Why Does My Low Back Hurt While Swimming?

While most of us think of swimming as a low impact activity that is easy on the joints, there is actually a relatively high prevalence of low back pain in swimmers! So what gives? 

Lack of hip extension for kicking: If the front of the hips are tight and you are unable to extend through the hip, you may “borrow” motion form your lower back, compressing the joints. How to fix it: Incorporate abdominal and lower back strengthening exercises that encourage good ribcage and pelvis alignment, such as deadbugs and bird dogs. You can also practice “balance kicking”, with your arms in front of you (without a kick board), and focus on keeping the glutes engaged while you kick. 

Poor flip turn form: Flip turning involves a very quick change from flexion to extension of the spine. When done repetitively, or when one’s back is already sore from running/cycling- this can increase back pain and potentially place undue stress on the lumbar joints. The stress of flip turning increases when you either flip too late or “twist” as you push away from the wall. 

Flipping too late places you in more lumbar flexion (bending), and demands that your spine go through a larger range of motion as you straighten your body out again. Ideally your feet would land on the wall with the hips and knees both be at 90 degree angles. This allows your spine to be neutral and places your glutes in a good power position to push. 

Streamline positioning, with the arms overhead and body straight, not only increases speed off the wall, but also avoids any twisting motion through the spine. Good shoulder and latissimus dorsi mobility, and upper back mobility are prerequisites of the streamline position. 

Body position: One of the hardest aspects of swimming for new athletes is proper body rotation, and the lack of gravity input surely doesn’t help. To avoid excess strain and movement of the spine while turning to breathe, smooth rotation of the entire body is essential. A very common pattern observed in triathletes is the “leg sink”, where the body is not parallel to the bottom of the pool. This position places more demand on the legs for balance, creating an inefficient kick and increasing activity of the ‘big” lumbar muscle responsible for a sore lower back, such as the Quadratus Lumborum and lumbar paraspinals. 

So, what is a new swimmer to do?

Utilizing a pull buoy occasionally can help teach the rotation portion of body position without managing the kick as well. Remember that it is just a tool and not a crutch! Eventually you must learn to kick and maintain body position.

Doing drills that involve kicking on your side, such as the 6 kicks-3 strokes-6 kicks drill can help you begin to incorporate kicking and body rotation. Once you get really good, one arm swimming drill can be a good challenge to your balance, kick, and rotation.

Breathing pattern: The diaphragm envelopes the bottom of your rib cage, and has attachments on the lumbar spine. Of course its main function is to create the pressure changes needed for us to breathe and stay alive, but it also plays a role in stability of the lower back and pelvis. Learning to allow your diaphragm to descend and fill your lungs is crucial to the use of both the arms and legs while swimming, allowing you to generate more force from a stable base. 

Shoulder flexion mobility: If a swimmer does not have sufficient shoulder flexion, or the ability to reach the arm straight overhead, they will attempt to “borrow” the motion from somewhere else, often the lower back. This same pattern can be seen when the thoracic spine, or upper back is unable to extend enough to allow the shoulder to utilize its full range of motion.

From a mobility standpoint, this can be addressed with stretching of the latissimus dorsi (or the “lats” for short) and working on thoracic extension. Additionally, strengthening the Serratus Anterior muscle can help with upward rotation of the scapula and increase shoulder range of motion as well. 

If you currently have an acute flare up of back pain, using a pull bouy and eliminating flip turns can help keep you active until it calms down.

Now that we’ve troubleshooted some reasons for back pain in swimming, stay tuned to our social media accounts for some of the fixes mentioned here! 

Just keep swimming,

Dr. Kacy Seynders, PT, DPT