Swimming is an excellent form of low-impact aerobic conditioning that is gentle on the back and spine. However, it may not be suitable for certain types of back pain or when performed with improper technique. Below are guidelines on how to swim safely with back pain, the best strokes to use, and tips to prevent discomfort.

Best Swimming Strokes for Back Pain

Swimming is good for low back pain when you do the following strokes and use these recommended modifications.

1. Backstroke

Keeps the spine in a neutral, supported position
Reduces pressure on the neck since the head remains in line with the body
Avoid over-arching the lower back by maintaining proper alignment

Modification:

Reaching overhead during the backstroke may cause excessive hip and lower back rotation
To minimize stress, keep arms by your sides and move them together to push water toward your feet—this stroke is called the elementary back stroke

2. Freestyle (Front Crawl) with Modified Breathing

The crawl is a good form of swimming because it provides a full-body workout with minimal spinal twisting.

Roll the body to the side and keep your chin tucked when taking breaths instead of jerking the head backward
Reach your arms overhead in line with your shoulder to avoid excessive twisting
Practice your arm movements using a pull buoy between your thighs, as this provides you with flotation support while focusing on proper form for your arms

Modification:

Use a snorkel and mask to keep your head in the water, with your eyes looking at the bottom of the pool, as this maintains your spinal alignment and avoids any twisting

3. Breaststroke (With Proper Form)

Many people enjoy the ease of breaststroke, but it can strain the neck and strain the lower back if not done correctly.

Keep your body level in the water by engaging lower abdominal muscles
Keep your head straight rather than lifted
Avoid bobbing the head up and down excessively

Modification:

Use a mask and snorkel to keep your head in the water; this can help avoid the tendency to arch your lower back when coming up for a breath

4. Swimming with a Kickboard (For Low-Impact Lower Body Exercise)

Supports the upper body while focusing on gentle leg kicks
Be sure to keep your body in line to avoid excessive arching or bending of the lower back
Using fins may increase lower back stress; to mitigate this:
- Ease into their use gradually
- Choose shorter fins for reduced stress
- Strengthen your core muscles to improve stability
- Avoid using fins if needed

Swimming with Specific Back Conditions

Herniated Disc

Many people find swimming helpful for relieving herniated disc pain.

The buoyancy of the water helps keep pressure off the painful nerve root
Strengthens core muscles, which in turn supports the spine and keeps pressure off the painful structures in your lower back
If traditional strokes are too challenging, try using a pull buoy. A pull buoy is a flotation device placed between your thighs. It keeps your hips and low back afloat and still (no twisting), using only your arms to swim

Sacroiliac (SI) Joint Pain

Swimming is good for sacroiliac joint pain and low back pain caused by sacroiliac joint dysfunction.

The water supports your body weight, reducing pressure on the inflamed SI joint
Provides a way to exercise without worsening discomfort
If you have a lot of stiffness, you can try water therapy in a warm pool to gently improve your range of motion in the SI joints

Pool Therapy (Water Aerobics)

Try swimming pool therapy as a good alternative if swimming causes or worsens back or neck pain.

Offers the benefits of water support without repetitive stroke movements
Simply walking in waist-deep water can be beneficial
The exercises are done in a warm pool, and the warm water tends to be soothing for joints and spine

See Water Therapy Exercises

Final Thoughts

Swimming creates minimal impact on spinal structures compared to running or other aerobic exercises, making it a good option for exercise.

Light swimming or aquatic therapy is commonly recommended for individuals with osteoarthritis, joint pain, or severe back pain
This is an excellent form of low impact exercise for many people who have had a spinal fusion or other type of spine surgery

Keep in mind that the benefits of swimming will largely depend on the underlying cause of your pain. Check with your treating physician to understand if swimming is a good fit for you.

Learn more: 3 Essential Tips for Swimming with Back Pain

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.