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3/24/20191
Ev
alu
atin
g s
wim
me
rs
for
sp
or
t rea
din
es
s:
Wh
at m
ea
su
res
are
imp
or
tan
t?K
ath
y W
ay
ma
n, P
T, D
PT
, SC
SC
o-a
uth
ors: P
inta
rJA
, B
rigg
s MS
, Sch
lue
ter
KR
Sw
imm
ing
is c
om
plic
ate
d!
M
uscu
losk
ele
tal in
jurie
s in sw
imm
ers a
re o
ften
mu
ltifacto
rial
oM
ob
ility
•Jo
int R
OM
•M
uscle
exte
nsib
ility
oS
tren
gth
/e
nd
ura
nce
oS
tatic/
dy
na
mic m
ov
em
en
t
U
niq
ue
train
ing
en
viro
nm
en
to
An
ti-grav
ityo
Wa
ter a
s a b
arrie
r•
visib
ility•
au
dito
ry
oH
igh
train
ing
vo
lum
e
Inju
rie
s in
Sw
imm
ing
In
crea
sed
inju
ry risk
in fre
esty
le
swim
me
rs ha
ve
be
en
asso
ciate
d w
ith
asy
mm
etrie
sin
:o
Up
pe
r extre
mity
(UE
) stren
gth
(Bu
tler 2
01
7; T
ate
20
12
; Ba
talh
a2
01
3)
oS
ho
uld
er ra
ng
e o
f mo
tion
(RO
M)
(Oz
cald
iran
20
02
; Su
20
04
; Th
om
as 2
00
9; W
alk
er 2
01
2)
oT
ho
racic ro
tatio
n(F
eije
n2
01
8; M
iche
li2
01
6)
oB
od
y ro
ll(P
sych
ara
kis 2
01
1; P
sych
ara
kis 2
01
0; P
ay
ton
19
99
)
In
jury
incid
en
ce in
swim
me
rs:o
Sh
ou
lde
r inju
ry
•4
1-9
1%
ou
t of 8
0 y
ou
ng
swim
me
rs (13
-
25
ye
ars o
ld) re
po
rted
ep
isod
es o
f pa
in(T
ate
20
12
; Wa
niv
en
ha
us
20
12
; Pin
k 2
00
0)
oK
ne
e in
jury
•m
ost p
rev
ale
nt in
bre
aststro
ke
swim
me
rs
(5x
mo
re lik
ely
)•
(Wa
niv
en
ha
us
20
12
; Ro
de
o 1
99
9)
oB
ack
inju
ry•
68
% o
f elite
swim
me
rs
•2
9%
of re
crea
tion
al sw
imm
ers
(Ca
pa
ci2
00
2; W
an
ive
nh
au
s2
01
2)
123
3/24/20192
Inju
ry
Sc
ree
nin
gE
va
lua
tion
Re
lev
an
t Fin
din
gs
Stre
ng
thS
ho
uld
er IR
/E
R m
uscle
imb
ala
nce
w
atch
pa
rticula
rly m
id a
nd
po
st sea
son
cha
ng
es (B
ata
lha
20
13
)
RO
M
SH
OU
LD
ER
•P
ec m
uscle
len
gth
: ≥9
.8cm
rest; ≥
11
.9cm
stretch
(Ha
rring
ton
20
14
)
•F
orw
ard
sho
uld
er p
ostu
re (H
ibb
erd
20
16
)
•S
ho
uld
er p
ain
hig
he
r with
join
t hy
pe
rmo
bility
(Oz
cald
iran
20
02
)
•S
cap
ulo
hu
me
ral
rhy
thm
≤
55
°o
f scap
rota
tion
at 1
35
°h
um
era
l ele
va
tion
(Su
20
04
)
•S
ho
uld
er E
R R
OM
≤
93
°o
r ≥1
00
°(W
alk
er 2
01
2)
•D
ecre
ase
d sh
ou
lde
r IR/
ER
AR
OM
mid
sea
son
an
d/
or in
crea
sed
scap
ula
r up
wa
rd ro
tatio
n a
t 90
°a
bd
uctio
n
(Th
om
as 2
00
9)
KN
EE
•D
ecre
ase
d h
ip IR
≤
37
°(b
ette
r if ≤4
6°) (R
ov
ere
19
85
)
•K
ick in
itiatio
n h
ip a
bd
uctio
n a
ng
le
≤3
7°
or ≤
41
°(V
izso
lyi
19
87
)
SP
INE
•H
igh
er risk
(by
2.5
x) if fe
ma
le; k
yp
ho
sis plu
mb
line
≥9
0m
m; lo
rdo
sis plu
mb
line
≥6
0m
m (Z
ain
a2
01
5)
Sta
bility
Up
pe
r Ex
trem
ityY
-Ba
lan
ce T
est (U
E Y
BT
–p
icture
be
low
)(B
utle
r 20
17
)
Tre
atm
en
t Op
tion
s
W
all a
ng
els
T
urk
ish g
et u
p
U
E ro
lling
Re
tur
n to
Sp
or
t
Ph
ase
1:
Re
intro
du
ctio
n to
wa
ter
GO
AL
-n
or
ma
lizin
g s
trok
e
me
ch
an
ics
Use
: swim
me
r ha
s be
en
rem
ov
ed
for ≥
6 w
ee
ks
•A
vo
id p
articip
atio
n in
form
alize
d p
ractice
fo
cus o
n te
chn
iqu
e
•F
ree
style
on
ly
it com
prise
s mo
re th
an
ha
lf of n
orm
al tra
inin
g v
olu
me
•R
est in
vo
lve
d b
od
y p
art:
•N
eck
, up
pe
r ex
trem
ity in
jurie
s: swim
on
ba
ck in
strea
mlin
e p
ositio
n a
nd
kick
•L
ow
ba
ck, lo
we
r ex
trem
ity in
jurie
s: use
the
pu
ll bu
oy
Ph
ase
2:
Em
ph
as
is o
n te
ch
niq
ue
res
tora
tion
Use
: swim
me
r ha
s be
en
rem
ov
ed
for <
6 w
ee
ks O
R h
as a
lrea
dy
com
ple
ted
Ph
ase
1
•R
etu
rn to
org
an
ized
swim
pra
ctice w
ith te
am
•Y
ard
ag
e a
nd
pa
cing
restrictio
ns o
utlin
ed
by
PT
/co
ach
for sa
fe p
rog
ressio
n
Ph
ase
3:
Mu
ltiple
pra
ctic
es
in 1
da
y
GO
AL
–g
rad
ua
lre
tur
n to
sp
or
t (RT
S)
Use
: Re
turn
to S
po
rt–
hig
hv
olu
me
•F
ollo
w p
ractice
gu
ide
line
s no
rma
lly d
urin
g first p
ractice
of d
ay
•R
estrict 2
nd
pra
ctice o
f day
to fo
llow
the
gu
ide
line
s ou
tline
d in
Ph
ase
2
•D
urin
g 2
nd
pra
ctice, a
llow
for re
lativ
e re
st of in
vo
lve
d b
od
y p
art:
•N
eck
, up
pe
r ex
trem
ity in
jurie
s: no
pu
ll bu
oy
or p
ad
dle
use
•L
ow
ba
ck, lo
we
r ex
trem
ity in
jurie
s: no
use
of k
ickb
oa
rd o
r fins
WK
1
456
Slid
e 6
WK
1
Waym
an
, Kath
erin
e, 3
/21/2
019
3/24/20193
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tr2
01
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66
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63
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7.
7
