Many triathletes struggle with the swim, the first part of their multi-discipline event. Lucy Fry looks at common aches and pains suffered by triathletes, and how to overcome them

Most triathletes say that swimming is their least favourite of the three disciplines, the one that challenges them the most. Firstly, learning good technique requires diligence and patience and, secondly, many triathlons involve an open water swim which can be tough on body and mind.

Despite the fact that it has a relatively low injury rate, research from the British Journal of Sports Medicine suggests the majority of injuries in triathlon come from overuse during running and focus on the lower limbs. However, swimming can cause pain and niggles in the lower back, knee and shoulder, particularly where technique is poor. Here are some of the main issues and tips to get stronger and faster.

Swimmer’s lower back

Lower back issues in swimming are more common in butterfly and breaststroke than front crawl. ‘The high arching position created in butterfly can cause issues and is usually the result of athletes not rotating properly in the water and arching up through the back when taking a breath,’ says Miles Busoni, a chiropractor at ActiveBacks ( Mobilising the lower and thoracic spine when out of the pool is important here, as you can’t rotate more if you’re locked up in that area.

Back issues in breaststroke occur also because of an overextension of the lower back. Busoni suggests, ‘Keep the head positioned down in the water during breaststroke (this limits back extension) and also practise with a pull buoy in-between the legs to help keep the legs high in the water and reduce the arch in the back.’

Swimmer’s knee

Swimmer’s knee is the most common lower limb injury in swimming, especially in triathletes who spend long hours training (on the bike and running) with knees bent and hips flexed. These areas can become chronically tight. Knee pain occurs most typically in swimmers who do breaststroke, due to that point in the stroke at which the leg lashes out to the side, the outstroke. ‘It’s an unusual angle for the hip and knee to maintain,’ says Busoni. ‘Make sure to warm up and stretch the hips and leg muscles before training sessions involving a lot of breaststroke and consider including more than one stroke during each session to avoid overuse injuries.’

Swimmer’s shoulder

Shoulder pain from front crawl and butterfly is by far the most common problem for swimmers and associated with over-training and the repetitive nature of swimming. ‘The shoulder is a very shallow ball-and-socket joint (the glenohumeral joint) that’s made more stable by, amongst other things, the muscles of the shoulder, including the rotator cuff,’ says Busoni. ‘Training your rotator cuff with specific strengthening exercises can be extremely beneficial in reducing potential shoulder injury.’

Why is the shoulder at risk with the front crawl?

One of the main causes of shoulder pain or problems is shoulder impingement. ‘Poor technique or tight and overactive internal rotator cuff muscles will need to be addressed and monitored, regardless of your experience or ability in the pool.’ says Busoni. ‘Unlike any other joint in the body, the shoulder joint’s range is vast and, unfortunately, all of this joint range of motion comes at a price – stability is compromised and, therefore, the importance of having a shoulder that’s both strong and mobile is important if you’re to avoid injury.’

What if it hurts?

If you are in pain in any of these areas after swimming (or in general after training), it’s likely that you’re inflamed. Inflamed muscle tissues or joints are often due either to imbalances in the muscles themselves or poor joint control. Sitting in the same position for long periods of time or doing the same repeated movements a lot can cause certain areas to tighten excessively whilst also becoming weak – a bad combination.

‘These parts can become chronically irritated and sensitised,’ explains Busoni, ‘leading to a build-up of scar tissue which results in tight, weak muscles that need to be treated by a professional.’ If in doubt, seek advice from a chiropractor, osteopath or physiotherapist to address and remove residual scar tissue and promote healing. Look for specialists in Active Release Techniques (ART) and Graston technique, two extremely effective treatments to help release sticky muscle tissues.