Why swimmers get hurt

Competitive and masters swimmers can cover thousands of metres a session, with most of the propulsion coming from the shoulders. The NHS describes otitis externa as an inflammation of the outer ear canal, often linked to swimming. Open water adds cold water, currents and limited visibility, and WHO's drowning fact sheet reminds that even capable swimmers can get into trouble.

01Swimmer's shoulder

Repetitive overhead strokes, especially with poor technique, fatigue or a sudden jump in distance, can irritate the rotator cuff tendons. The NHS lists overuse among the common causes of shoulder pain.

What helps

  • Have your stroke technique reviewed, particularly hand entry and body rotation.
  • Increase distance gradually and vary strokes.
  • Strengthen the rotator cuff and shoulder blade muscles out of the water.
  • Reduce or modify training (for example kick sets) when pain appears.

02Swimmer's ear

Water that stays in the ear canal softens the skin and makes infection more likely. Symptoms include ear pain, itching, discharge and muffled hearing. The NHS advises not using cotton buds and keeping the ear dry while it heals.

What helps

  • Dry your ears gently after swimming; tilt your head to drain water.
  • Use earplugs or a swim cap over the ears if you are prone to infections.
  • Do not put cotton buds or fingers in your ear canal.
  • See a pharmacist or doctor for ear pain or discharge.

03Open-water risks

Cold water shock, currents, fatigue and poor visibility make open water riskier than a pool. WHO highlights supervision and safe rescue skills as key protections.

What helps

  • Swim with others or at supervised venues, and use a bright tow float.
  • Acclimatise to cold water gradually and wear a wetsuit when appropriate.
  • Know your exit points and check conditions before entering.
  • Never swim after drinking alcohol.

Weekly checklist for swimmers

  • Do shoulder strengthening exercises twice a week.
  • Track weekly distance and avoid large jumps.
  • Dry your ears after every swim.
  • Vary strokes and include technique sets.
  • Check open-water conditions before every swim.
  • Rest a day after unusually long sessions.

When to see a professional

  • Shoulder pain that lasts more than a few weeks or wakes you at night.
  • Ear pain, discharge or hearing loss that does not settle in a few days.
  • Repeated ear infections.
  • Weakness or clicking in the shoulder.

If someone is in difficulty in water, call for help and emergency services, throw something that floats rather than going in unless trained, and start CPR if they are not breathing once out.

Where ONU fits

ONU brings your activity, sleep and recovery trends together, so you can see how training blocks affect your recovery. It does not detect shoulder injuries or ear infections; those need a professional.

Try ONU Health today

Common questions

What causes swimmer's shoulder?

Repetitive overhead strokes, fatigue, technique faults and sudden increases in training. Strength work and technique coaching help.

Do ear drops prevent swimmer's ear?

Some people use acidifying drops after swimming, but ask a pharmacist or doctor first, especially if you have a perforated eardrum or grommets.

Is cold water swimming safe?

It can be done safely with gradual acclimatisation, supervision and short swims. Cold water shock can cause gasping and panic, so enter slowly.

Sources and further reading

Educational information drawn from the public-health sources listed on this page. It is not a diagnosis, a treatment plan or a guarantee that you will avoid an illness or injury. ONU does not diagnose, treat or prevent disease. Speak to a qualified professional about anything that concerns you, and follow the rules of your employer, sport or local health service.