Risk factors and interventions for injury in competitive swimmers: a scoping review

Competitive swimming involves repetitive, high-load movements that predispose athletes to overuse injuries, particularly affecting the shoulder, lumbar spine and knee. However, prevention programmes often target isolated body regions, limiting their relevance to the range of injury sites and risk factors observed in swimmers. This scoping review aimed to map swimming-related injury risk factors and explore current injury-reduction interventions across body regions. Five databases were searched up to September 2025. Data were extracted by two independent reviewers and synthesized narratively. Of 4,394 studies identified, 58 met the inclusion criteria and included only competitive swimmers. Among 46 risk-factor studies, most focused on shoulder injuries, with fewer examining the lumbar spine or knee. The most frequently reported risk factors were training volume and intensity, injury history and muscle imbalance. All 12 intervention studies were exercise-based and targeted the shoulder or back. These findings support the need for multicomponent, whole-body prevention strategies in swimmers.