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Don’t let your fitness take a dive: A guide To swimmer's back

Woman swimming underwater in a swimming pool.

When it comes to back pain, swimming is known to have many easing benefits, not least the low-impact weightless environment, relief of compassion on your nerves and an increase in blood circulation. It’s one of the most effective forms of cardiovascular exercise for all ages.

However, poor technique and stroke mechanics can sometimes have a detrimental effect on your lower back muscles, caused by lumbar hyperextension. This is where the lumbar spine is subjected to repetitive bending or arching beyond its normal range of motion.

Swimming breaststroke with your head held high out of the water and your chin pointed skywards can put excess pressure on your lumbar spine, as can excessively twisting your body during front crawl. This poor technique can lead to and torsional strain injuries and sustained pressure on the lower spine, often known as ‘swimmer’s back’.

Reducing the Risk

As with most sports, steady progress and having ample rest between bouts of intense physical activity is key to the prevention of swimmer’s back. Without strength training, warm-ups and cool-downs, sufficient rest periods and the correct technique, you can suffer from muscle fatigue, subsequently leading to strain on your lower back. Swimmers should also be aware of factors out of the water that can exacerbate back pain, such as sitting with poor posture or sleeping on an inadequate mattress.

Mixing your swimming strokes may help prevent repetitive overuse of the lower back muscles, and a good dryland exercise routine is always critical for the serious swimmer. Focus on specific exercises to improve your core strength and build up your abdominal muscles to support your back. These may include the following:

Superman - Useful for building lower back muscles and glutes

  • Lie down on your stomach and extend your arms out in front of you
  • Facing the floor (avoid looking up), slowly raise your right arm and left leg around 15cm off the floor. Hold for 2-3 seconds then slowly lower your limbs back to the floor
  • Repeat for your left arm and right leg

Bird-dog – a simple, core-strengthening exercise that relieves lower back pain

  • Begin on all fours with your knees directly under your hips and your hands directly under your shoulders. Keep your spine straight, avoiding sagging or arching
  • Facing the floor, raise your right arm and left leg until they are parallel with the floor
  • Hold this position for 4 seconds, then lower back down gently to the start position
  • Repeat the process with your left arm and right leg.

Cat and camel pose

  • Start on your hands and knees with your back in neutral position
  • Extend your back by lifting your head up and pushing your tailbone out, making a disc shape with your spine
  • Then flex your back by tucking your head and tailbone in and pulling your belly button in towards your spine
  • Hold this exercise in each position and repeat

Maintain a good technique

Swimmers should always seek technical guidance from a qualified coach or a more experienced swimmer to adopt a good routine and techniques. Adopting these techniques can take time and training, but they are an important injury-prevention strategy. Below we look at some of the best ways to perfect a good technique for different strokes. 

Front crawl:

  • Imagine your body, when viewed from the side, as a straight line parallel to the surface of the water, with your hips kept close to the surface. This will help avoid a bend in your lower spine.
  • Focus on rolling your body as a whole unit when you take a breath.

Breaststroke:

  • Keep your head aligned with your spine when swimming, looking downward rather than forward. Your face should be looking at the water rather than the ceiling. This stops your hips and legs sinking, avoiding a bend in your lower spine.
  • Position your head slightly forward with a mild tuck in your chin to help you keep your neck straight.

Swimmers experiencing any kind of persistent pain or mobility issues should seek professional advice. Pain may be managed with physical therapy techniques such as massage and soft tissue mobilisation, ice and heat therapy or, if appropriate, anti-inflammatory medication.

At Benenden Hospital, our experienced, friendly team of state-registered physiotherapists treat a variety of sports injuries, such as musculoskeletal issues, joint pain and rheumatic problems, as well as offering post-operative rehabilitation.

If you need to speak to our physiotherapy team, and are self-funding your treatment, you can refer yourself directly with no need for a letter from your GP. Book an appointment by calling our Private Patient Team on 01580 363 158, by completing our online enquiry form or book your appointment online using our online booking tool.

Published on 11 July 2024