Swimming for Back Pain: How to Soak up the Benefits

When done properly, swimming is a great form of exercise for those dealing with back pain.

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Swimming has long been touted as a no-impact form of exercise, often recommended for those recovering from injuries or surgery, and people for whom higher-impact exercises such as running would be painful or dangerous. Unlike other types of cardio that can be tough on the body, swimming not only burns calories and builds muscle, but it’s also refreshing.

Swimming for back painSwimming builds your cardio and spares your back.

Studies suggest aquatic exercises can relieve low back pain. Dan Enz, physical therapist, licensed athletic trainer, and sports certified specialist at the UW Health Research Park Sports Rehabilitation Clinic, has seen it first-hand.

“The buoyancy of the water counteracts gravity to decrease the compressive load of the spine,” Enz says. “For many people, it allows them to get cardiovascular activity without an increase in pain, which is therapeutic in itself.”

He adds that many studies suggest that regular cardiovascular activity is a benefit in reducing pain.

“The key is finding appropriate strokes and the length of time you’re able to exercise without becoming too fatigued or increasing pain,” Enz says.

Jeffrey Wang, MD, Co-Director of the University of Southern California Spine Center, Keck School of Medicine, mentions that it is important to understand that exercises with strengthening of the paraspinal muscles is a key element to help with supporting the spine and potentially reducing back pain. Swimming may allow patients with back pain to utilize the buoyancy of water, enabling these patients to exercise these important muscles more effectively.

When you find that sweet spot, swimming can offer myriad benefits when it comes to your back pain. Here’s how to discover the happy medium when starting a swimming routine.

Do Some Prep Work

Whether you’re swimming in a lap pool at your gym or heading to a public outdoor pool with lanes, Enz says that it’s key that you feel comfortable in the water and know how to swim. If you don’t feel like you’re a strong swimmer, it might be a good idea to seek out some basic adult swimming lessons before embarking on a regular routine.  

Enz warns, “If you’re not a super-efficient swimmer, you will compensate and add to the stress load of your back.”

Once you feel more confident in the water, or if you’re already an experienced swimmer, Enz recommends a warm-up either in the shallow end of the pool or you can do some deep-water walking and/or cycling prior to swimming in the deep end of the pool.

Best Strokes for Back Pain

Your choice of strokes for your swimming workout will either help or harm your back, so it’s important to stick to strokes that will protect your spine and keep pain in check.

“The safest strokes for individuals with back pain are freestyle and backstroke,” Enz explains.

Swimming for back pain - backstrokeThe backstroke is a great option when your back hurts.

He adds that a snorkel can be helpful as well, saying, “In freestyle, individuals can also use with skill a center snorkel so they do not have to lift their heads, which would cause them to arch their backs.”

Some strokes that force arching of the back aren’t the best idea if you’re dealing with pain.

“Performing a butterfly stroke or breaststroke causes a natural extension or arch in the low back, which may be quite painful for certain individuals,” Enz says.

How Often and How Long

Swimming may feel so good to you that you may want to head to the pool every day. But like each form of exercise–especially when you’re struggling with back pain--it’s all about moderation so you can avoid overuse injuries.  

Although Enz says that it depends on each swimmer, his advice for those dealing with back pain is to avoid any activity that progresses the pain while performing the activity.

“Post-activity soreness that dissipates within a couple hours is okay,” he shares. “Post-activity soreness that lasts into the next day is a warning sign that you may be doing too much.”

For swimming, Enz says that he usually recommends starting with three days a week at 20 to 30 minutes per workout. He also says, “Use the response to the activity as a guide to progress or decrease volume.”

Dr. Wang cautions that moderation is the key, with a gradual increase in activity until one reaches a workout that fits with their own age, conditioning level, and physical abilities.

Things to Consider

When swimming or performing any sort of exercise, Enz stresses that the benefits are completely dependent on the individual and the type of back condition.

“We can’t paint with a broad brush to say that swimming is more beneficial than other forms of exercise,” he says. “It totally depends on each individual and the condition that they are dealing with.”

He notes that in general, individuals with arthritis or spinal stenosis seem to do very well in the pool “because of the decreased compressive loads compared to land.” 

Others may need to make certain accommodations based on their condition.

Enz says, “For example, if somebody has cervical spine arthritis or stenosis, they may have a difficult time lifting their head to breathe while swimming. For this individual, they may have to swim using backstroke exclusively or using a stroke goal so they do not have to lift their head.” He suggests starting with aquatic therapy if you’re not yet comfortable in the water.   

Dr. Wang points out that each patient is different, and although swimming in general is a great form of exercise, each patient needs to try and see what works for their specific condition. “What works for one patient, may not work as well for another,” he says.

Swimming for back pain water aerobicsUse aquatic therapy or water aerobics as a way to get more comfortable in the water before you begin a swimming program.

In other words, it’s probably good thinking to contact your doctor and find out if swimming is advised for your back condition. With these tips in mind, you’ll likely find a form of aquatic exercise that suits your unique needs. 

Ready to take the plunge but want to run your program by a spine specialist first? Find one here.

Updated on: 06/12/20
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Water Exercises for Rehabilitation
Jeffrey C. Wang, MD
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