Swimmer's Back Pain

Swimmer’s Back

Swimming, as a full-body exercise and a competitive sport, is one of the healthiest ways to stay in shape and maintain a high fitness level. However, like any sport, it has its unique physical demands and potential injuries. Among swimmers, back pain is one of the most common complaints.

This condition, often referred to as “Swimmer’s Back,” primarily affects the lower or lumbar spine, with competitive swimmers often sustaining back injuries due to the repetitive movements and high-intensity training involved in their stroke techniques.

Causes of Swimmer’s Back Pain

Several factors contribute to the development of Swimmer’s Back:

• Stroke techniques: Physically demanding swimming strokes, like the breaststroke and butterfly, cause low back pain in swimmers. These require excessive hyperextension of the lumbar spine, placing high loads on the intervertebral discs and facet joints, potentially leading to injuries. Disc degeneration in elite competitive swimmers is incredibly high, ranging from 77%-87%.
• Tight Hip Flexors: Swimmers often struggle with tight hip flexors. When these muscles are excessively tight, pelvis is tilted too far forward, increasing the lower back’s inward curvature (lordosis) and putting additional stress on the spine.

Symptoms Swimmer’s Back – Low Back Pain

The primary symptom of Swimmer’s Back is lower back pain or lbp, which can vary from a dull ache to severe pain, affecting daily activities and performance in the pool.

• The pain is usually localized in the lower back but may radiate to the buttocks or down the legs if nerve roots are involved.
• In some cases, swimmers may also experience shoulder pain and neck pain due to the interconnected anatomy and function of the spine and shoulder blades.

Diagnosis of Swimmer’s Back

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Diagnosis of Swimmer’s Back starts with a thorough physical exam and a detailed history of the symptoms.

• The swimmer’s technique and training regimen should ideally be evaluated by a sports medicine specialist, a swim coach or instructor, as poor form or excessive training can contribute to pain in the back.
• Imaging studies, such as an X-ray or MRI, can confirm the diagnosis and reveal specific conditions like spondylolysis, a stress fracture of the pars interarticularis that is common in young athletes.

Treatment of Swimmer’s Back

Treatment of Swimmer’s Back focuses on alleviating pain and addressing the underlying cause.

• Initially, rest and anti-inflammatory medications may be recommended to relieve acute pain.
• For long-term management, physical therapy involving core strengthening and stabilization exercises can help improve muscle imbalances and prevent atrophy.
• If hip tightness is a contributing factor, targeted stretching exercises will be included in the treatment plan.
• Sometimes, a lumbar corset may be prescribed for better support during the healing process. Severe cases of Swimmer’s Back, such as those involving nerve compression or significant structural problems, may require surgical intervention.

Preventive Measures for Swimmers

Preventive measures are crucial in managing the lumbar spine strain often associated with regular swimming activities. These interventions aim to reduce the development or progression of Swimmer’s Back.

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Proper Swimming Techniques:

• Emphasizing adequate body roll during swimming can help distribute the strain evenly across the back, reducing the pressure on the lumbar region.
• Regular breaks between high intensity training sessions allow the spine time to recover, reducing the risk of overuse injuries.

Strengthening and Flexibility Exercises:

• Exercises targeting the core, back and hips can increase strength and flexibility, reducing the strain on the spine.
• Stretching routines focusing on hip flexor muscles can help alleviate tightness, often contributing to lumbar spine stress.

Even for recreational swimming, incorporating these preventive measures can potentially mitigate the risk of Swimmer’s Back.

Frequently Asked Questions (FAQs) About Swimmer’s Back Pain

What are the causes of back pain in swimmers?

Swimmers often develop low back pain due to the repetitive movements of hyperextension in swimming strokes, especially the butterfly and breaststroke. These place excessive loads on the spine, causing strain. Additionally, bending forwards and poor form can also cause pain. Core sturdiness is vital; if the abs are weak, this can lead to pain in the back.

How can swimmers prevent pain in the back?

Swimmers can prevent low back pain by practicing proper form, especially when performing the butterfly and breaststroke. Core stability exercises can strengthen the abdominal and back muscles, helping to maintain the spine’s alignment. Advice from a swim coach on technique can also help prevent pain in the back. Furthermore, swimmers should avoid excessive hyperextension and ensure their whole unit, including arms and torso, is firing in the proper sequence.

What treatments are available for swimmers with pain the back?

Treatment for back pain from swimming includes rest, physical therapy, and sometimes a lumbar corset for better support. Therapies focus on core stability exercises to strengthen the abs and extensor muscles. In some cases, modifications to the swimming cadence or changes in the training regimen may be necessary. If there is severe back pain, a medical consultation is advised.

Are some swimmers more prone to back pain than others?

Yes, elite swimmers and those specialising in strokes such as the butterfly and breaststroke, which involve high degrees of spinal flexion and torsion, are more prone to developing low back pain. Additionally, swimmers who have weak abdominal muscles or an improperly tilted pelvic bone may be more susceptible to back pain.