Hello, everyone; thank you for attending and thank you ASCA for setting this up. Let me know if you have any questions: I will be glad to answer them at the end. As Scott said, I am a personal trainer; I am certified through the American College of Sports Medicine. Certified Group Instructor through ACE, Water Exercise Instructor, Trainer with the Arthritis Foundation. I am a chair for the Allegheny Mountain LMSC; Head Coach for group and high school, and this is my second year on the USMS Sports Science and Medicine Committee. So that’s just a little bit about me.
Today I would like to go over:
- Identifying what a Masters swimmer
- Talk a little bit about activities and injuries.
- give you some ideas or suggestions on pathways to success and injury reduction
- And then helpful remediation tactics to consider; some things to take back to the pool with you.
And then we will wrap up.
So the first thought I would like to have you think about: how many of you have played with Tinkertoys? So, I want you to think about what Tinkertoys might have in common with Swimming and at the end we will figure it out.
So first I would like to identify who is a Masters swimmer? This is taken from the USMS membership survey from 2011 of 7,180 respondents. As you can see it’s a pretty good indicator of what we have across the United States in terms of membership in the male to female ratios.
Who is a Masters swimmer? Again, this was taken from the same survey. And as you can see… what I find interesting up-there is that we do have 9 respondents in the 90+ category. Which… how they did this, they did an online survey, and to have 9 respondents in the 90+ is pretty amazing for an organization. The U.S. census projects that nearly 1-in-5 of all residents in United States will be 65 or older by 2030. And I think that’s pretty amazing as we look at where we are with USMS, and then overlay where the U.S. census projects us to be: our population is only going to increase in those upper numbers.
But age is not just something that we have to consider, it’s just a number, right? We also have to consider the fitness level of our participants rather than age. Biological age means simply how your body performs and functions compared with other bodies of the same age. Yes, with age comes increased health risk and an increased incidence of disease conditions. So we have to think: just as a younger person might have a limitation, so too might an older adult and appropriate modifications must be made.
And this data is taken from an online survey that the USMS Sports Medicine committee put-out this past Spring. And we asked: Why do Masters swimmers swim? What brings you to the pool? What drives you? And as you can see a large component was for fitness: to stay in fitness, staying fit, staying healthy. And it’s also interesting that we do have respondents that say it’s the only sport I can physically do. So, we have a wide spectrum of people, but we also need to remember that that we have some people who are not interested in anything but coming to the pool just to stay fit.
Another question that we had on our survey is: In one day, how many other things do you do besides just Swimming? So, I listed the top ten answers. Respondents had about 44 different choices, and these are the top-10. And they were allowed to, of course, select multiple things. As you are keenly aware, there are triathletes in our group and they do cycle and run, so we allowed for multiple answers. I think it’s interesting that five choices up-there that Masters do in one day include: more cardio. I also think it’s interesting that four are strength building; five if you count yoga—yoga could go both ways. And five are non-impact.
We also asked our participants: when you participate in other types of exercise, what is your goal? And it’s interesting, I think, that 30.6% were wanting a variety in their activities. We also asked respondents about the dryland that they do. We asked them: When they do dryland, where do they get their ideas? And 85% said they were recommended by a physical therapist, occupational therapist or a doctor. 50% responded that they are recommended by a certified trainer. And, again, this was a question that we allowed for multiple answers.
And finally, we asked the question: Do you need to modify your land-based activities? And amazingly, 26.6% said they do need to modify their land activities. We followed-up the question with: If yes, do you modify for…. 57% said injury or rehab. So it’s pretty interesting to think that 1 in every 7 or so of the swimmers in your lanes is modifying a land activity for an injury. We thought that was pretty significant.
And then when we overlaid it with the next question Are your modifications permanent or temporary?, an amazing 63% said: yes, these were permanent modifications, permanent injuries. So, as we put-together and think-about our dryland activities, we need to start taking some of these things into consideration.
Anybody want to take a guess on the #1 injury? 35% of our swimmers said it was the shoulder injury. 27%, it was the knee. So we have to take considerations for the adult swimmer.
The first consideration is the availability to train. We all know that we are busy: we have family and work commitments. And we have to figure out when our workout is going to occur: is it before or during or after we drop the kids off, get dinner, get groceries. And if we are not at the pool, then where are we?
The next consideration I have already briefly mentioned was age. And we have to consider age only in a sense that part of the aging process is that: one does lose muscle mass, one does lose the ability to recover, range of motion is lost. Aging also affects: the cardio automatic function, and it also lends to a higher risk of cardiac events. We also need to consider physical restrictions or limitations. These would be: joint replacements, preexisting conditions, previous injuries, medications.
And as a coach, we also have to evaluate how a person moves. Can they move through all ranges of motion? That would be back to a range of motion. Can they turn their head on land? And we have to consider how they are moving, because we can’t begin to strengthen or stabilize something that doesn’t move. So, when you look at your swimmers: how are they moving on land? And that’s something we need to consider when we start adding a dryland component.
As I already mentioned: the fitness level is something we need to consider. Something unique to Masters swimmers that is different than the Age Group and the high school and the college, is that Masters have what we call an episodic training cycle. They go away on a business trip: that’s two weeks out of the pool. They go away on vacation. There are many things that factor-into taking time-off. And when they come back to the pool, are they ready to jump right back in the lane where they were? Or do we need to take time and build back-up. So those are things to consider.
We also need to consider what their posture is like on land? If they slump their shoulders and are hunched over, are they going to be able to swim? And there are things that we need to consider. And again on fitness-level, the body needs time to recover. And as you would work with adults, we need more time to rest and recover.
We also need to consider a level of interest: why are they in our lanes? To maintain fitness level? To improve times? Or to combat the black-line syndrome?
Another important one is diet. We all get to eat and drink what we want—our moms aren’t telling us anymore what we have to eat. Just as we can have fruits and vegetables, we can have chips and ice-cream in the middle of the night. And another thing to consider for adults is when we consume alcohol, it wreaks havoc on our metabolic system. And then what else are we having with our shots and beers? Is it a basket of fries or is it a leafy green salad? Dollar-to-donuts, it’s the basket of fries, right? So we have to consider garbage-in/garbage-out when we work with adults, and I always encourage diet, nutrition, hydration.
And another interesting factor to consider for our adult swimmers is our body awareness. When someone becomes uncomfortable, there is a fear; and then that fear, it paralyzes them to a degree that it becomes dysfunctional in the body. The body can’t function, it doesn’t move. So if a swimmer is used to being in the water and exercising in the water, and now you are asking them to come out and perform that same thing on land, body awareness is not necessarily going to come with it. So it is a consideration for dryland.
So let’s talk about building a workout. When we talk about building a workout, we want to think about the muscles that are used in Swimming. What are some of our muscles that we use in swimming? Lats and core and triceps and… there are lots; there are lots of muscles that we use.
The weakest muscle on a swimmer, anybody have any idea? I will help you out. No, it’s not the mouth muscle. It would be the mid- and lower-trapezius and also the subscapularis. The picture on the left shows the entire trapezius, so we are talking from the shoulder blade down the spine—that would be the mid-to-lower. Yes, we use that area at the back, but it’s the muscles that are underneath and/or supporting that particular muscle that are weak. And then the subscapularis is underneath the shoulder blade. So those are the two muscles we want to consider to strengthen for the swimmer, because they are supporting so many other things.
And as we build a workout, we want to think about and assess: how does this exercise apply to swimming? Does it improve a stroke? Does it prevent injury? Will it improve or maintain range of motion?
And then as we are building a workout we want to evaluate the space and equipment available for our participants. Do we have deck space? Do we have wall space? What kind of equipment do you have? Med-balls? Swiss balls? Yoga mats? Stretch cords? Or are you in one of those really fancy facilities and have a Nautilus circuit, ergs and Vasa Trainers? Or do you just have your towel and your swimmer? So you need to pick exercises that you have equipment for to make modifications and/or performance an exercise.
As we are building a workout, we need to consider who has what type of need; the limitations. As we mentioned before, we may not know as coaches what the limitation is until a swimmer looks at you and says, “I can’t do that, I have a total knee replacement.” You don’t know that, and some of those situations are unavoidable. But at the same time as you prepare your workout and you build a workout, you can anticipate what some of your swimmers issues are and be prepared to make modifications for your swimmers.
And finally we are going to question the exercise: Is this the best exercise? What is the outcome for that intended exercise? And finally, and most importantly: Are all the participants and swimmers going to be safe?
So we are going to analyze the push-up. Lots of us have push-ups in the program; and I think the younger Age Group may have it in their program and the high school might have it in their dryland program. But let’s consider it for the adult swimmer. So we are going to take it through that series of questions that I just had up. We are going to identify the primary muscle group that we are intending to strengthen. Is it the chest? The triceps? Both muscle groups? And what is the goal for the push-up; what is our goal for this exercise?
Why I ask if it’s going to strengthen the chest, the triceps or both? That is going to depend on your hand position. And that’s a little bit more complicated, but it’s something to think about how you put the workout together. So, then we are going to assess how it applies to swimming. Does scapular linking and strength translate to swimming? Absolutely. Does linking of the scapular translate? Yes.
However, a full push-up does not focus on linking at all if you go chest to the ground. If you go all the way down, you are putting your rotator cuff at risk. Why? Because the torso is now putting all of the pressure on the front side of the shoulder joint. You will put too much stress on the clavicle and the front of the shoulder joint. So rather, we would like to strengthen the back muscles, the subscapularis. We are going to call this exercise bad, and I don’t recommend it for the Master swimmer.
Instead, I would like to use the scapular push-up. We are going to take this through the same series of questions. Identify the muscle that we are intending to strengthen: in this case it’s the subscapularis. If you need to make a modification on this one, you would elevate the feet ever-so slightly. By elevating the feet, you are taking the pressure off of the shoulder.
Assess how it applies to swimming. Does scapular linking and strength translate to swimming? Yes. We are strengthening the subscapular muscle, so that there is a strong and smooth movement. We want to strengthen from within. A weak scapular muscle will put too much stress on the rotator cuff.
Next we are going to evaluate the space and equipment. Yes, we can perform this one on the floor. But what if you have somebody who has vertigo or another health issue that would prevent them from getting on and off the floor? This exercise can be performed by leaning against a wall. So, again, we have to consider wall space, floor space. Do you have yoga mats to provide a little bit extra cushioning, if somebody wanted to go to their knees to do this exercise? Do you have towels, extra towels, available? So our special considerations are taken care of: if you are not ready for the floor we have the walls.
If you have participants who have arthritis in the wrist, or sore wrists, or pins and plates in their wrist, you can take a dumbbell as a handle and put that on floor and then they have something to use a straight wrist instead of a bent wrist.
So we are going to question the exercise. After taking into the account all of the above, is this the most effective exercise for the intended outcome? And most importantly, are my participants going to be safe? Absolutely. As the muscle fatigues, distinct changes in the function of the shoulder result in overuse and fatigue, which lead directly to injury and pain. So we don’t want to do too many of these; you don’t want to do them to fatigue. The shoulder joint is very unstable, and we are trying to strengthen it and give it stability. Muscle forces are critical for maintaining stability, proper motion and painless function.
So, next we are going to analyze a v-up. A v-up is an abdominal exercise. Does abdominal strength translate to swimming? Yes, we absolutely need it; it’s part of the core. But the v-up, this is a very static exercise. Swimming is a very fluid exercise. So we want to focus on exercises that promote a constant moving or a flowing motion.
The v-up puts tremendous amount of pressure on the lower back. And if any of your participants have a bad back, you are putting them at risk. Additionally, many participants when they do this exercise, due to a lack of strength, it puts too much stress on the neck—as they try to thrust their jaw forward to try to maintain that v position. So in my opinion, this is not a safe exercise or a recommended exercise for Master swimmer.
Instead, I would recommend a reverse crunch. The primary muscle group is the abs and the little bit of a back, which is also part of the core. Core means the center of the body; the center. The core is essential for balance when we are swimming: if you have a weak core, then you have an unbalanced swimmer in the water. If you have an unbalanced swimmer in the water, the first thing to go is the arm stroke. They start over-compensating/under-compensating, the arm pattern changes. When the arm pattern changes, now you are putting the shoulder at risk. And that’s not what we need to do.
So this exercise, it translates to swimming because we are strengthening the torso. By putting the block that is… you can either use a foam roller (which is as pictured) or participants can just put their towel underneath their knees. They are going to pull their knees to their chest. In this particular picture, the exerciser has his hands over his head, but participants can also put their arms straight out to the side and pull their knees to their chest. So it is a moving exercise. We want to have our bodies trained to move in steady, smooth movements.
Evaluate the space you need: you need just that much space on the floor. You can use the yoga mat or a towel; you need an extra towel perhaps for underneath the knees. So very limited pieces of equipment.
As you think about who on your team may have a particular limitation, if anybody on your team has a bad back, the back is protected on this exercise. You are using your abdominals to pull your knees to your chest.
And then finally we are going to question the exercise: after taking into account all of the above, is this the most effective exercise for the intended outcome? And most importantly are my participants going to be safe? Yes.
[inaudible question from audience]
We are definitely not using momentum. You want to be in control of your body at all times.
[inaudible question from audience]
Oh, seconds. 1, 2, out, 2. And you are holding an object underneath your knees to keep your knees bent. So that you are not using your whole leg and you are getting into using, almost like a catapult, putting too much stress on your lower back. Okay?
[inaudible question from audience]
Correct, or feet just to toes. So that you don’t want to drop the object. And that’s just to keep the form. As soon as you lose the form, stop the exercise.
Okay, any other questions?
So putting a workout together. Now that I have given you some guidelines to evaluate exercises, how do we put a workout together for the Master swimmer? Have a plan. How does your particular dryland session work into your season plan? How does it fit into the workout schedule? And most importantly are you giving your swimmers enough time to rest and recover?
Balance. Choose a variety of exercises; don’t get stuck on the same particular exercise or muscle group. You want to start with the core muscles, get the blood flowing, get the body warm, get the heart pumping. Next, we’ll move into the scapular exercises and then into the rotator cuff. So you want to start with the larger muscle groups and move to the smaller ones.
We want to keep is simple. Rather than trying to make each exercise have multiple components, keep it simple, so that your swimmers don’t get lost or confused along the way. You don’t want to spend time re-explaining the exercise 5,000 times to each swimmer. Keep it simple, so they can remember it and they can do it.
You will also want to have as many people as possible doing the same exercise. This will make it easier for you to spot areas for correction and also make sure everybody is doing it safe.
Injury prevention strategies would be to train the core muscles. Strengthen, stabilize and flexibility is essential to any injury prevention program. The most important muscles to strengthen: the abdominals and the scapular muscle. The goal of core and abdominal strengthening is to develop an increased control of the pelvis region. So you want to avoid anterior pelvic tilt and lumbar lordosis. Endurance training and strength training program for the shoulder muscles will also help prevent injuries.
As soon as the athlete experiences pain, training intensity, distance and frequency should be adjusted.
In short you want to make sure that your workout sessions benefit a large range of ages and abilities, and always ensure the safety of your swimmers.
So how do we put a workout together? Pre-warm-up, meaning before your swimmers get into the water, I recommend a joint mobility; getting the joint warmed-up. Some examples would be taking a light stretch band and pulling it apart, or tethering it to a pole and pulling across and then pulling this way. The ball drop, which is holding a tennis ball, dropping it, and circling around. Another one would be ball on the wall. Small slow circles. (I can give you a link to this if you want to talk about it later.)
Then I would do the swimming workout. And then after the swimming workout is when you would want to do your stretching to increase your range of motion. We want to make sure that we are stretching the muscle, not tendons or ligaments. You want to make sure that if you are stretching you are maintaining the joint, and the joint isn’t being pulled out of socket.
I also want to throw out that maybe instead of doing your stretching on land, that you incorporate your stretching in the water. There are a number of reasons to think about doing your stretching in the water. The joint is supported by the water. Most of our swimmers are very comfortable in the water, so they are already going to be more relaxed. And this is where I went back to, and I talked earlier about body awareness. Most of our swimmers are very comfortable there. That means they are going to be a little bit more relaxed, and they are going to be able to get a deeper stretch in the muscle. Again, I stress stretching the muscle. And therefore there is less tension.
Examples of exercises that you could do in the water would be basic standing yoga poses. They translate very well to the water. The biggest problem you have with taking yoga into the water is that it’s very slow, and you don’t want your participants to get too chilled. So just be aware of that as you do some stretching and cooling down at the end of practice.
Cautions. It is best to do exercises after you swim or several hours before you swim. This is because you want to work on muscle endurance. As soon as form is lost or the exercise is compromised, stop the exercise. It’s easier to stop the exercise on land and see where it falls apart, than somebody saying, “Oh, I know I can do my 3,000 yards” and you just fatigued their shoulders. If you do your exercises before you swim, you need to give the muscle adequate time to recover because we don’t want to compromise the strokes. We are looking for performance in the water, not to over-fatigue the muscles—that leads to injury.
What you do before the swim is to focus on the joints that will be under stress; warming them up. Movement patterns and specific joints that are going to be used during the workout. By getting the joints warmed-up, you will increase the range of motion and this will prevent injury.
Most importantly: what works for one may not work for another. Simply because you saw it on YouTube where someone suggested that it may improve power, doesn’t mean that it will work for all of your participants. Base your exercises on science and a multi-disciplined approach. Our swimmers aren’t looking to get a CrossFit program from you; they are looking for safe and effective exercises to improve their swimming performance.
Some general ideas to avoid also. Anybody who has osteoporosis or a dysfunction, you don’t want to have them lifting weight in the front—so that their body is doing this. That will put too much pressure on their back. You also don’t want to give people too many things to think about at one time. They will get confused—I know I do.
And then I found an interesting study. The University of Alabama did a study on women, and they found that resistance and aerobic training—and we are going to consider Swimming an aerobic training mode–they found that two days a week on non-consecutive days was very successful at improving body composition, strength and aerobic fitness training. As opposed to one day a week; as opposed to three times a week. So that would be… what they are suggesting, is alternating. So have a swim day, dryland day, swim day, dryland day. And that is perfectly acceptable, and they had the most gains with that mode.
And then we need to consider overtraining. As I mentioned, components of successful training for any discipline include: sufficient nutrition, adequate training loads and rest. And keeping these items in balance is many of the keys to success. The training model does include an increased workload; and that’s intended to create fatigue so that body can adapt—that is part of the process. However, you want to make sure that your athletes rest.
The different stages in overtraining are:
- over-reaching, known as OR;
- overtraining, known as OT;
- overtraining syndrome, which is OTS;
- and then there is an extreme.
When an athlete’s performance becomes stagnant or even regresses for a short period of time, it’s called over-reaching. And an example of that would be when your participants, your swimmers, go to a training camp; and that’s an intense training camp, and every day they are in the pool, and every day they are working out really hard. And they come back and they are pretty tired and it takes some maybe a week or two to recover from one of those expeditions. That’s called over-reaching.
More severe cases would be overtraining. And that’s when they don’t listen to their body; and they keep going, and they keep going, and they keep going. That’s a situation where it’s called overtraining. It may get to a point where they have disrupted sleep cycles, exhibit signs of depression and mood swing.
If they still don’t listen to their bodies, that can develop into something called overtraining syndrome. Overtraining syndrome, it’s possible that it will take months to recover from. For extreme cases, it can be felt for a year or more. And it’s very common that if you experience it as an Age Grouper or even into high school and college, odds-are you are going to be very susceptible to for having this pitfall later in life as well.
The most severe cases everybody says, “Yeah, okay, I over-trained, I over-trained. How do I know when I got too far?” When you get too far, muscle tissue will begin to breakdown. The athlete will notice a reddish-brown tint in their urine, and that’s the most extreme condition. And that is the athlete not listening to their body’s demands.
How do I recognize those different stages of overtraining? It’s quite vague, but you have to take into account a number of things. The athlete’s response to overtraining. The non-specific nature or the perception of fatigue is very vague. The anecdotal nature: my ability to express how much stress the person is under. And also the quality of the effects: the physical, the mental, the emotional. Even though each one of those piece standing alone would not lead to overtraining, we have to evaluate a full spectrum of ideas, for a proper diagnosis of OTS. And before we even diagnosed OTS, we have to rule out other organic illnesses or diseases; meaning, you know, just a cold or the flu, or whatever might be going around.
How do we remedy? We should allow for adequate rest and recovery, consume ample nutrition and hydration. And when injuries, illnesses, emotional or mental or other stresses present themselves, we need our athletes to be able to feel comfortable to adjusting their training schedules appropriately. And this might mean encouraging our athletes to swim in a slower lane for a while, sitting out a 50 or two, and reassuring them that it’s okay, their body is telling them that they need rest.
So together, athletes and coaches, working together, can achieve goals. Studies continue to prove “move it or lose it”. We don’t want to hurt our athletes, we want to help them improve. There was a study that was done by the women’s hospital in the National Cancer Institute. They followed 650,000 people for 10 years. The subjects were 21 to 90 years-old. They found that 75 minutes of walking per week resulted in a gain of 1.8 years of life. 150 minutes of physical activity per week added 3.4 to 4.5 extra years of life.
So, why do I say all those stats? Because we want to give our athletes what they are looking for: safe and effective exercises.
So we are going to go back to the Tinkertoys. As anyone who has ever played with Tinkertoys knows, in order to have a large structure you need to have a strong base. In Swimming, as I mentioned, you need to have a strong base to have power and strength at the extensions. Swimmers need a strong base to perform, which is very similar to the Tinkertoys needing a strong base to have an elaborate structure.
[inaudible question from audience]
Yes, you are. If you are coming down, where has the torso gone? The torso… the pressure is in the front. And that’s what we are saying we want to avoid. So, that’s why you have to think through and evaluate anybody who has ever had a rotator cuff injury or clavicle problem. You are putting all of your body weight (I will show you) has now come forward, okay, and is on the front of your body. And the shoulder is now… all that weight, has shifted forward. So where is your bone? It’s moved forward. You see what I’m saying? If this is your shoulder joint. Because of gravity.
[inaudible question from audience]
Yeah, what you can do is, if you have… so you want to look for something stable. I don’t recommend a Swiss ball unless you have somebody who is going to hold it. But again, that’s an all wobbly, topsy-turvy thing. Unless you have an athlete who needs that challenge and can handle that challenge, I don’t recommend doing it. So you want to have maybe like a step that the person can put their foot on, and that is reducing the angle.
So again, if my feet are up a little bit higher, it’s going to change my angle and put less stress on those shoulder joints because of my angle. Does that make sense? Did I answer your question?
[inaudible question from audience]
We want to do between 8 and 10, and that’s fine. If at first, you only get to 5, but 5 good ones, that’s what we are looking for. We are looking for quality not quantity.
[inaudible question from audience]
Yes. I have co-presented with Dr. Jim Miller for 2 years now.
[inaudible question from audience]
Right. Because Dr. Miller has done extensive research, he is way smarter than I am on the topic and I will certainly see to any of his suggestions.
[inaudible comment from audience]
As long as the participants and swimmers are able to perform them without compromising the integrity of the joints and the muscles. Then you can certainly mix it up. But the problem, so many times is, Oh yeah, I know how to swim, I can do this, and they don’t realize that their form is falling apart.
And the adult has a habit of thinking they are ten years younger than they really are, anyway. Okay? So, okay, we are going to combine I know how to swim because I have been doing this for 5,000 years, and I can get through this, with thinking Oh, you know, back in my day. And now you are asking them to do things on the deck, and then jump back and forth, and back and forth. Either focusing on too many other things, rather than the task and the exercise at hand. And that’s when you are setting yourself up, in my opinion, for injury. I would be very careful about doing things like that.
[inaudible question from audience]
If it’s a break between the rounds. But also make sure that, again, the joints are protected, the muscles are working appropriately, and form is not compromised either on land or in the water.
I put up my sources. If anybody wanted to double-check any of my sites, that’s where I got my sources from. So that’s all I have.
Thank you for coming.
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