Teach the swimmer to achieve balanced body positions in the water for breathing and propulsion.  Swimmers with dwarfism, especially younger children who are just learning to swim, frequently experience difficulty achieving proper horizontal alignment in the water because of their relatively large head size and short limbs.  In addition, lack of neck flexibility for some dwarf swimmers may cause difficulty in turning or lifting the head to breathe.  Experiment with different head and body positions to help resolve these problems.

Teach good stroke technique.  Use the same principles for increasing propulsion and decreasing drag as you would for "average-height" swimmers. Most dwarf swimmers with achondroplasia are capable of correctly performing the competitive swimming strokes; however, some "achons" are unable to fully extend the elbow due to abnormal bone structure in the joint, and some develop a breaststroke kick that is not textbook perfect but is nevertheless effective given their knee and ankle flexibility.  The limited flexibility and musculo-skeletal problems associated with other forms of dwarfism may prevent those swimmers from learning some of the strokes.

Give special attention to reducing drag.  Factors that increase drag for the dwarf swimmer are short arms and legs (and sometimes bowed legs) that prevent a truly streamlined body position, a relatively large head, and excessive lordosis (a curve in the lumbar area of the spine).  Drag can be reduced by using effective head positions, increasing shoulder roll and body rotation, and working on joint flexibility. Lordosis can be minimized or avoided by working on trunk strength.

Find the best combination of stroke length and stroke rate for the swimmer.  Although swimmers with short-limb forms of dwarfism generally have limited stroke length in relation to body height and in comparison to other swimmers, they should still be encouraged to maximize stroke length by emphasizing body roll and using effective hand positions throughout the stroke.  A rapid stroke rate will help to compensate for limited stroke length. 

Teach effective starts and turns.  Most dwarf swimmers can master forward starts from the starting blocks; however, some swimmers start from the water because of orthopedic limitations.  Dwarf swimmers may have difficulty using the starting blocks for backstroke starts because of the height of the starting grips.  Encourage an effective streamlined position and a strong push-off for all starts and turns. 

Use the same training principles that you would use for "average-height" swimmers.  Because the dwarf swimmer is likely to be slower than same-aged "average-height" swimmers, the coach may need to adjust distances or intervals.  Although it may be expedient to group the dwarf swimmer with same-speed younger swimmers, most swimmers with a disability prefer to practice with same-aged swimmers at least some of the time.

Use the same dry-land exercises (e.g., weight training, band work, or calisthenics) that you would use for “average-height” swimmers.  Many dwarf athletes excel in weight training, demonstrating good strength relative to body weight.  Use of “on-the-feet” exercises such as plyometrics should be evaluated on an individual basis giving consideration to the stability of the swimmer’s hip and knee joints.

Instability in the cervical spine (the neck area) of dwarfs who do not have achondroplasia may lead to spinal cord injury if stress is placed on the neck during racing dives or other activities involving forward flexion of the neck.  This instability can be detected by a physician using X-ray analysis.  Swimmers with this problem should start in the water rather than perform racing dives.

Some dwarf swimmers have spinal stenosis, a structural abnormality of the spine in which the opening for the spinal cord is too small.  The spinal cord may become compressed, leading to muscle weakness and some loss of sensation in the affected limbs.  Dwarf swimmers who complain of these problems should be referred to their physicians.

Many persons with dwarfism suffer back problems as they age.  Coaches should encourage good physical fitness and flexibility to help athletes prevent back problems.

Many young swimmers with dwarfism have implanted drainage tubes in the ears which may affect ability to participate in activities such as diving or going to the bottom of the pool.  Anecdotal evidence also suggests that swimmers with dwarfism are more likely to experience ear infections than other swimmers.  The usual precautions of drying the ear canal after swimming or using ear drops should prevent such infections.

Most dwarf swimmers need step stools in the locker rooms and other areas of the swimming facility so that they can reach shower handles and other appliances.  Be sure that the step stool is covered with a non-slippery material.