In article <fqX0b.8901$S_.811@fed1read01>, "DaKitty" <
[email protected]> writes:
>
http://www.physsportsmed.com/issues/2003/0103/johnson.htm (Talks about how holding one's head too
>high, assymetrical body rolls and unilateral breating all contribute towards shoulder impingement)
I know Dr. Johnson, author of the above article). I met Dr. Johnson (of Stanford U) at a USA
Swimming sportsmedicine meeting in Colorado Springs in April of 2001. At that meeting, I gave a 10
minute presentation on shoulder friendly swimming technique, which was unchallenged by Dr. Johnson
and by all the other physicians, orthopedic surgeons, and physical therapists present. It presented
the exact same concepts published in the two Swimming Technique articles and then on the ASCA
website. I read the above article when it was originally published in January, 2003, in the journal
Physician and Sportsmedicine (which I have received every month for more than 20 years). I quoted
from this very article in a previous post on r.s.s. earlier this summer. You may also note that Dr.
Johnson recommends entering the water pinky first instead of thumb first, to maintain external
rotation. This was part of my presentation and Dr. Johnson came up to me personally after my
presentation and told me that he agreed with my presentation, and specifically about the importance
of maintaining external rotation, which then made it way into the above article. This is of
importance, as it centrally relates to the issues of body roll and head lifting.
I am quite certain that Dr. Johnson would have no disagreement at all with me. He was writing an
article for physicians out in the community who see recreational swimmers (and not expert elite
swimmers). You simply do not understand the biomechanics of shoulder pain in swimming (as shown by
your assertion that it is caused by problems related to the deltoid muscle, which is so rare as to
be a zebra among the hoofbeats of North American horses), and you particularly do not understand
them in the context of the swimmer in question, which I reported in my original post.
Bilateral breathing is of help in avoiding impingement injury in the average recreational swimmer
for the following reason. It is harder to maintain external rotation on the non-breathing side than
on the breathing side, if one is rolling more to the breathing side and less to the non-breathing
side. It can certainly be done (and is done, at the elite level, by lopers who use this technique).
One can (and should) consciously "feather" the recovering hand on the non-breathing side to maintain
external rotation. Or one can raise the head and forequarter (as suggested by Fagan as a reason why
"lopers"...who rotate very little to the non-breathing side...do it) to assist the non-breathing
side arm clear the water. These are, however, sophisticated techniques and, again, the article was
just written to provide busy primary care physicians with some practical guidance on things to
suggest. If an average community swimmer is having symptoms of shoulder impingement on the
non-breathing side, then having that swimmer roll more to the non-breathing side (or to bilaterally
breathe) will help that swimmer (as would "feathering" and/or raising the non-breathing shoulder in
the style of many lopers).
However, the swimmer in my post had the opposite problem. She had symptoms of impingement on the
BREATHING side. Which she was relieving by rolling more to the breathing side and less to the
non-breathing side. This will help a lot to lessen impingement, pain, and injury. But the coach
advised her to rotate more to the non-breathing side, which makes it harder to stay in external
rotation on the breathing side during the pull. Which is bad.
With regard to the head lift, again, it is addressed to community physicians, seeing a diverse range
of community swimmers. There is a right way and wrong way to raise the head. The method which is
used by lopers actually REDUCES impingement and does not increase it. This follows from easy to
explain biomechanics (I could easily show you on an articulated skeleton with muscle origins and
insertions mapped out). But you don't have to take my word for it; there is actually a formal
reference from the peer review medical literature which explains how _proper_ head lifting is
beneficial and not harmful. Penny,J and Smith, C. Canadian Journal of Applied Sportsmedicine
5:195-202, 1980. Entitled Prevention and Treatment of Swimmer's Shoulder or something very similar.
With regard to PASSIVE drag being increased by head lifting, this is not what happens in ACTIVE
swimming with PROPER headlifting. True, when you push off the wall and streamline, there is less
drag keeping the head down instead of lifting it up. But, with active swimming, a proper head lift
counteracts leg sinking torque of the pull and therefore reduces drag, rather than increasing
it. As discussed in the Yanai article which I have referenced often.
Look, you are trying to say that the greatest female distance swimmer in history (Janet Evans) who
has the oldest records in swimming and who lifted her entire head out of the water with each and
every stroke of her 400 and 800 meter freestyle swims was increasing her drag with her head lifts?
Just like the _ _ instructor who said on this newsgroup that Ian Thorpe would swim faster if only
his head didn't bob up and down. Everyone else, before me, has just ignored all of the head lifting
and asymmetric swimming and loping which is going on all around us in the world of swimming. Just
ignored it. You are very good at coming up with literature and web sources. Find me some published
research or even some un-published musing on why it is that Evans lifts her head and Munz (currently
the greatest active American female distance swimmer) lifts her head and why Hackett (greatest
distance swimmer in history) lopes (swims so asymmetrically and rotates much more to the breathing
side than to the non-breathing side and has markedly asymmetric hand entry timings) and where anyone
has ever studied the relationship between kicking effectiveness and stroke length and swimming
performance. Perhaps you think that all these questions are not worthy of consideration. Perhaps you
think it's inappropriate to formulate hypotheses and discuss them on the r.s.s. bully pulpit. At the
USA Swimming sportsmedicine meeting, I was the only one in the shoulder pain session who even talked
about the relationship between technique and impingement. Everyone else was talking physical therapy
and surgery. But the latter are treatments and my way is prevention. Which virtually no one in the
world of swimming was aware of before I started to blabber all about it on
i.u.s more than 5 years ago. Why it's bad to internally rotate on recovery and entry. But word is
getting around and things are changing for the better. I claim credit for not a little of it.
You are good at coming up with technical references. I'd be very interested in the technical
references which, we have heard so often, prove that bumblebees can't fly.
Larry Weisenthal
Certitude is poison; curiosity is life
