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Paddles Overload the Forearm. The Wall Breaks the Fingers.
Can you swim with a hand or wrist injury? A jammed finger: usually within days, buddy taped, no paddles for 2 to 3 weeks. A broken finger: kick sets first, full pulling from around 6 weeks if your surgeon agrees. A cast, an open wound or pins in the hand: no pool until the skin is sealed and your surgeon says yes. Forearm pain from paddles: drop the paddles, not the swim.
Swimmers’ hand and wrist problems come from two places:
- HAND PADDLES, which multiply the load on your forearm tendons, and
- WALL AND LANE STRIKES, which break and dislocate fingers.
Backstrokers hitting the wall, and swimmers clashing hands in crowded lanes, cause the acute finger injuries. Paddle sets added too quickly cause the forearm and wrist tendon pain.
The classic mistake: a fingertip jams on the wall, it droops a little, it doesn’t hurt much, so training carries on. Weeks later the tip still won’t straighten…and the easy fix has quietly expired. Or a sore forearm gets pushed through one more paddle block, and a two-week niggle becomes months of tendon pain.
Shoulders take most of swimming’s overuse load. This article covers the hand, wrist and elbow. For a painful shoulder, see a physio or doctor who treats shoulders.
How swimming hand injuries happen
- Paddles. A larger surface means more water resisting every pull, and your wrist and forearm muscles hold the paddle’s angle against it for the whole set.
- Tight paddle straps. Tubing pulled tight across the fingers and wrist presses on the soft tissue beneath.
- Backstroke finishes and turns. Miscounting strokes from the flags drives an outstretched hand into the wall at full speed.
- Lane crowding. Hands strike another swimmer’s head, hand or foot mid-stroke, or catch the lane rope.
- Breaststroke and butterfly touches. Two-handed finishes jam fingers when the timing is off.
- Open water. Rocks, boats and other swimmers at mass starts.
Count your strokes from the flags on every backstroke length, including the easy ones.
Which swimming hand injury do I have?
- A swollen finger after a wall or lane strike: jammed finger, or a PIP sprain or dislocation that stays fat for months.
- A finger that looks crooked or crosses its neighbor when you make a fist: broken finger.
- A fingertip that droops after hitting the wall: mallet finger.
- Pain and swelling over a knuckle after hitting the wall with a closed hand: metacarpal fracture.
- Forearm and wrist tendon pain after paddle sets: extensor overload, tennis elbow or golfer’s elbow depending on the side.
- Thumb-side wrist pain building through a paddle block: De Quervain’s.
- Wrist pain after a slip on a wet pool deck: wrist fracture or scaphoid fracture.
How swimming hand injuries are diagnosed
- Finger strikes. An X-ray if there’s swelling over the bone, a crooked finger, a joint that won’t fully bend or straighten, or a drooping tip. With a mallet finger, the X-ray shows whether a flake of bone came off with the tendon.
- Rotation. Make a gentle fist. If one finger overlaps its neighbor, the fracture has rotated, and that needs a surgeon’s opinion that week.
- Forearm tendons. Diagnosed by examination: pain when you grip or lift the wrist against resistance, and tenderness at the tendon’s attachment near the elbow.
- De Quervain’s. Tuck the thumb into your palm, close the fingers over it, and tip the wrist toward the little finger. Sharp pain at the thumb side of the wrist points to it.
- Pool deck falls. A scaphoid fracture can hide on the first X-ray. Tenderness in the hollow at the base of the thumb after a fall means a repeat X-ray or an MRI.
Mallet finger and swimming: the window that closes
Mallet finger is the clearest Closing Window injury a swimmer can get. Splinting started early and run continuously gives the tendon its best chance. Every time the tip bends during the splinting period, the healing tendon can pull apart, and the clock goes back to day one.
- 6 to 8 weeks of splinting 24 hours a day, then nights for a further 2 to 4 weeks.
- Pool water softens the skin under the splint. Check it daily, and dry it properly.
- Changing a wet splint: hand flat on a table, slide the splint off with the tip still pressed straight against the table, dry the finger, slide the dry splint back on. The tip never leaves the table. Have your therapist show you once before you try it.
- Swimming during splinting only if your therapist has given you a waterproof splint and you can do that change without the tip bending. Otherwise, kick sets with the hand resting on the board.
(Dory says just keep swimming. Dory is a fish. Dory does not have a mallet finger.) See mallet finger splints.
When can I swim again? Return times by injury
Your surgeon or doctor may give you different dates. Use theirs. These are the conservative versions.
- Jammed finger (sprain): swim within days, buddy taped with waterproof tape. No paddles for 2 to 3 weeks. The joint can stay puffy for 3 to 6 months. See buddy strapping.
- Finger dislocation that went back in: buddy taped for 3 to 6 weeks. Swim once you can make a comfortable fist. No paddles for 4 to 6 weeks.
- Simple finger or hand fracture: 6 to 12 weeks for the bone to heal. Kick sets with the good hand on the board while it’s protected. Full pulling from around 6 to 8 weeks if your surgeon agrees. Paddles not before 10 to 12 weeks.
- Mallet finger: as above. Paddles and hard wall finishes wait until the splinting is complete, around 3 months.
- After hand surgery: no pool until the wound is fully closed and dry, usually at least 2 to 3 weeks, and never with pins sticking out of the skin. See K-wire care.
- Wrist fracture: no swimming in a standard cast. Once it’s off at around 6 weeks, easy swimming from about 6 to 8 weeks. Butterfly, hard pulling and paddles usually after 3 months.
- Scaphoid fracture: 8 to 12 weeks or longer to heal. Full strokes only once a scan shows it has healed.
- Forearm tendon pain from paddles: keep swimming without paddles, add tendon loading on land, and bring paddles back small over 4 to 6 weeks. Most settle within 6 to 12 weeks.
- De Quervain’s: a thumb splint out of the pool for 4 to 6 weeks if it’s flared. Easy swimming is fine if pain stays under about 3 out of 10. Paddles back once pinching and wrist turning are pain-free, usually 6 to 8 weeks.
Exercises for forearm pain from paddles
- Isometric holds. Forearm on a table, palm down, wrist level. Push the back of the hand up against your other hand at a moderate effort and hold 30 to 45 seconds. 5 holds, once or twice a day.
- Slow lifts. Once the holds are easy: a light dumbbell or water bottle, lift over 3 seconds, lower over 3 to 4 seconds. 3 sets of 15, once a day or every other day.
- Inner forearm version. Same two exercises with the palm facing UP.
- Forearm rotation. Hold a hammer by the handle, elbow at your side, and slowly turn the palm up and down. 3 sets of 10.
- The pain rule. Up to about 3 out of 10 during the exercise is fine, as long as it has settled by the next morning.
Full program on the tennis elbow exercises page. What a hand therapist adds: the dose, the progression back to paddles, and a waterproof splint when a finger needs protecting in the pool.
The changes that make the most difference
- Build paddle volume gradually. Add a few hundred meters of paddle work per week, not a full block in the first session back.
- Start with smaller or finger paddles and move up in size over weeks.
- Loosen the straps, and drop the wrist strap if the paddle stays on without it.
- Backstroke: count strokes from the flags and reach the final stroke with a relaxed, slightly bent arm.
- Circle swim with spacing, and swim wider strokes only in a lane with room.
- Walk the pool deck. A slip on wet tiles onto an outstretched hand is a common way to break a wrist.
Get it checked today if
- A finger points the wrong way, or crosses another when you make a fist.
- A fingertip droops and won’t straighten on its own.
- A finger is numb, pale or cold after a strike.
- A surgical wound turns red, hot, swollen or starts leaking after swimming.
Get it checked if
- A finger won’t fully bend after a strike.
- Thumb-side wrist pain after a slip, even with a normal X-ray.
- A finger joint is still swollen and stiff after 3 weeks.
- Numbness or tingling in your fingers during or after training.
- Forearm pain is still there after 6 weeks without paddles.
Rowers share the paddle-style forearm problem. See rowing injuries.
Small paddles, loose straps, and count to the wall.
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. A fingertip that droops after a wall strike needs a splint this week, not after the meet.
Part of: Hand, wrist and elbow pain by job, sport and hobby
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.