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Data Source: Zamparo P, Bonifazi M (2013). Bioenergetics of cycling sports activities in water.

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Brief Swimming Review Volume 1 Edition 2

In an attempt to improve swimming transparency, a brief swimming related literature review will be posted on Saturday. If you enjoy this brief swimming review, consider supporting and purchasing the Swimming Science Research Review.

Lactate Threshold Alters Swimming Kinematics
It is not surprising that a recent study found swimmers who reached lactate threshold incurred stroke kinematic changes (Figueiredo 2013). Now, one must determine if this threshold level improves with training, or if training can improve the velocity below lactate threshold...

Hand Paddles Increase Swimming Velocity and Stroke Length
Paddles alter swimming kinematics by increasing velocity and distance per stroke, while decreasing stroke rate (López-Plaza 2012). These changes likely occur from an increase in propelling area. These alterations sound find, but is a greater propelling surface on the hand encouraging athletes to pull a moving hand past their body, not move their body past a stationary hand? Also, do paddles discourage the use of the forearm (a larger surface than the hand) as a propelling surface? [Stay tuned for the the audio podcast with Dani López-Plaza].

The Science Behind Hand Paddles

Track and Grab Start are the same? 
Despite the anecdotal use of the track start, coaches still argue about the best starting style. One could argue the principle of individuality applies, especially as no significant differences were noted between these two start styles (Thanopoulos 2012). Yet, in this study, no mention of the swimmer’s abilities (other than being trained) or their starting style preference was noted. It is likely their starting style preference plays a large role in their starting ability. Moreover, the parameters off the blocks are not sufficient in determining the ideal starting style, as velocity in the water and to 10/15-meters is more appropriate.

Yet, more research is necessary on the Omega Track Start. 

Omega Track Start Tragedies Part I

Breast stroke Technique
Many feel breast swimmers have the most variable kinematics. A recent study by Martens (2012) looked at the kinematics of wave-breast, noting foot supination at the end of the kick increased water displacement. Inward sculling grabbed more water than outward sculling. The wave breast swimmer paddled downward pull. The added mass increases water displacement.

Supination at the end of the kick is essential for breast swimmers. However, the role of the downward pull for a wave-like breast appears unnecessary and decrease force production and horizontal velocity.

Science of Performance: Breaststroke

Depression and Swimmers
With Men's NCAA starting today, let us not forget the potential of post-exercise depression in elite swimmers.

"Before competition, 68% of athletes met criteria for a major depressive episode. More female athletes experienced depression than their male peers (P = 0.01). After the competition, 34% of athletes met diagnostic criteria and 26% self-reported mild to moderate symptoms of depression. The prevalence of depression doubled among the elite top 25% of athletes assessed. Within this group, performance failure was significantly associated with depression (Hammond 2013)".


Giving them the tools for long-term health is essential and it doesn't just end at a swim meet!

Effects of Flavanoid Rich Drink of Elite Swimmers
 Post-exercise drinks are a massive market, with minimal to no supporting research. 

"In a randomized, crossover design with a 3-wk washout period, swimmers (n = 9) completed 10-d training with or without 16 fl oz of JUICE (230 mg flavonoids) ingested pre- and postworkout. Blood samples were taken presupplementation, post-10-d supplementation, and immediately postexercise (Knab 2013)".

Compared to the controls, the swimming workouts minimally alter inflammation, oxidative stress, and immune markers. Moreover, these drinks did not significantly alter "resting levels or postexercise inflammation, oxidative stress, immune function, and shifts in metabolites (Knab 2013)".

Overall, this high anti-inflammatory and anti-oxidant drink did alter the physiology of elite swimmers. This suggests dismissing these drinks, but performance, arguably the most important variable, was not assessed, making more research necessary, as the "influential variables" may not have been analyzed.

The Main Set, Auburn Sprinters | Weekly Wednesday

References
  1. Hammond T, Gialloreto C, Kubas H, Davis HH 4th. The Prevalence of Failure-Based Depression Among Elite Athletes. Clin J Sport Med. 2013 Mar 22. [Epub ahead of print]
  2. Knab AM, Nieman DC, Gillitt ND, Shanely RA, Cialdella-Kam L, Henson DA, Sha W. Effects of a flavonoid-rich juice on inflammation, oxidative stress, and immunity in elite swimmers: a metabolomics-based approach. Int J Sport Nutr Exerc Metab. 2013 Apr;23(2):150-60.
  3. Martens J, Daly D. Qualitative evaluation of water displacement in simulatedanalytical breaststroke movements. J Hum Kinet. 2012 May;32:53-63. doi: 10.2478/v10078-012-0023-7. Epub 2012 May 30.
  4. Thanopoulos V, Rozi G, Okičić T, Dopsaj M, Jorgić B, Madić D, Veličković S, Milanović Z, Spanou F, Batis E. Differences in the efficiency between the grab and track starts for both genders in greek young swimmers. J Hum Kinet. 2012 May;32:43-51. doi: 10.2478/v10078-012-0022-8. Epub 2012 May 30.
  5. López-Plaza D, Alacid F, López-Miñarro PA, Muyor JM. The Influence of Different Hand Paddle Size on 100-m Front Crawl Kinematics.J Hum Kinet. 2012 Oct;34:112-8. doi: 10.2478/v10078-012-0070-0. Epub 2012 Oct 23.
  6. Figueiredo P, Morais P, Vilas-Boas JP, Fernandes RJ. Changes in arm coordination and stroke parameters on transition through the lactate threshold. Eur J Appl Physiol. 2013 Mar 21. [Epub ahead of print]
By Dr. G. John Mullen received his Doctorate in Physical Therapy from the University of Southern California and a Bachelor of Science of Health from Purdue University. He is the founder of the Center of Optimal Restoration, head strength coach at Santa Clara Swim Club, creator of the Swimmer's Shoulder System, and chief editor of the Swimming Science Research Review.

December Swimming Science Research Review

The December edition of the Swimming Science Research Review was published on Saturday December 15th (remember if you sign-up for the December edition, you'll receive an exclusive paper on dry-land for swimmers!). Below are the articles reviewed in this edition. Most notably was an outstanding study on the effects of pre-exercise non-steroidal anti-inflammatory drugs (NSAIDs) on the intestinal lining of the gut. 

In this study, Van Wijck found taking NSAIDs the night and morning before endurance exercise resulted in intestinal wall damage more than exercise alone. This suggests this practice should not be followed, despite it's common use on swim decks. However, this study did require athletes to consume this medication on an empty stomach, potentially not providing a protective lining to the gut upon consumption. Nonetheless, it seems NSAIDs prior to exercise is not necessary and likely causes intestinal gut damage, especially since it seems inflammation is necessary for improvement (Inflammation in Sports).

Another key area reviewed were those addressing myofascia. Myofascia is described as a layer of fibrous tissue which surrounds muscle and is typically discussed in rehabilitation circles, but little is known about its composition or response to manual therapy, especially in painful patients. However, it seems myofascial trigger points (MTrP) correlate with pain in multiple joints (Muñoz-Muñoz 2012; Shah 2012). Moreover, manual myofascial techniques  may result in improved immune system response (Fernández-Pérez 2012). However, trigger point release therapy for 60-seconds around the hip yielded no improvements in muscle torque in those with patello-femoral knee pain (Roach 2012). This brings up three different possibilities: 
  1. Trigger point pressure release therapy is not effective for improving the myofascial trigger point.
  2. The MTrP only correlates, but does not cause the pain.
  3. The application of the trigger point pressure release therapy method was not correct (possibly too short of a session, maybe to the wrong muscles). 
Future studies on myofascial are required, as many rehabilitation specialist utilize these techniques with favorable results.
$10/month



December 2012 
Unexpected Hip Abnormalities in Asymptomatic Adults
Laser Treatment for Knee Pain
Effects of Shoulder Mobility Deficits on Shoulder Biomechanics
Inflammation in Ultra-Endurance Exercise
Inflammation, Endurance Exercise, and the recovery response
Analysis of Elite Flip Turn Kinematics
Hip Muscle Activation during Common Rehab Exercises
Myofascial Trigger Points in Patellofemoral Pain Syndrome
Trigger Points in the Hip for those with Knee Pain
Can bad posture induced by backpacks be fixed with education?
Training for Aerobic Capacity and Hypertrophy Simultaneously
Night Time Calf Cramps
Accuracy of Physical Shoulder Tests
Comparison of Shoulder Tests
Trigger Points and Sleep Quality for those with Neck Pain
Improving Scapular Positioning with Rehab Exercises
Transverse Abdominus Activation and Drawing-In
Effects of Myofascial Techniques on the Immune System
Searching for Trigger Points
Taking Ibuprofen prior to training: Potentially Dangerous
Assessing performance of a squad based on competition
Genetic factors influencing odds of tendon injuries
Movement Perception ability and Lower Back Pain 

$10/month

References:
  1. Muñoz-Muñoz S, Muñoz-García MT, Alburquerque-Sendín F, Arroyo-Morales M, Fernández-de-Las-Peñas C.Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain.J Manipulative Physiol Ther. 2012 Oct;35(8):608-13. doi: 10.1016/j.jmpt.2012.09.003.
  2. Fernández-Pérez AM, Peralta-Ramírez MI, Pilat A, Moreno-Lorenzo C, Villaverde-Gutiérrez C, Arroyo-Morales M. Can Myofascial Techniques Modify Immunological Parameters? J Altern Complement Med. 2012 Nov 23. [Epub ahead of print]
  3. Ahah JP, Phillips TM, Danoff JV, Gerber LH. An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle. J Appl Physiol. 2005 Nov;99(5):1977-84. Epub 2005 Jul 21.
  4. Roach S, Sorenson E, Headley B, San Juan JG. The prevalence of myofascial trigger points in the hip in patellofemoral pain patients. Arch Phys Med Rehabil. 2012 Nov 2. doi:pii: S0003-9993(12)01079-9. 
  5. VAN Wijck K, Lenaerts K, VAN Bijnen AA, Boonen B, VAN Loon LJ, Dejong CH, Buurman WA. Aggravation of exercise-induced intestinal injury by Ibuprofen in athletes. Med Sci Sports Exerc. 2012 Dec;44(12):2257-62. doi: 10.1249/MSS.0b013e318265dd3d.

Inflammation in Sports

Inflammation in sports is a baffling subject. Some view inflammation as beneficial, while others consider it detrimental. This subject is confusing as inflammation occurs in seemingly two different scenarios. For example, how can inflammation after exercise be beneficial, where inflammation about injury is harmful if both are the same process?

This article tackles the difference between inflammation after injury and exercise while providing a practice approach for using common anti-inflammatory medication.

Spotting Inflammation
There are five attributes to inflammation in sports:
  • Redness, swelling, heat, pain, loss of function
Moreover, pain all the time (not only during movement) and pain in the morning are typical signs of inflammation. Increased joint fluid increases pressure on pain receptors (nocioceptors), causing pain all the time. If pain is worse in the morning, it is likely inflammation surrounds the joint, as muscle contractions did not pump the fluid away from the joint during sleep. This increased fluid increases the pressure on pain receptors increasing pain during the morning.

Exercise Induced Inflammation
Many feel inflammation in sports help long-term strength gains as inflammation repairs damaged muscle fibers following exertion. Mishra in 1995, determined supplementing a strength training group with anti-inflammatory medication had an acute increase in strength, compared to the control group. This increase persisted at 7 days, but at 28 days the medication group experienced a step back, as their maximal muscle tension dropped by about 1/3 of their maximum tension.

It appears anti-inflammatory medication resolves acute exercise induced inflammation resulting in increased strength, as it would allow them to recover and be stronger, as they less sore from the muscle fibers being destructed during the exercise.

However, the mechanism which NSAIDs improve acute performance has not been justified:
“anti-inflammatory doses of ibuprofen reduced CK activity but not the neutrophil response or other indirect markers of muscle injury during recovery from eccentric arm exercise (Pizza 1999).”

After training Gulick performed an analysis of many types of treatment and concluded:

“none of the treatments were effective in abating the signs and symptoms of DOMS. In fact, the NSAID and A. montana treatments appeared to impede recovery of muscle function (Gulick 1996).”

Therefore, it seems NSAIDs improve acute strength with NSAID, but it seems to prevent overall recovery of muscle and strength gains.

This is perhaps from NSAIDs masking the amount of damage during exercise, allowing the body to do more damage without allowing proper recovery time. Don't beat yourself while you're down!

No study has directly studied NSAIDs on in-water strength, but one could guess NSAIDs would impair in-water strength development. This loss of strength impairs swimming progress as in water strength (especially of the upper body) correlates with speed (Hsu 2000).

Injury Induced Inflammation
After any musculoskeletal injury inflammation occurs. This process increases the volume of fluid in an unwanted area. When too much fluid is in a confined area, the amount of mechanical pressure increases. This mechanical pressure presses on nocioceptors and causes pain. Pain inhibits strength and athletic performance, therefore resolving this mechanical pressure is mandatory to move the injury from inflammation to remodeling.

The best method to improve this is with homeopathic and over-the counter medication. Combining Ginsenosides and Large volumes of NSAIDs helps inflammation by helping the medication reach 'titer level' or the minimum effective level (Read more about tips to improve shoulder inflammation) (note: take with food and watch stomach irritation).
Once the inflammation subsides, discontinuing the anti-inflammatories is essential for improving strength (see below).

If you are looking for short-term improvement whether you are at a competition or injured, NSAIDs acutely improve strength. However, if you’re seeking long-term strength gains, do not use NSAIDs to trick the body into working harder or not letting inflammation to aide full repair and remodeling, essentials for muscle strength.

Last Point
Lastly, the chronic use NSAIDs appears damaging to tendons.

In rats, Dimmen 2009 determined:
“We found a significantly lower tensile strength in rats given both parecoxib and indomethacin (anti-inflammatory medications) compared to the control group. Stiffness in the healing tendons was significantly lower in the parecoxib group compared to both the placebo and the indomethacin groups. The transverse and sagittal diameters of the tendons were reduced in both the parecoxib and indomethacin groups. Both parecoxib and indomethacin impaired tendon healing; the negative effect was most pronounced with parecoxib (Dimmen 2009).”

This has not been proven in humans, but is worrisome nonetheless.
Summary
Make sure you are not abusing NSAIDs and use them properly, as overuse is damaging and reckless. Follow these simple guidelines:
  • Only take NSAIDs after an acute musculoskeletal injury
  • Discontinue intake after inflammation resolves
  • Do not take NSAIDs after exercise unless at a competition, where performance not strength gains are most important
References:
  1. Pizza FX, Cavender D, Stockard A, Baylies H, Beighle A. Anti-inflammatory doses of ibuprofen: effect on neutrophils and exercise-induced muscle injury. Int J Sports Med. 1999 Feb;20(2):98-102.
  2. Gulick DT, Kimura IF, Sitler M, Paolone A, Kelly JD. Various treatment techniques on signs and symptoms of delayed onset muscle soreness. J Athl Train. 1996 Apr;31(2):145-52.
  3. Dimmen S, Engebretsen L, Nordsletten L, Madsen JE. Negative effects of parecoxib and indomethacin on tendon healing: an experimental study in rats. Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17(7):835-9. Epub 2009 Mar 19.
  4. Hsu, K. M., & Tsu, T. G. The relationships among shoulder isokinetic strength, swimming speed, and propulsive power in front crawl swimming. Medicine and Science in Sports and Exercise. 2000 32(5).
  5. Defreitas JM, Beck TW, Stock MS, Dillon MA, Kasishke PR 2nd.An examination of the time course of training-induced skeletal muscle hypertrophy. Eur J Appl Physiol. 2011 Mar 16.
By G. John Mullen founder of the Center of Optimal Restoration, head strength coach at Santa Clara Swim Club, creator of the Swimmer's Shoulder System, and chief editor of the Swimming Science Research Review.