Swimming is an excellent form of low-impact aerobic conditioning that is easy on your back and spine. The buoyancy of the water supports your body's weight, reducing stress on your joints and spine and allowing for greater range of motion.

Learn more: Swimming and Back Pain

However, as with all forms of exercise, you need to be careful if you swim for exercise. Many strokes and maneuvers in the pool can actually make your lower back or neck condition worse. Read on to learn about the Do's and Don'ts of swimming if you have back pain.

Learn more: Lower Back Pain Symptoms

Essential advice for swimming with lower back pain

  1. Avoid shear forces.

    One problem with swimming is that many strokes and approaches create shear force across the structures in your lower back through repetitive rotating in your lower spine and hips. Shear force contributes to the breakdown of the discs and other sensitive structures in your lower back.

    See Spinal Anatomy and Back Pain and Back Muscles and Low Back Pain

    To avoid this kind of force, consider the following adjustments :

    • Use a mask and snorkel to eliminate the need to arch your lower back while lifting your head up for air, or as your rotate your lower back when turning your head to take a breath. 1 Cole A, Herring S. The Low Back Pain Handbook. Philadelphia: Hanley & Belfus; 1997.
    • Work with a coach or athletic trainer to perfect your stroke, such as learning to keep your shoulders in line with your hips while swimming.
  1. Focus on spine-friendly strokes.

    The position and movement of various strokes will affect your spine in different ways, for example:

    • Butterfly and breaststroke force your lower spine to arch backward during the stroke. These movements add stress to the facet joints in the back of your spinal column, and can lead to problems or worsening pain over time.

      See Symptoms and Diagnosis of Facet Joint Disorders

    • Freestyle and backstroke do not force your back to arch; however, you run the risk of developing or worsening pain related to your discs and other structures in your lower back due to the repetitive rotation in the lower back.

      Learn more: Causes of Lower Back Pain

    The bottom line is that there is no one best or safe stroke for anyone with back pain. It will depend on a number of factors, including the underlying cause of your back pain and your swimming ability, mechanics, and workout intensity. Because of potential risks involved, if you have back pain it's best to get advice from your doctor and/or physical therapist before starting a swimming exercise program.

    See How a Physical Therapist Can Help with Exercise

  2. Start with water therapy.

    If you love swimming but find it's hard on your lower back, you may find it best to start with water therapy.

    Water therapy, also known as pool therapy, is an exercise program that takes place in warm water. You benefit from the gentle resistance of the water, as well as its buoyancy.

    Water therapy can provide many of the same benefits as swimming, as the activities are done in water so there is less pressure on the spine than during land-based exercise. The warmth of the water for water therapy has also been shown to relax tight muscles, allowing for additional range of motion during exercise and may allow you to exercise for longer periods.


    See Benefits of Heat Therapy for Lower Back Pain

    Like many exercise programs, a good water therapy program will start out with gentle exercises and get progressively more challenging over time.

    See Water Therapy Exercise Program

Many individuals also say that by its nature, working out in the water—either through swimming or water therapy—provides an added benefit of enhanced feelings of calm and peace.

Before starting swimming or any new exercise program it is a good idea to get the all clear from your doctor and/or physical therapist. As with any exercise, the bottom line is to let pain be your guide—if it hurts, stop what you're doing.

Learn more:

Sport Injuries, Back Injuries, and Back Pain

  • 1 Cole A, Herring S. The Low Back Pain Handbook. Philadelphia: Hanley & Belfus; 1997.

Dr. Andrew Cole has 30 years of experience specializing in spine and joint pain management. Dr. Cole has held numerous medical appointments throughout his career, and recently served as the Executive Director of Rehabilitation & Performance Medicine Enterprise for Swedish Health Services and as Medical Director of Ambulatory Musculoskeletal Services for Swedish Medical Group.