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A guide to swimmer's neck

Underwater shot of male swimmer turning over in swimming pool.

Although swimming is a fantastic low-impact, joint-friendly exercise for all age groups and is a relatively injury-free sport, it can put repetitive demands on certain muscles, bones, ligaments or tendons, resulting in some common overuse injuries. These are often caused by poor technique, and although roughly 90 per cent of these swimming injuries are in the shoulders, your back and neck can suffer too.

The pressure that swimming can place on the neck is not surprising when you consider that the average human head weighs in the region of 5kg – the same as an average-sized pumpkin – a significant load to be constantly lifting out of the water to breathe, and one that is supported by only seven cervical vertebrae and 20 muscles. These neck vertebrae are separated by intervertebral discs: fibrocartilaginous cushions that function as small shock absorbers for your spine. Some of the repetitive motions involved in swimming can affect the pivoting motion of these discs and potentially inflame ligaments or pinch nerves.

Causes and Symptoms

When swimming breaststroke, some people employ a head-high-above-water style, tilting their chin up to the ceiling, whilst those swimming front crawl often abruptly rotate their heads to breathe. Both of these manoeuvres can lead to significant strain on the neck and trapezius muscle, a broad, triangular muscle that covers the upper back, shoulders and neck. This strain can, in turn, cause a pain that is often referred to as ‘swimmer’s neck’, which may manifest as any of the following:

  • A constant dull ache or sharp pain across, or on one side of, the neck
  • Restricted movement, such as being unable to look over your shoulder
  • Headaches
  • Pain in the shoulder and hands such as numbness, pins and needles – which can be transferred from neck problems

Improving your technique and stroke mechanics, plus a solid warm-up and stretching routine, are the keys to preventing swimmer’s neck. Adopting these techniques can take time and training, but they are an important injury-prevention strategy.

Pre-pool warm-up routine

A pre-pool – or dryland - warm-up is an essential for the serious swimmer, and it is always best practice, where possible, to spare 10-15 minutes to prepare your body before jumping in. A good dryland routine increases your heart rate, warms up your body and prepares your muscles for the demands of the pool. Your warm-up could include some of the following simple exercises:

Neck rotations

Relax your shoulders and lower your chin until it touches your chest and take a deep breath while rotating your head very slowly clockwise. When your head is as far back as you can get it, slowly begin to exhale while circling your head back to rest your chin on your chest again. Do this five times clockwise, then five times anti-clockwise to relax and stretch tense neck muscles.

Head Tilt

Tilt your head to one side and allow gravity to gently pull your head down, with your ear toward your shoulder. Ensure your shoulders remain heavy and relaxed. Repeat on the other side.

Maintain a good technique

To avoid swimmer’s neck and other muscoskeletal issues, it’s key to adopt a good stroke technique. Some key points to maintain these optimum stroke mechanics are:

For 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!
  • Position your head slightly forward with a mild tuck in your chin to help you keep your neck straight.
  • Keep your hips as close to the surface as possible to avoid a bend in your lower spine.

For front crawl:

  • Rotate your entire body to breathe rather than just your head, avoiding over-twisting your neck

It’s also sensible to mix in different swimming strokes as part of your swimming routine, which will keep your neck muscles from performing repetitious movements. Swimmers should always seek technical guidance from a qualified coach or a more experienced swimmer to adopt a good routine and techniques.

A total pain in the neck!

In some cases, stress on the neck can lead to thoracic outlet syndrome (TOS) – the compression of blood vessels or nerves in the space between your collarbone and your first rib. TOS can be alleviated through physiotherapy and sufferers may benefit from anti-inflammatory medication.

Swimmers experiencing any kind of persistent pain or mobility issues should seek professional advice. 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 using our online booking tool.

Published on 11 July 2024