Swimming Smarter: How to Keep Low Back Pain from Sinking Your Season

Swimming is widely celebrated as a low-impact activity, but for competitive athletes and high-load recreationalists, the repetitive motions and intense training volume can place significant stress on the spine.

Low back pain (LBP) is a real concern for many swimmers, potentially sidelining them from the sport they love.

The good news?

By understanding the problem and taking proactive steps, you can significantly reduce your risk and keep yourself powerful and pain-free in the water.

How Many Swimmers Are Affected?

While some studies suggest recreational swimming may be protective against LBP, the reality for competitive swimmers is often very different. The numbers show that low back pain is a frequent issue:

• Prevalence Varies: Studies on competitive and elite swimmers have reported a wide range of LBP prevalence, with some lifetime rates climbing as high as 77% to 87% in high-load athletes.

• High-Risk Strokes: Specific strokes are often cited as contributors, with some reports indicating that up to 50% of butterfly swimmers and 47% of breaststroke swimmers experience back pain.

• Incidence Rate: One study specifically investigating the incidence of LBP in swimmers found a rate of 37%.

The high prevalence is often attributed to the repetitive hyperextension (excessive arching) and rotation of the lower back, which is inherent in strokes like the butterfly and breaststroke, as well as the high overall training volume.

Why Low Back Pain Hits Swimmers

The common culprit in swimmer's back pain is often a combination of factors related to technique and muscle imbalances:

1. Lumbar Hyperextension

2. Weak Core/Trunk Muscles

3. Tight Hip Flexors

4. Poor Thoracic (Mid-Back) Mobility

Addressing Low Back Pain: Prevention and Management

The key to a long, healthy career in the pool lies in a proactive approach that focuses on technique correction and dryland strengthening.

1. Master Stroke Technique 🏊

Work with your coach to prioritize a neutral spine position, especially during the breath and kick phases of your stroke.

• Freestyle/Backstroke: Focus on full body roll as a unit, reducing the need to excessively twist or lift your head and neck.

• Breaststroke/Butterfly: Avoid excessive arching of the back by engaging your core as you lift your chest out of the water. Keep your head relatively aligned with your spine—don't throw your head back. A proper dolphin kick originates from the hips, not just the lower back.

2. Strengthen Your Core (Beyond the Abs) 💪

A strong, stable trunk is the most important protective factor. Focus on exercises that teach your core to resist movement rather than create it.

• Spinal Stabilization: Incorporate exercises like Bird-Dogs and Dead Bugs, which train your deep core to maintain a neutral spine while your limbs move.

• Glute Strength: Your glutes stabilize your pelvis. Strong glutes (e.g., through glute bridges and clamshells) take pressure off the lower back.

• Low Back Endurance: Specific exercises like the Superman are excellent for building endurance in the paraspinal muscles that support your spine.

3. Improve Mobility and Flexibility 🤸

Address the tightness and stiffness that force your lower back to compensate.

• Hip Flexor Stretching: Regular stretching of the hip flexors (e.g., in a kneeling lunge position) can help reduce the anterior pelvic tilt that leads to back arching.

• Thoracic Mobility: Use a foam roller or specific rotation exercises to increase mobility in your mid-back, which allows your body to rotate better during freestyle and backstroke without twisting your low back.

When to Seek Professional Help

If you experience persistent or sharp pain, or if self-management strategies don't bring relief within a week or two, it’s crucial to consult a sports-focused physical therapist or doctor.

They can provide an accurate diagnosis, analyze your stroke mechanics, and create a targeted rehabilitation plan to get you back in the water safely.

Don't push through pain—early intervention is key to preventing a minor ache from becoming a long-term injury.

In good health,

Dr. Sandra and Team