Prevalence of Freestyle Biomechanical Errors in Elite Competitive Swimmers

BACKGROUND Poor freestyle stroke biomechanics is a suggested risk factor for shoulder pain and pathology, but this has not been proven in biomechanical or clinical studies. Furthermore, the prevalence of these theoretical errors has not been identified, which would help coaches, athletic trainers, and researchers determine the most appropriate errors to focus on and develop interventions. HYPOTHESIS The majority of swimmers will present with at least 1 freestyle stroke error. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS Stroke biomechanics for 31 swimmers from a collegiate swimming team were captured using underwater/above-water cameras. Each video was evaluated for biomechanical errors: a dropped elbow during the pull-through phase, a dropped elbow during the recovery phase, an eyes-forward head-carrying angle, incorrect hand position during hand entry, incorrect hand entry angle, incorrect pull-through pattern, and inadequate body roll. Error prevalence was calculated, and relationships among the errors were evaluated using chi-square statistics. RESULTS A dropped elbow during the pull-through phase (61.3%) and a dropped elbow during the recovery phase (53.2%) had the highest prevalence. A dropped elbow during the recovery phase was significantly associated with a thumb-first hand entry angle (P = 0.027) and incorrect hand entry position (P = 0.009). An eyes-forward head-carrying angle was associated with an incorrect pull-through pattern (P = 0.047). CONCLUSION Biomechanical errors potentially detrimental to the shoulder are prevalent among swimmers. Many of the errors were interrelated, suggesting that one error may lead to other errors. CLINICAL RELEVANCE These errors highlight the need for proper stroke instruction and evaluation to decrease the risk of shoulder injury in competitive swimmers.