Recently I consulted with a swimmer who had been dealing with low back for pain for the last year. Lets say this swimmers name is Sarah. Sometimes Sarah’s low back pain affected her swimming, where she would then get out of the pool and ice her back. But sometimes Sarah’s low back did not bother her at all. Sarah was an incredibly tough swimmer and was getting ready to go off and swim at a division one college in the fall. Sarah expressed worry that if her college coach found out about her off and on back pain that it would impact her ability to swim in college. She had tried physical therapy in the past. Where the PT did a combination of manual therapy and core exercises. Examples of the core exercises she did were dead bugs, side planks, planks, and bridges. She said it helped a little, but it was not able to make a significant difference in her pain levels.
At this point, it is pretty easy to see why Sarah would be worried and frustrated about her back. While the last PT certainly did nothing wrong, they were missing one crucial piece in her rehab. The exercises Sarah was doing did not load the low back enough.
What does this mean? Simply put, the exercises were not challenging enough. In swimmers with low back pain, the low back needs to be appropriately loaded in order for symptoms to fully resolve. Lets break this down further…
What Are The Steps To Get Rid of Low Back Pain In Swimmers?
Step #1 Symptom Control
First and foremost, the most important thing to do if you are dealing with back pain is try and decrease your symptoms. This is especially true if the onset of your back pain was recent. For those that have had a low level of back pain for a long time, you may not need to spend as much time in this step.
For swimmers, some of my go to movements in step #1 are…..
Open Books
Cat Cow
Step #2 Movement Control
This is where things start to become more fun. Once your symptoms decrease, its time to start loading! For a swimmer with low back pain, you want to begin to load the muscles around the trunk and hips. The most important consideration during this phase is you want to have the right muscles doing the work in whatever movements you choose to do.
For example, many swimmers with low back pain will feel there low back doing most the work in a bridge. However, the bridge is made to work on your glutes and hamstrings, not your low back. Modifying the bridge by digging your heels into the ground and limiting how much you raise your hips will get your glutes and hamstrings doing the work, not your low back.
Some of my favorites exercise in step #2 are….
Single Leg Bridge
Hollow Hold
Paloff Press
Bear Crawl
Step #3 Functional Optimization
Now this is where the serious fun begins. This is the step that Sarah missed during her first bout of PT. During the functional optimization step, you want to really challenge the low back. Of course, you want to do so appropriately and within reason.
By challenging the low back through exercises like deadlifts, hex bar deadlifts, single leg deadlifts, rear foot elevated split squats, etc., you get the muscles that surround your low back to become comfortable under tension. By doing challenging exercises, you teach the low back that stress does not equal danger. It will remind your low back that it is strong, robust, and resilient, and can tolerate a good amount of load.
Some of my favorites movements in this stage are….
Deadlifts
Trapbar Deadlift
Rearfoot Elevated Split Squat
Important note: It is okay to have some discomfort but not more than a 4/10 pain level when doing these movements. If you want to know why having a little discomfort is okay, check out a previous blog post on it here.
Important Reminders if You A Swimmer With Low Back Pain
- Low back pain is more common than you think in swimmers
- Having pain in your back does NOT mean any structural damage is occurring.
- Increases in pain does NOT equal increases in structural damage.
- Your low back is stronger, more resilient, and more robust than you think.
The Wrap Up:
Situations like Sarah’s are incredibly frustrating and more common than you think. Having low back pain for a long time can lead to a lot of frustration and make you feel like your body is fragile. If this are a swimmer with back pain know that it does not have to be like this. You can improve, you are strong, and your back pain does not have to stop you from reaching your goals.. Many of the clients I have worked with felt like this when we started to work together, but have made great recoveries and are not swimming better than ever.
If this is you and you want to get back to the sport you love, please schedule a call and let’s get this sorted out.
Happy Swimming,
Alex Ewart