A Retrospective Career-Long and Seasonal Study of Injury Patterns in 196 Elite Swimmers: The Role of Primary Discipline and Competitive Distance

Elite swimming is characterized by high training volumes, which increases the risk of overuse injuries. Detailed information on whether specific disciplines or competitive distance matters for the occurrence of injuries is sparse. This study aimed to describe the injury epidemiology among elite swimmers and to identify potential explanatory factors. We employed a retrospective, self-reported design, with the known limitations of recall bias. In June 2024, a questionnaire was sent to elite swimming clubs across Denmark, Norway, and Sweden. A total of 220 swimmers completed the questionnaire describing training and injury characteristics in the 2023/2024 season and injury history from their entire swimming career. Throughout their careers, 128 out of 196 swimmers experienced at least one injury, resulting in a total of 183 injuries. We documented 113 injuries in 93 participants during the 2023/2024 season. For the 2023/2024 season, a total of 73 580 athlete exposures (AEs) were recorded, yielding an injury incidence of 1.54 injuries/1000 AEs. The shoulder was the most prevalent injury site (0.87 injuries/1000 AEs). Injury location appeared to differ across primary disciplines. When looking at overall injury incidence across disciplines, butterfly and breaststroke swimmers showed a slightly higher numerical injury incidence than other disciplines, although non-significant (1.69 and 1.58 vs. 0.98 injuries/1000 AEs). Finally, freestyle sprinters had a higher injury incidence compared to freestyle long-distance swimmers (rate ratio = 2.17, 95% CI 1.15–4.31). This indicates that both discipline and competitive distance play important roles in the risk for injury in elite swimming. However, due to the limitations of the study design, this should be interpreted with caution.