance7,8 
  • Previous injury2,4 
  • Kinetic chain dysfunction 

WHAT IS SWIMMER’S SHOULDER?

The term ‘Swimmer’s Shoulder’ dates back to at least 1978 and was initially described as a ‘common painful syndrome of repetitive shoulder impingement in swimmers.18,19 The pathophysiology appears to differ between patients but frequently involves the rotator cuff soft tissue to some degree. This includes their tendons are susceptible to going into a ‘state of disrepair’ as described by the tendinopathy continuum, leading to pain.21

WHY SEE A SWIMMING SPECIALIST AT RICHMOND PHYSIOTHERAPY? 

  1. Injury prevention 
  2. Injury rehabilitation 

For injury prevention, there are assessment methods to help identify injury risk patterns in swimmers.16 For an injured individual, physiotherapy focuses on movement assessment, progressive strengthening, stroke modification, and load management to reduce pain and prevent recurrence.3,7,9 Work by Struyf’s team at the University of Antwerp, has helped to identify exact musculoskeletal dysfunctions that can be assessed and targeted within a physiotherapist’s approach to rehabilitating the injury.20

As a former Olympic Trials swimmer and current coach at Wandsworth Swimming Club which was recently voted best club in the London region (Swim England), Tim Robinson combines clinical physiotherapy expertise with real-world coaching insight to keep swimmers training safely while addressing the root cause of pain. 

FOR PARENTS OF JUNIOR COMPETITIVE SWIMMERS 

Early pain should not be ignored. Junior swimmers often train through symptoms, increasing long-term injury risk. Evidence supports early assessment, technique correction and load management over prolonged rest alone.2,6 

WHEN TO REFER? 

• Shoulder pain not improving after 1 week 

• Performance drop linked to pain 

• Recurrent injuries each season 

• Injury prevention screening (pre-injury) 

Early referral reduces time lost and chronic injury risk. 

References 

  1. Sein, M.L., Walton, J., Linklater, J., Harris, C., Dugal, T., Appleyard, R. and Kirkbride, B. (2010) ‘Shoulder pain in elite swimmers: primarily due to swim-volume–induced supraspinatus tendinopathy’, British Journal of Sports Medicine, 44(2), pp. 105–113. 
  2. Tate, A., Turner, G.N., Knab, S.E., Jorgensen, C., Strittmatter, A. and Michener, L.A. (2012) ‘Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers’, Journal of Athletic Training, 47(2), pp. 149–158. 
  3. Walker, H., Gabbe, B., Wajswelner, H., Blanch, P. and Bennell, K. (2012) ‘Shoulder pain in swimmers: a systematic review’, Physical Therapy in Sport, 13(2), pp. 67–75. 
  4. McMaster, W.C. and Troup, J.P. (1993) ‘A survey of interfering shoulder pain in United States competitive swimmers’, The American Journal of Sports Medicine, 21(1), pp. 67–70. 
  5. Bak, K. and Faunø, P. (1997) ‘Clinical findings in competitive swimmers with shoulder pain’, The American Journal of Sports Medicine, 25(2), pp. 254–260. 
  6. Hibberd, E.E. and Myers, J.B. (2013) ‘Practice habits and attitudes and behaviors concerning shoulder pain in competitive swimmers’, Clinical Journal of Sport Medicine, 23(6), pp. 450–455. 
  7. Kennedy, J., Huynh, L., Wong, T., Kemp, S. and Cordy, J. (2019) ‘Scapular dyskinesis, shoulder strength and swimming-related shoulder pain’, Journal of Science and Medicine in Sport, 22(7), pp. 798–803. 
  8. McLaine, S.J., Ginn, K.A. and Bird, M.L. (2016) ‘Scapular and shoulder muscle activation patterns in swimmers with and without shoulder pain’, Journal of Electromyography and Kinesiology, 27, pp. 78–85. 
  9. Heinlein, S.A. and Cosgarea, A.J. (2010) ‘Biomechanical considerations in the competitive swimmer’s shoulder’, Sports Health, 2(6), pp. 519–525. 
  10. Rodeo, S.A. (1999) ‘Swimming injuries: prevention and treatment’, Clinics in Sports Medicine, 18(2), pp. 379–394. 
  11. Wanivenhaus, F., Fox, A.J., Chaudhury, S. and Rodeo, S.A. (2012) ‘Epidemiology of injuries and prevention strategies in competitive swimmers’, Sports Health, 4(3), pp. 246–251. 
  12. Jürimäe J, Haljaste K, Cicchella A, Lätt E, Purge P, Leppik A, Jürimäe T. (2007). Analysis of swimming performance from physical, physiological, and biomechanical parameters in young swimmers. Pediatr Exerc Sci. 2007;19(1):70‐81. doi:10.1123/pes.19.1.70 7.  
  13. Troup JP. The physiology and biomechanics of competitive swimming. Clinics in Sports Medicine. 1999;18(2):267-285. doi:10.1016/s0278-5919(05)70143-5. 
  14. Trinidad, A., González‐Garcia, H. and López‐Valenciano, A., 2021. An updated review of the epidemiology of swimming injuries. PM&R, 13(9), pp.1005-1020. 
  15. Schlueter, K.R., Pintar, J.A., Wayman, K.J., Hartel, L.J. and Briggs, M.S., 2021. Clinical evaluation techniques for injury risk assessment in elite swimmers: A systematic review. Sports health, 13(1), pp.57-64. 
  16. Fernández-Galván, L.M., Alcain Sein, J., López-Nuevo, C., Sánchez-Sierra, A., Ladrián-Maestro, A. and Sánchez-Infante, J., 2025. Injury Patterns and Frequency in Swimming: A Systematic Review. Applied Sciences, 15(3), p.1643. 
  17. Arrillaga, B., Pérez-Bellmunt, A., García, I., Rodríguez-Adalia, L., Möller, I. and Miguel-Pérez, M., 2025, January. Swimmer’s shoulder: ultrasound anatomical description of shoulder tendons in elite swimmers and water polo players. In Healthcare (Vol. 13, No. 2, p. 151). MDPI. 
  18. Kennedy, J.C., Hawkins, R. and Krissoff, W.B., 1978. Orthopaedic manifestations of swimming. The American journal of sports medicine, 6(6), pp.309-322. 
  19. Pollard, H. and Croker, D., 1999. Shoulder pain in elite swimmers. Australasian chiropractic & osteopathy, 8(3), p.91. 
  20. Struyf, F., Tate, A., Kuppens, K., Feijen, S. and Michener, L.A., 2017. Musculoskeletal dysfunctions associated with swimmers’ shoulder. British journal of sports medicine, 51(10), pp.775-780. 

Lewis, J.S., 2010. Rotator cuff tendinopathy: a model for the continuum of pathology and related management. British journal of sports medicine, 44(13), pp.918-923.