Swimming is considered a symmetrical sport; however, musculoskeletal asymmetries have been reported in strength, range of motion and kinematics. Due to the influence of body position and kinematics on drag, these asymmetries may potentially alter sports performance and, ultimately, vulnerability to injury. Apparently, if an imbalance exists in strength, the athlete will develop compensatory strategies by either summating strength asymmetries or altering kinematic patterns to produce a symmetrical force. This symmetry may protect against injury. However, whether symmetry should be the goal of rehabilitation in swimming populations, particularly as reliable tools for clinical assessment are currently lacking, is still debated. The influence of age, weakness and disability on the presentation of musculoskeletal asymmetry was investigated to gain further insight into asymmetry in populations of elite swimmers. While the exact incidences of both musculoskeletal asymmetry and injury differed in the three distinct groups of elite swimmers examined (junior, senior and Paralympic), 81-85% of swimmers presented with asymmetry of strength, and 100% presented with some form of scapula asymmetry. These findings highlight the need for evidence-based screening protocols in order to develop individualised pre-habilitation and rehabilitation strategies.
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