May 31st, 2013

Health N

Staff Report

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Louisville Orthopaedic Clinic shares swim insight

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation. 

On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to

Answers By: J. Steve Smith, M.D.

Why is swimming a good sport/activity for people?

As a general rule, it is difficult to find a sport or exercise that is more healthy than swimming. This athletic activity is outstanding for cardiopulmonary fitness, muscle strength, joint preservation, and stress relief. It’s actually pretty rare for an athlete to suffer an injury from everyday swimming. However, as with any endurance sport, overuse injuries do occur and they are almost always related to competitive swimming events (e.g. the Ironman). Young athletes are also prone to this type of shoulder injury because they swim in multiple venues, i.e. high school, club teams, and private lessons.

What injuries can occur with swimming? What treatments are available?

The etiology of shoulder pain from the swimming stroke most often comes from rotator cuff tendonitis. This condition, sometimes referred to as tendinopathy, is usually a result of impingement of one of the four rotator cuff tendons on the bones within the shoulder. The progression of this condition to significant rotator cuff tear is possible, but unlikely from this athletic activity. This is important because full thickness rotator cuff tears often require surgical intervention, especially in active, healthy individuals, regardless of age. If a patient is diagnosed with cuff tendonitis, then anti-inflammatories (e.g. Naprosyn or Ibuprofen), physical therapy, and ice are usually prescribed. A corticosteroid injection is often given in the shoulder as well. If these non-operative treatment regimens do not alleviate the discomfort then time off from swimming will be required. Depending on the patient’s physical exam, a MRI might be necessary to further diagnose or rule out a significant injury. Overhead athletics, such as baseball, volleyball, tennis, and certainly swimming can injure this cartilage, especially if scapular dyskinesis is present. A MRI is often necessary to confirm a labral tear, but if present, surgery is not a predetermined destiny. Often physical therapy, NSAIDs, and time away from swimming will eliminate the discomfort. Surgery may eventually become necessary, but not until all non-operative options are exhausted.

What are your overall thoughts about swimming?

Overall, swimming is full of many more positives than negatives. Any pain or injury as a result of this activity can usually be treated and eliminated with attention to proper swimming technique, changing up the swimming stroke (e.g. rotate freestyle, backstroke, and breast stroke), and cross training.  Endurance athletes relentlessly push themselves to achieve goals that many consider insurmountable. I have a tremendous amount of admiration for their dedication, determination, and athleticism. On the other hand, it is important for these competitors to remember that their sport, when taken to extremes, can lead to body breakdown. Unfortunately, swimming is no exception. 


J. Steve Smith, M.D. Biography

Smith specializes in area of orthopaedic sports medicine, arthroscopic surgery, total shoulder replacement and athletic-related injuries.

Dr. Smith specializes in orthopaedic sports medicine and athletic-related injuries.  He completed his fellowship training at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles, California, this intensive training and research program is one the country’s largest and most respected sports medicine fellowship programs.

Dr. Smith is the Medical Director of Baptist Sports Medicine. He is also the team physician for Ballard High School and North Oldham High School.  In addition, he was on the medical staff of the LA Lakers, LA Dodgers, USC Football Team and numerous other collegiate and high school sports teams.  He has published numerous research papers, abstracts, and has made presentations relating to the advancement of arthroscopic surgery in sports medicine.

Dr. Smith is a native of Kentucky earning his undergraduate degree at Western Kentucky University and attended the University of Kentucky College of Medicine.  He completed his internship and residency at the University of Rochester in New York, and then completed his orthopaedic sports medicine fellowship.  He is board certified in orthopaedic surgery and is a member of many national, state and local medical societies.

Louisville Orthopaedic Clinic & Sports Rehab Center

Main Office: 502-897-1794

Physical Therapy: 502-897-1790


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