The Hand the Elbow and the shoulder
These three anatomical joints are worth considering in relationship to the shoulder complex as a continued investigation from previous articles on this subject. Let’s start by taking note that each one of these joints has its own unique function and structure. For example: the hand alone has 26 bones, 33 joints, and a multitude of ligaments and muscles. As swimmers we might not need to know all the names of the bones, or joints held within this evolutionary masterpiece. One could draw a comparison from this anecdote. A noble knight on his random ride came upon his enemy, across the way. The archers let go of their arrows, as they flew across the void. After falling from his horse, the noble knight cried, “who shot me”? “How did he hit me from over there, who is this archer”?
This line of questions and inquiring into details not worthy of our attention. Why does one need to know all the details of who shot the arrow, how far away he was? No! Just get the poison arrow out of your leg!!
I draw a parallel to not having to know how many bones in your hand, Interesting as it might be, but not essential. But this line of inquiry might be worthy of our attention, especially if you are considering how to swim in an efficient way. Don’t waste time paying attention to details beyond your scope at that given moment.
The beginning: Please consider when swimming, where is your hand?
It does not matter at what point you start from; at the front end of the stroke, or at hand entry into the water, perhaps the catch phase, or pull, or recovery phase. Where is your hand? The position of the hand gives a wonderful insight to the affect it has on the elbow. For example: rotation at the hand and wrist will have a dramatic consequence to the position of the elbow (Ulnar and the radius). These two long bones form parts of the elbow in the forearm. One being medial (midline) one being lateral (Outside towards the outer edge). At the wrist these two bones form medial and lateral joints forming parts of the wrist joint.
The elbow joint is a link between the shoulder, wrist and hand; its function is to provide, stability and motion. Allowing movement at the elbow joint will facilitate arm movements at the shoulder, wrist and hand. When the elbow is static it provides an anchor or brace supporting movement at the shoulder complex. This being important for swimmers as the arm is the main element in propulsion of the body through the water. The elbow joint is made up from 3 parts: The radio humeral joint this allows movement between the radius and humerus. The ulnohumeral joint, this is between the ulna and humerus.
The superior radioulnar joint, this is between the radius and ulna. These are all contained within the joint capsule. The main movements occurring at the elbow joint are flexion, extension, pronation and supination. The biomechanics of the elbow joint are all affected by the bones, muscles and ligaments.
Forearm rotation, this occurs as the radius wraps around the ulna, guided by the muscles from the wrist and elbow joints, these also contribute to upper arm mobility. Forces at the wrist affect the transmission of force through the forearm and the elbow joint, these motions are stability and force interactions, this allows for the forearm to function. It should be noted that an event at the elbow joint affects the forearm and the wrist, and conversely injury at the wrist joint can affect the elbow and the shoulder complex.
Elbow stability
The biomechanical stability of the elbow joint is maintained through action of both active and passive stabilizing structures:
Active stability this is dependent on the action of muscles providing joint compressive forces.
A number of muscles cross the elbow joint which on contraction can create an important dynamic role in stabilising the joint. Passive structure are the ligaments and connective tissues holding the joint together.
Please imagine your arm as it enters into the water and extends forward in front of your shoulder, this is followed by an underwater pull-through, which starts with the early pull-through phase, which is marked by the initiation of the backward arm movement. The palm and forearm should face the back- ward direction with the fingertips pointing down. The point at which the forearm is perpendicular to the body is called the mid pull-through. After mid pull-through is the late pull- through. The hand continues back and passes next to the hip until it exits the water, leading with the elbow. After the arm exits the water, the recovery phase begins.
It is worth noting that shoulder pain in swimmers are reported in two main phases: the early pull through to mid pull through phase and the second is on hand exit to mid recovery phase; your hand as it leaves the hips and travels out of the water in the recovery phase. The pain may still be present until mid-recovery phase, before the hand, elbow move forward to start the cycle again.
Swimmers who have painful shoulder may shorten the length of the pull-through, or adopt a wider hand entry position to try and stop the pinching of the supraspinatus muscle in the front of the shoulder.
Points
Don’t over rotate your torso more than 40-45 degrees, this can lead to hyperextension of the head of the humerus (ball and socket) in the shoulder.
Common for swimmers to over rotate when breathing to one side.
If you try the catch-up drill this can minimise the over rotation.
Hand position on water entry, (over-rotations) of the shoulder can lead to impingement and injury.
Larger muscle groups
Establishing how the hand plays an important role in the force transmitted to the elbow in freestyle swimming is vital, not only in creating less resistance, from its position in the water, but also in propulsion of the body through the water. The surface areas of the hand and forearm combined makes for an efficient use of the main propulsion unit of swimming. The hand position carries with it an anatomical functional reciprocity with the elbow and the shoulder complex as they work together. Some hand positions may not be an advantage as seen in the over pronation’s at the hand when it enters the water at the front end of the swim stroke. When the thumb enters the water first as the hand is turned sideways, (pronated).
This hand position, was once considered a benefit in decreasing water resistance, drag. Over pronation has been suggested to increase the shoulders chances of injury, by the nature of impingements of the rotator cuff muscles. Thinking about swimmer’s shoulder conditions, we decided to look into some common injuries in this area. The results highlighted, potential injuries from freestyle swimming could be related to the dysfunction of the Serratus anterior and Subscapularis muscle.
In healthy swimming shoulders, the serratus anterior muscle fire’s continually, at about 20% of its maximum. The role of the serratus anterior is to stabilize the scapula against the rib cage as the arm pulls the body over it, (in mid pull-through phase). In swimmers with painful shoulder this muscle has been shown not to be as active in the pull-through. The scapula needs to form a solid base from which the arm can pull against, overcoming the water resistance, and creating propulsion for the swimmer. To compensate for the lack of contraction of the serratus anterior an adjacent muscle (Rhomboids) will contract as an attempt to stabilize the scapular. This action could well be responsible for altered positioning of the acromion, thus impinging the rotator cuff muscle. The rotator cuff muscles are the Supraspinatus, Infraspinatus, Teres minor, and subscapularis. This group of smaller muscles act to stabilize the scapular and keep the GH joint, (ball and socket joint) of the shoulder in a stable position.
The subscapularis muscle in swimmers also continues to fire at 20% max, in a healthy shoulder. In swimmers who have painful shoulders this muscle plays a less active role in the pull-through. This may suggest how compensations and altered scapular positions affect the shoulder joint, especially on longer swim distances. When fatigue sets in posture and alignment suffer creating hazards to harrowing to mention in this wild open swim blog.
One thing to save our asses is understand this: The Latissimus dorsi (Lats) and Pectoralis major (Pecs) are the primary power muscles during swimming. Yeah! So: get to know these and learn how to use them.
My journey into visualization of bones, joints, and actions just got more interesting. Fine tuning these details of hand positions in relationship to the elbow and shoulder. My understanding of the power muscles involved in swimming helps focus the mind, paying attention to details that matter and starting on the effective swimming stroke that seems to be the elusive obvious.
Key points for the next article in your swim life
Learn how to keep these two muscles healthy and function correctly, this is a good way to avoid shoulder injuries and pain. Who wants to give up the beauty of open water swimming for the sake of these two vital swimming muscles?
Serratus anterior
Subscapularis
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