From head to toe, swimmers must kick the injuries and pain to get to the top

By Julie Gardner for ATI Physical Therapy

From head to toe, swimmers must kick the injuries and pain to get to the top

While many probably consider swimming a relatively safe sport, injuries can still put these athletes in hot water.  Katie Varnado, ATC from the ATI Sports Medicine department knows about swimming injuries first hand from her work with these athletes.  Here’s what Katie has to say…

What injuries are common…

  • Swimmer’s Shoulder:  The shoulder is the joint most commonly injured, and may include rotator cuff impingement, biceps tendinitis and shoulder instability.  All can result from overuse, fatigue and weakness, especially when proper techniques are not used.
  • Swimmer’s Knee:  This injury occurs during the breaststroke because of the “whip kick,” which places all of the force of the kick on the outside of the knee. The inner ligament of the knee, called the medial collateral ligament, is put under stress.
  • Other Lower Body Injuries: Breaststrokers may experience pain from inflammation of the hip tendons. Lower back disk problems or spondylolisis, a stress fracture in the vertebrae of the spine, may be caused by the dolphin kick.

Prevention…

Katie recommends these tips to help prevent injury. In addition to stretching, there are specific things a diver can do to help ward off a repetitive injury:

  • Understand and focus on proper stroke techniques
  • Lessen repetitive strokes that are causing the  overuse injury
  • Perform core strengthening and cross-training exercises as part of pre and early season routines
  • Be sure to warm-up and cool down after activity and use periods of rest to recover
  • Focus efforts on rotator cuff and scapular strengthening for most shoulder injuries,  and pelvic and hip strengthening exercises for hip and knee injuries
  • Speak with a sports medicine professional or athletic trainer if you have questions  about injuries, exercises and  prevention

Segment 102.1: Athletico’s Overhead Athlete Program

Matt Gauthier, PT, DPT, SCS from Athletico Physical Therapy talks with Steve and Dr. Cole about the unique characteristics of the Overhead Athlete, types of overhead throwing injuries: causes, prevention and treatment.

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There’s more to throwing than just the motion of your arm.  There’s actually a whole science dedicated to it-and Athletico offers a comprehensive approach. Our team of physical therapists, occupational therapists, certified athletic trainers, and physical therapy assistants combine their expertise in throwing analysis with slow-motion video analysis to enhance performance and help prevent injuries.

Whether you are returning from an injury or simply working to refine mechanics, Athletico has skilled professionals to assist you in optimizing your form and preparing your body for the field of competition, bringing you one step closer to making your goals a reality.

Matt Gauthier specializes in the treatment of high-level athletes, and is the most passionate about treating shoulder and knee injuries. He is the head of Athletico’s Overhead Athlete Program,  and is a member of the USOC physical therapy volunteer program. As a sports specialist, he has experience treating athletic injuries at the youth, high school, college, professional, and Olympic levels.

Matthew’s Story

Matthew Lee, 22, of Oak Park, discovered his passion for playing lacrosse at a youngmatthew lee age. Although he also excelled in baseball and tennis, it was the ‘brotherhood’ of lacrosse that drew him into the sport.  Playing lacrosse gave him a supportive foundation throughout his years at Oak Park River Forest High School and when it was time to make college decisions, his love of lacrosse played a big part. He enrolled at Beloit College in Beloit, WI and joined its NCAA Division III lacrosse team.

College life and lacrosse were going very well for Matthew until his spring break trip to Washington, DC his sophomore year. This was a special time during which the team had an opportunity to scrimmage against the U.S. Naval Academy. While attempting a shot on goal, Matthew fell on his hand and wrist. He immediately felt a ‘pop’ followed by intense pain and swelling. To his disappointment, the team’s trainer had to sideline him for the rest of the trip.

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After returning to Wisconsin, he was evaluated at a local hospital where he was diagnosed with a fracture to the scaphoid bone, one of several small bones in the wrist. He was casted for six months and then underwent occupational therapy. It was tough time, but he looked forward to returning to lacrosse.

A Second Opinion

Unfortunately, after the cast was removed, he still felt pain and an unusual grinding sensation in his wrist. Matthew felt something was still wrong and his mother insisted they get a second opinion. After researching several specialists, they chose Dr. John Fernandez, a hand, wrist, and elbow specialist at Midwest Orthopaedics at Rush. They liked Dr. Fernandez’s reputation for treating high level athletes and for performing particularly challenging cases.  Coincidentally, Dr. Fernandez also has three sons who play lacrosse and is a big fan of the sport himself. He immediately connected with Matthew and understood his frustration.

Dr. Fernandez carefully assessed Matthew’s wrist.  He used simple measures like examining the normal side which no one had done previously.  He also used high-tech techniques including examining his wrist under a live video xray to see what the wrist was doing in real time and under stress. This led to the discovery that Matthew hadn’t suffered a wrist fracture at all.  Instead, he had torn a very important ligament in the wrist.

This ligament is a crucial connection between the carpal bones in the wrist. Without it healing, Matthew would likely have continued problems, including long term arthritis and disability.  This would make it hard for him to use his hand for simple tasks, much less playing lacrosse. He explained that Matthew needed surgery to repair the torn ligament and restore function. This was devastating news because it meant more time away from lacrosse.


“Even though it was tough to hear that the casting period was a waste of time, Dr. Fernandez and his amazing physician assistants were so helpful throughout the whole process.”


Dr. Fernandez recommended a technically demanding and unusual surgery to reconstruct the scapholunate ligament of the wrist. This required transplanting one of Matthew’s tendons to replace the ligament he had lost.  Stainless steel pins would be used across the bones to maintain alignment during the recovery process. This cutting-edge technique was designed for higher demand individuals with and a better success rate.

Complicating matters further, before his surgery Matthew fell and injured his other wrist. This time he truly did fracture his scaphoid bone.  But, instead of casting it, Dr. Fernandez suggested a method of repairing the bone internally with a screw. This would then act as an internal cast and decrease healing time.

Now, the stakes were higher. Matthew required a staged surgical approach so that he could use one of wrists during the healing process, but not compromise the outcome. Several surgeries and nine months of recovery were needed to make this work.  Dr. Fernandez and Matthew confidently agreed to take this plan head on. As hoped, the surgeries were successful and Matthew’s recovery was smooth.  Finally, eighteen months after his initial injury, Matthew was functioning well and pain free. He finally scored his ‘goal’ — with Dr. Fernandez making the assist.

Back on the Field

Dr. John Fernandez

Dr. John Fernandez

After a long time away from lacrosse, Matthew was able to join his teammates back on the field during his senior year. “I was able to score over 25 points this season and could not be more thankful to Dr. Fernandez, his PAs, and MOR for making my senior year a great one to remember,” he says.

During this process, Matthew received a unique look into the practice of orthopedics and expressed an interest in a career as a physician assistant. Dr. Fernandez admits that he has seen this happen before and encouraged Matthew to follow his passion. He hopes that one day Matthew will be able to pay it forward by performing a surgical assist of his own to help someone else score their goals.


To schedule an appointment with Dr. John Fernandez, call 877-MD-BONES.