Dr. Brian Cunningham

To teach a neck breather to breathe more efficiently, have them rest their head and put their hand on their stomach. Ask them to breathe into the floor and fill the space. Have them practice belly breathing while lying on their stomach and back, focusing on relaxing their neck and pushing their belly into the floor with each breath.
 
Transcript: "How do I teach a neck breather? How to change the way that they breathe, obviously for a more efficient Breathing, by changing the position and eliminating their head, and their neck? What I mean by that is a couple of easy positions are taking the head out of it. If you just rest your head, put your hand on your stomach and ask the athlete to breathe into the floor and fill this space. So it's a looks like this. So, you're going to breathe. And you want them to fill this whole area and then you can observe and also put your hands on their neck. You don't want this to be happening. You want the movement to come here and then into the floor or you can get them to put their hand down here and get them to breathe and so, just relax their neck. Another position would be on your stomach, I'm going to turn my head but normally I put my head down and I call it belly breathing. So you're going to see. I'm going to take a breath in Can you feel that your belly pushes into the floor and this raises up. So here goes again. And then the last position would be on your back. Same thing breathing into here and here relax."

When working with swimmers to avoid shoulder pain, it is important to identify the root cause of the problem. It could be fatigue, muscle imbalance, hypermobility, or a mechanical problem. Strengthening the shoulder alone may not be enough, and it's important to look at the misuse rather than overuse of the shoulder. If you need more help with this, please reach out!
 
Transcript: "Hey, Jude. Brian here, physical therapist specialized in swimmers. How to avoid shoulder pain in swimming? There's a couple of things that you want to understand when working with swimmers and why they get pain. It can be because of fatigue. It can be because of a muscle imbalance. It can be because of hypermobility, where they are stiff or hyper, where they are too flexible, or a mechanical problem. And I think too many people think there's a muscle imbalance and they go to a physical therapist and they'll do some strengthening of the shoulder. What you really need to look at is the root cause of the problem. Swimming is a mechanical problem. I alluded to this before in another post that the athletes that I see on a regular basis are not the elite athletes. I'm lucky enough to have worked with three Olympic teams. But on a daily basis, it's athletes that aren't at that level. And so I think it's more misuse than overuse. So hopefully that gives you some ideas. If you have any questions and you'd like some help, please reach out to me."

Ankles may hurt and feel stiff due to tight muscles or joints, which can be treated with stretching and mobilizations. Common causes include wearing heels and jump roping.
 
Transcript: "Why might someone his ankles hurt and feel stiff to reasons because of a tight muscle in the back, or a joint? And how you'll figure that out? Is if you stretch your calf muscle and you do some stretches like this or your Achilles muscle, where you, bend your knee, and then you can do some try planar movements and if that improves it, then you know, that that's a stiff muscle. If it And then you may need to do mobilizations to your ankle. A lot of times when you have an unresolved ankle sprain, there's a joint here or bone called your fibula. And sometimes that gets stuck and in order for you to be able to squash, which is one of the main things that I find, that people lack the ability to do, which can affect the whole kinetic chain. So, I sometimes more Mobilize or put a tape on here and then see if you can do your activities. Some causes of this are wearing heels or a lot of people do jump rope and then it puts tightness on here. And then when they're trying to squash it limits, this ability to move over here, which then affects their lower back when they're squatting and sometimes people come in with back pain but it's caused from their ankle."

Jim suggests bodyweight movements such as squatting, lunging, pushing, pull-ups, chin-ups, and lat pull-downs for swimmers. Additionally, he recommends bracing exercises such as planks in different positions. If more specific help is needed, Jim can be contacted directly.
 
Transcript: "Recommended Jim programs for swimmers. I'm not quite sure what you're asking Amber, but you really want to get a personalized program, but there are some general movements that you need to be able to do. So thinking about swimmers, you need to be doing a lot of pulling, maybe some pushing movements from squatting hip hinging bracing, turning twisting, those type of movements so do machine. Ins work they can do if you're inexperienced what lifting but you really want to do free weights and I would initially start off with bodyweight movements of squatting. Lunging, pushing push-ups with varied hand positions, pull-ups. Okay, chin-ups, any of that type of lat pull-downs. Okay. Bracing, what are you were doing different types of Planks on your side, on your back, on your Front what arm movements, any of those type of movements. But if you'd like more specifics, please reach out to me directly and and I can help you with that."

Prior injury and not rehabbing old injuries correctly are the two main predictors of an injury. It is important to maintain regular injury prevention in order to avoid future injuries.
 
Transcript: "How many I would say the number one predictor of an injury as having a prior injury. Take for instance, I saw a lady yesterday who had back surgery in 2018 and completely got rid of her leg ping, however, surgeon didn't send her for rehab in anyway. So just because you get rid of the pain and this is typical for Weekend Warriors and regular people, not so much Elite athletes because they always tend It rehab, but it's somebody, that either twists, her ankle and just because the pain goes away, doesn't mean that movement, compensations and how you dealt with that totally resolve on their own. You need neuromuscular, re-education to allow those movement patterns to breathe to be up by reloaded, and kind of upload new software into your movement profile. So, I think prior injury and not rehabbing Your old injuries, correctly is another predictor, and I think it's just really good that we should look at this function. This function is something that's just not operating right now. Whether it's something that you're tied or unstable, you don't want to wait till the injury occurs, you want to try to catch that beforehand. So I would agree. Number one is prior injury, and number two would be not rehabbing all day. Injuries correctly and not maintaining what you do on a regular basis for injury prevention. Hope that helps"

Breathing exercises out of the water are vitally important for swimmers for a number of reasons. These exercises help reset your system after intense races and workouts, as well as help with strength, race performance, stroke mechanics, and shoulder activation. Diaphragmatic breathing is the most efficient form of breathing, and physical therapists can assess breathing patterns in order to help athletes become more efficient.
 
Transcript: "Michael, this is a brilliant question. Yes, I think breathing exercises out of the water are vitally important for every athlete, but really important for swimmers for a number of reasons. The more efficient you can be with breath control and how you're breathing and where your breathing comes from can affect many different systems. If you think about fight or flight or as a recovery, breathing can help, diaphragmatic breathing from down here, can help reset your system and really bring you down from that workout or intense race. It helps you to calm down. But as a physical therapist that specializes in swimmers, I will look at swimmers' breathing and how the rib mechanics, where to breathing is coming from, do use their neck muscles too much. So you have three types of breathing. You have apical breathing, you have chest breathing and belly breathing. And there's many different theories on where we should breathe from, but if you can be really efficient, it can impact your strength negatively and positively. It can affect how you race, how you turn your head, and how your stroke mechanics are and it can affect your shoulders. So if you think about if you're breathing and you're lifting your chest, that can affect the position and the stability and activation of your shoulder muscle. So I look at it quite a bit and really teach athletes to be able to do the three types of breathing and understand when you need to do that. But the quicker you can get back to diaphragmatic breathing, that will help you to recover between sets. The one trick is when I'm assessing people, I look at it at resting and just when they're talking and I'm getting them to do movements, I'm looking at their breathing. I won't necessarily tell them up front that I'm looking at the breathing, because then they're going to naturally change it."