Four Key Assessments For Swimmers


The swimming population has been our fastest-growing demographic, so we've had a decent amount of assessments within the last year. At Achieve, we're big on assessing, and not on guessing. When we get a swimmer in the door, there are a whole host of things we're looking for. A thorough assessment should include both general and specific components. So, I'll outline five things we specifically look at for swimmers.

1. Cervical Rotation

Swimming is a unique sport in that breathing for three of the four strokes cannot occur at any random time; it has to be at specific times during the stroke because you're, well, underwater. While some swimmers may have breaststroke, backstroke, or butterfly as their primary stroke, freestyle is where they get a lot of their volume during practices.

If you look at the freestyle stroke, a vital aspect of the stroke is something called body roll. Body roll is when the swimmer rotates side to side along the longitudinal axis both to breathe and to recover without the arm and forearm swinging out to the side.

Neck mobility is crucial to the body roll for two reasons. First, maintaining the correct head and neck position during the stroke involves the body rolling from side to side with the head and eyes focusing on the bottom of the pool. Secondly, breathing has to take place meaning rotation at the neck. If the swimmer is unable to get adequate rotation at the neck, it can cause the head to be lifted too high to compensate or move excessively through the thoracic spine via the body roll.

While cervical rotation is something that swimmers tend to have more of as a result of swimming compared to non-swimmers (1), it's something we still assess for to make sure the range of motion is adequate.

2. Multisegmental Rotation

The freestyle and backstroke swim strokes both involve body roll previously discussed. Freestyle, in particular, involves up to 60° of rotation of the body. There is typically more rotation during distance events when the stroke frequency is lower, and the stroke length is higher compared to sprint swimming (2,3,4).

To reach upwards of 60° of body roll, that involves mobility of the hips and shoulders to rotate. While we can narrow down the specific parts of the body that need to rotate, such as the thoracic spine, we look globally at the entire body moving as a unit just as it would in the pool. We like the multisegmental rotation to quickly assess if there are limitations, so we're better able to insert correctives in the athlete's program to fix any issues.

3. Supine Shoulder Internal Rotation

Adequate shoulder internal rotation is a necessity for all of the swim strokes. There's a small rotator cuff muscle called the subscapularis that attaches on the underside of the scapula and right on the humeral head. This muscle controls motion at the shoulder, is an internal rotator, and provides stability to the front of the joint. It has to keep up with the strong pull of the pecs and lats that attach further away from the joint.

Typically, in swimmers, they are in a resting position of internal rotation, but that is generally due to the dominant lat muscle. A simple table test will determine if there's an actual limitation at the joint itself. The interesting thing about shoulder internal rotation is that it isn't just range of motion we're looking at. If there is a restriction, it can often be indicative of the position of the shoulder blade (and, therefore, the socket) not allowing the joint to fully internally rotate.

4. Supine Active Shoulder Flexion

Every swim stroke involves an extensive range of motion at the shoulder in multiple different planes of motion. Among many similarities, all four swim strokes involve the arms moving into an overhead position.

To get into this position, the swimmer needs rotation at not only the shoulder joint, but also upward rotation of the shoulder blade to allow full overhead motion. After about 30° of abduction (arm moving away from midline), the shoulder blade moves 1° for every 2° of motion at the shoulder joint (5). Without this movement of the shoulder blades, about 120° of motion is achievable. Full flexion would be about 180°.

Upward rotation of the shoulder blades can be affected by numerous things, but in swimmers, lat stiffness is a huge culprit. If you think about moving through the water, the lat is a big, strong muscle capable of providing a lot of force.

Because of this, it's common for these muscles to get stiff, tight, and overused limiting the swimmer's ability to get the arms overhead without compensation safely (6). The lat muscle has attachments on the bicipital groove of the humerus and the lumbar spine (via the thoracolumbar fascia), with a small part of the population having additional attachments on the ilium. If we contract the lat without adequate strength of the core, for instance, you're looking at lumbar hyperextension as a compensation, which can manifest itself in lower back pain and improper breathing mechanics with overuse of neck muscles to aid in respiration. A second common compensation resulting from the inability to get the arms overhead includes a forward head posture, which also happens to be very common among swimmers (7).

Every single athlete that walks in the door will get an individualized assessment that is tailored to his or her sport, and this represents a little bit about my thought process in assessing swimmers. If you're in the Naperville/Aurora area and would like to work with us, please contact us at 630.340.4114 or email us at


1. Guth EH. (1995). A comparison of cervical rotation in age-matched adolescent competitive swimmers and healthy males. Journal of Orthopaedics and Sports Physical Therapy. Jan;21(1):21-7.

2. Riewald, S. & Rodeo, S. (2015). Science of Swimming Faster. Champaign, IL: Human Kinetics

3. Castro, J., Minghelli, F., Floss, J., & Guimaraes, A. (2002). Body roll angle in front crawl swimming in different velocities. Biomechanics and Medicine in Swimming. Etienne, France: University of St. Etienne.

4. McCabe, C. & Sanders, R. (2012). Kinematic differences between front crawl sprint and distance swimmers at a distance pace. Journal of Sport Sciences, 30(6):601-608

5. Neuman, D. (2010). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. St. Louis, Missouri: Mosby Elsevier.

6. Laudner K, Williams J. (2013). The relationship between latissimus dorsi stiffness and altered scapular kinematics among asymptomatic collegiate swimmers. Physical Therapy In Sport. Feb;14(1):50-3.

7. Hibberd EE, Laudner KG, Kucera KL, Berkoff DJ, Yu B, Myers JB. (2016). Effect of swim training on the physical characteristics of competitive adolescent swimmers. American Journal of Sports Medicine. Nov;44(11):2813-2819.