Low Back Pain in Swimmers

Swimming is a very complete sport that involves almost all muscle groups in the body and is certainly a good form of exercise because it:

• Provides an important workout for the cardiovascular system
• Strengthens all major muscle groups
• Improves joint mobility.

When swimming, our body is supported by water, which results in less stress on the bones and joints.

In recent years, there has been some confusion about the rehabilitative benefits of swimming, especially in terms of posture for individuals with musculoskeletal imbalances and back pain.

Today, we know that while swimming is an excellent sport, it should not be considered a rehabilitation therapy.

Low back pain (lombalgia) accounts for 10% of all swimming injuries.

When we talk about low back pain, we refer to a disorder that causes painful symptoms in the lumbar region of the spine, specifically located in the lower back.

The pain can vary depending on whether it is caused by muscular issues or problems related to the bones and joints of the lumbar vertebrae.

The predisposition of certain spinal structures to develop specific injuries is related to the biomechanics of different swimming strokes.

Freestyle and backstroke, for example, increase axial rotation of the lumbar spine and, therefore, twisting forces, putting the annulus fibrosus (the outer part of the intervertebral disc) particularly at risk. Meanwhile, butterfly and breaststroke, which involve greater extension of the lumbar spine, can easily cause damage to the facet joints.

In elite athletes performing these two strokes, there is a particularly high risk due to excessive undulation, which inevitably increases the risk of facet joint injuries due to repeated microtrauma and the appearance of stress fractures.

Treating low back pain in swimmers is not simple: it is necessary to make an accurate diagnosis, identify the predisposing factors for pain, and develop a precise therapeutic strategy aimed at restoring the specific movements needed for the sport.

Dott. Luca Tomaello