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Peter asked...

My elbow aches when I swim.

I am a keen swimmer and swim around 4-5 times a week for around half an hour to an hour. I have found that after around 20 lengths my left elbow aches (a dull ache, not a sharp pain). I have never injured my elbow. I have had physio but it doesn’t seem to have helped. Can you recommend a course of action/a physio in London who specialises in swimming injuries?

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The answer

It is not uncommon for swimmers to develop elbow pain particularly those who do high volumes of training. The elbow is particularly prone to two overuse type injuries called tennis elbow (lateral epicondylitis) and golfers elbow (medial epicondylitis). Although these conditions were originally named after two sports, those injuries occur just as often in other sports and activities.  

The wrist and elbow action of the breaststroke and butterfly more commonly lead to 'tennis elbow' (pain on outer aspect of elbow) with front crawl and backstroke more likely to cause 'golfers elbow' (pain on inner aspect of elbow).  It is overuse micro-tearing of the attachment of the forearm muscles at the elbow that cause these conditions. Treatment will involve a period of relative rest combined with physical therapy.  

All trained musculoskeletal physiotherapists, chiropractors and osteopaths will be familiar with the treatment of tennis and golfers elbow and will be able to give you most of the advice and treatment that you need. It might be useful to find a physical therapist with knowledge of the biomechanical actions involved in swimming so that a discussion about swimming technique can be brought into the management plan.  Try asking at your local swimming club to see if there is a physical therapist in your area who is used to dealing with swimmers. It may also be helpful to seek out advice from an experienced swimming technique coach to see if there are aspects of your elbow and wrist movements which could be changed.  

Answered by Dr A Wright.


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