Training while addressing an Injury

Continue Swim Training During an Injury

When I consult with club teams or individuals I am continually surprised to see how many injured swimmers are not training! Now, I know this opposes the view of many physicians and rehabilitation specialist, who suggest rest and medication during any injury, but even during an injury, it is essential and possible to train!
For example, let us discuss someone with a shoulder injury. Let’s say a swimmer has should pain and they are diagnosed with impingement. We've discussed ad nauseum about the presence of structural abnormalities in asymptomatic athletes (See  Radiologic Imaging and the Asymptomatic Athletic Shoulder and  Abnormal MRIs in Tennis Players), but let us pretend the athlete actually has an acute shoulder impingement. 

For optimization of swimming, the athlete cannot miss anytime from the water. Now, this doesn't suggest doing heavy volume or even using the injured arm, but getting in the water and swimming without pain is often possible. Pretend the athlete has shoulder pain with the easiest of strokes. Then, it is key to have the athlete kick in a position (likely on their back in streamline or with their arms at their side) to allow continued in water improvements. Many dismiss this form of training, but the arm - leg cross transfer can help an athlete maintain their physical work capacity during an injury. Numerous studies suggest training only the arms (via an arm crank) or solely the legs (leg cycling) will improve performance in both the arms and legs (Lewis 1980; Pogliaghi 2006; Bhambani 1991; Loftin 1988; Tordi 2001; Roesler 1985; Magel 1978).
Issurin (2013) notes the following benefits of arm – leg cross transfer:

  1. Training with either arms or legs produces a transferred cross effect on the untrained limbs—on average 32 % of the gain recorded in the trained limbs (i.e., specific effect) with a wide range of variation from 5.7 to 93 %; these large variations reflect the high variability of training groups in the different studies, which included young athletic subjects or middle-aged and elderly persons.
  2. The specific effect producing by arm training is usually much more pronounced as compared with leg training; this can reflect a substantially lower initial training status of arm—compared to leg—muscles. This is especially characteristic of relatively low trained subjects (Pogliaghi 2006).
Another training method during an injury is mental imagery. Many dismiss mental imagery, but mental imagery is thought to activate similar cortical regions as actually performing the task. This doesn't suggest mental imagery can train a swimmer to the Olympics, but it can be an adjust to rehabilitative training. Moreover, dynamic mental imagery appears to result in greater athletic performance (Guillot 2013). 
Practical Implications
If you injury your knee or your shoulder, continue training without pain! Find a way to continue swimming without aggravating the injured body part and you can still have success and enjoyment in the sport throughout the rehabilitation process. Whether you are kicking during a shoulder injury or performing dynamic mental imagery, no swimmer should sit on the side, as improvements are always possible!
  1. Lewis S, Thompson P, Areskog NH, et al. Transfer effect of endurance training to exercise with untrained limbs. Eur J ApplPhysiol. 1980;44:25–34.98.
  2. Pogliaghi S, Terziotti P, Cevese A, et al. Adaptations to endurance training in the healthy elderly: arm cranking versu sleg cycling. Eur J Appl Physiol. 2006;97:723–31.99.
  3. Issurin VB.Training Transfer: Scientific Background and Insights for Practical Application. Sports Med. 2013 Apr 30. [Epub ahead of print]
  4. Bhambani YN, Eriksson P, Gomes PS. Transfer effects of endurance training with the arms and legs. Med Sci SportsExerc. 1991;23:1035–41.100.
  5. Loftin B, Boileau A, Massey BJ, et al. Effect of arm training on central and peripheral circulatory function. Med Sci SportsExerc. 1988;20:136–41.101.
  6. Tordi N, Belli A, Mougin F, et al. Specific and transfer effects induced by arm and leg training. Int J Sports Med. 2001;22:517–24.102.
  7. Roesler K, Hoppeler H, Conley KE, et al. Transfer effect in endurance exercise: adaptations in trained and untrained muscles.Eur J Appl Physiol. 1985;1985(54):355–62.103.
  8. Magel JR, Mcardel WD, Michael T, et al. Metabolic and cardiovascula radjustment to arm training. J Appl Physiol. 1978;45:75–9.
  9. Guillot A, Moschberger K, Collet C. Coupling movement with imagery as a new perspective for motor imagery practice. Behav Brain Funct. 2013 Feb 20;9:8. doi: 10.1186/1744-9081-9-8
By Dr.  G. John Mullen received his Doctorate in Physical Therapy from the University of Southern California and a Bachelor of Science of Health from Purdue University. He is the founder of Mullen Physical Therapy, the Center of Optimal Restoration, head strength coach at Santa Clara Swim Club, creator of the Swimmer's Shoulder System, and chief editor of the Swimming Science Research Review.