by Charlotte Walker
Swimming is widely recognised as an excellent form of exercise for maintaining flexibility in the spine and strength whilst minimising strain or pressure on the spinal structures present in weight-bearing activities. In effect the water acts as a supporting structure so light swimming is often recommended as part of an exercise therapy regime. However, the emphasis here should be placed on the word ‘light’ as with any form of exercise which is carried out incorrectly, or over-used, problems can arise. With the increase in popularity of triathlon events, swimming injuries amongst amateur competitors are becoming more common.
Low back Pain – what is the cause in swimmers?
Swimmers that train excessively may suffer from low back pain, particularly those using front crawl and butterfly strokes. These strokes involve extending the lumbar spine, and with over-use, this can create a repetitive extension strain particularly at the junction of the lowest lumbar vertebra (L5) and the sacrum. In front crawl, a torsional strain through the spine can also result. This occurs when stiffness in the back and pelvis does not allow the whole body to “roll” as a unit. This strain occurs where the rolling is prevented, most commonly at the junction of the spine and pelvis.
Overtime, these strains may cause the lowest discs to become damaged and worn, leading to inflammation in the surrounding tissues, and possibly some irritation and wear to the facet joints too. Symptoms may include pain and spasm in the lower back region, buttocks and aching in the posterior thighs. Occasionally, a nerve root in the back may also become compressed by a bulging disc, or irritated by inflammation, and cause shooting pains or cramps into the legs with or without neurological signs.
In severe cases of extension strain, there may occur a “spondylysis”. This is a stress fracture in a particular part of the vertebra, most commonly at L5. This may cause the vertebra to slip forwards in relation to the sacrum, and cause what is known as a “sponylolisthesis”.
Prevention
Amateur swimmers should seek professional advice as to their training schedule.
Swimming training should not be limited to the pool – core strengthing exercises and gym work, as recommended by a physiotherapist, should accompany any schedule.
Regular treatment sessions with a manual therapist, such as a chiropractor or osteopath, are also recommended so the spine remains flexible. This helps to prevent localised strain, and allows the rolling forces of swimming to be distributed throughout the length of the spine.
The use of a pool buoy should be minimised, as this also focuses the rolling forces at the lower lumbar spine.
If hip flexor muscles are tight, the amount of extension in the hips will also be reduced, which then adds further extension strain to the lower back. Manual therapy can also help with this.
If pain does start to appear, swimmers should not be tempted to ‘swim through the pain’, as this will just make symptoms worsen.
Swimmers should also check their stroke technique.
