The elbow is a complex joint system, so any pain or injury in the area can be difficult for a health professional to diagnose. Injuries are often due to overuse of the joint, which can be caused by swimming strokes, especially if a swimmer uses an incorrect technique or swims competitively. The type of stroke the swimmer uses most often can also impact on the risk of an elbow injury developing.
Vulnerable Regions of the Elbow
The upper arm bone, called the humerus, attaches to the radius and the ulna bones of the forearm at the elbow. Three different joint articulations allow these bones to attach together and to move relative to one another. Each joint permits a particular type of movement, such as the joint between the humerus and the radius that allows the arm to fold up and down, and also to twist. Depending on the type of stroke that a swimmer prefers, different joints may be affected by overuse to a greater or lesser extent. In addition, use of the elbow involves four different muscles, two different ligament structures and three individual nerves.
Swimming Strokes and Elbow Overuse
Freestylers or swimmers who use backstroke tend to be less likely to develop elbow problems from overuse than those who spend a lot of time swimming the breaststroke or the butterfly. The angle at which competitive swimmers, in particular, raise the elbows up high to get more power from the arm during the stroke can aggravate the elbow joints, according to Sports Injury Bulletin. Coupled with repetition, this type of elbow usage can produce overuse injuries such as lateral epicondylitis, bursitis of the elbow and triceps tendinitis.
Each joint in the body is surrounded by a protective soft portion of tissue with a fluid interior. This allows for movement of hard bones relative to softer parts of the body without producing too much wear and tear. When this protective layer, called the bursa, becomes irritated through overuse, it can produce more fluid inside and develop into bursitis. This can occur through swimming and manifest as elbow bursitis. Tennis elbow, or lateral epicondylitis, is a condition in which the tendons that attach the elbow muscles to the bones become strained; pain from the outside of the elbow shoots inward to the rest of the arm. Tennis elbow can also be due to the high angle style of breaststroke and butterfly. Inflammation of the triceps tendon, which attaches the triceps muscle in the back of the upper arm to the elbow, is also a common cause of elbow pain in swimmers.
As water has a cushioning effect, traumatic injury to the elbow is uncommon in swimmers, unless received during a dive into the water, or if the elbow comes into contact with the side of the pool during a stroke. Traumatic injury may require more invasive treatment such as surgery to repair, whereas overuse injuries generally need less extreme treatment.
Often, an overuse injury such as tennis elbow may merely require rest, ice and elevation for the pain to dissipate over time. Non-steroidal anti-inflammatory medications, or NSAIDs, may also be useful to reduce pain and swelling, but are best taken under supervision of a healthcare professional. Physiotherapy can help ease strain, and if the overuse injury is caused or exacerbated by a poor stroke technique, a swimming coach can help correct this. Some people with elbow pain may find splints or other supports useful when not in the water. Temporarily avoiding the swimming stroke that caused the injury in the first place is an important part of treatment.
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