Child Swimming Development and Prevention of Shoulder Overuse Injuries

Introduction

Swimming is one of the most common extracurricular activities for children in Taiwan. Building water confidence, physical fitness, and self-rescue skills from a young age are all good reasons to have children learn to swim. However, as competitive swimming training starts earlier and earlier, more and more children are undertaking high-intensity, high-volume training programs while their skeletons are still immature. Understanding the physiological characteristics of children’s swimming and injury patterns is a crucial issue for parents and coaches in protecting young athletes.

The Unique Nature of the Pediatric and Adolescent Shoulder Joint

Vulnerability of the Growth Plate (Epiphyseal Plate)

The ends of children’s long bones contain growth plates (epiphyseal plates), which are cartilage tissue responsible for longitudinal bone growth. The tensile strength of the growth plate is far lower than that of mature bone, meaning the same external force is more likely to cause growth plate injuries in children rather than ligament or tendon injuries (because ligaments are stronger than growth plates).

• Growth plate closure timing: Most bone growth plates fully close between ages 14–16 in girls and 16–18 in boys
• High-intensity training before closure: Repetitive impact may lead to growth plate stress fractures or deformity

Common Overuse Injuries of the Pediatric Shoulder

Health Benefits of Swimming Training for Children

Appropriate swimming training offers numerous benefits for children’s physical and mental development:

• Cardiorespiratory fitness: Improves VO₂max, building a lifelong foundation for aerobic capacity
• Muscular coordination: Swimming’s multi-planar movements promote neuromuscular coordination development
• Posture: Helps correct postural issues common in modern children, such as prolonged forward head and rounded shoulders
• Mental health: Regular exercise reduces the risk of anxiety and depression in children, and swimming in particular offers a relaxing effect from being in the water
• Sleep quality: The proportion of deep sleep increases after swimming, supporting growth hormone secretion in children

Warning Signs of Overtraining and How to Respond

Parents should watch for the following signals:

• The child persistently complains of shoulder pain before and after swimming (>1 week)
• Obvious asymmetry in swimming movements (one arm visibly weaker during the stroke)
• Refusing to go to swimming practice (may be avoiding pain)
• Nighttime shoulder pain that disrupts sleep
• Limited or weak arm elevation

If any of these symptoms appear, the following steps should be taken:

1. Pause high-intensity swimming training, switching to kickboard work or water-based activities to maintain water comfort
2. Consult a sports medicine physician or pediatric orthopedist
3. If a growth plate issue is suspected, X-ray confirmation is needed

Reasonable Recommendations for Children’s Swimming Training

Training Volume Guidelines (by Age)

Stroke Mix Recommendations

• Under 12 years old: Focus primarily on freestyle and backstroke; butterfly should not exceed 10% of total training volume
• Avoid sudden large increases in training volume before competitions
• Reserve at least 1 full rest day per week

Practical Advice

• Parents should be mindful of their language: Do not let children continue training through pain because of a “can’t lose” mentality. Any shoulder pain lasting more than 3–5 days requires evaluation.
• Choose coaches who prioritize technique over distance: A good children’s swimming coach should prioritize building correct technique rather than targeting training distances.
• Start dry-land supplementary training early: Training for scapular stabilizer muscles (lower trapezius, serratus anterior) can begin lightly with resistance bands from age 10, laying the foundation for shoulder protection.
• Don’t swim only one stroke: Multi-stroke training promotes balanced development across the body and reduces the risk of overuse in specific muscle groups.

Conclusion

Swimming is one of the best athletic gifts you can give a child, but it must be built on healthy training volumes and a solid technical foundation. Parents and coaches should work together to pay attention to children’s physical signals, striking a balance between competitive performance and physical protection, so that Taiwan’s young swimmers can enjoy the sport healthily for years to come.

Related Reading

• Shoulder Overuse Injuries in Child Swimmers: A Complete Guide to Identification, Prevention, and Rehabilitation
• Growth Adaptations in Adolescent Swimming Training: Bone Age and Training Volume Adjustments
• Training Volume During the Growth Period for Adolescent Swimmers: Training Principles for Epiphyseal Plate Protection
• Shoulder Joint Protection for Adolescent Swimmers: Prevention and Early Intervention for Swimmer’s Shoulder