Review ArticlesSwimming Overuse Injuries Associated With Triathlon TrainingBales, James MD*; Bales, Karrn DO†Author Information *US Air Force Academy, Colorado Springs, CO †JKB Medical Exams, Monument, CO Disclosure: The authors declare no conflict of interest. Reprints: James Bales, MD, 18270 Bent Oak Lane, Monument, CO 80132. Sports Medicine and Arthroscopy Review: December 2012 - Volume 20 - Issue 4 - p 196-199 doi: 10.1097/JSA.0b013e318261093b Buy Metrics Abstract Most triathlon overuse injuries occur due to the running and cycling aspects of the sport. By nature of swimming being a non–weight-bearing sport, triathletes have a tendency to use swimming for rehabilitation and recovery. Swimming has a significantly lower injury rate than the other 2 disciplines in a triathlon. Most triathletes use the freestyle stroke, because it is typically the first stroke learned, it is for many the fastest stroke, and by lifting the head the freestyle stroke allows triathletes to sight their direction, which is important in open water swimming. During the freestyle stroke, the shoulder undergoes repetitive overhead motion, and shoulder pain is the most common and well-documented site of musculoskeletal pain in competitive swimmers. It is felt that the pathologic process is attributable to repetitive overhead motion causing microtrauma in the shoulder from either mechanical impingement or generalized laxity or both. Without sufficient rest and recovery, the development of inflammation and pain may result. Depending on the age of the triathlete and the exact etiology of the shoulder pain, treatment options range from nonsurgical to surgical in nature. © 2012 Lippincott Williams & Wilkins, Inc.