Johnny (not real name) is a collegiate swimmer and came to Lifestrength PT when he was home for break. Johnny’s season so far has been a roller coaster of emotions. He had an amazing summer of training, which carried into an even better start of his collegiate season. He was swimming well, he felt strong, and was getting really excited for his conference championships in February. All of a sudden after thanksgiving break, Johnny started to develop some mild low back pain. Johnny did not really think anything of it though since his back was not bothering him in the weight room or the pool. After he knows plenty of swimmers with low back pain too and it does not seem to effect them. Johnny was getting worried though and was starting to wonder if there was any swimming specific exercises or mobility drills he should be doing for his low back pain.
Fast forward to around his final exams, Johnny’s low back really started to bother him during butterfly and breaststroke. So much so, that he started to limit doing those strokes in practice. This is when Johnny really started to worry, since his best event is the 200 IM. He asked his coach and athletic trainers what he should do, but all they said to do is rest. Johnny feels like there has to be something he can do for his low back pain, but has no idea what to do.
What Exercises Should Johnny Do for His Low Back?
Before saying what exercises will be the best for a swimmer with low back pain, it is important to determine during what movements does Johnny’s back hurt during. For Johnny, his back hurt more when leaning backwards, or going into extension. It hurt more to stand, than it did to sit. It hurt more during butterfly and breaststroke because those strokes go into more lumbar extension (more of an arch), compared to backstroke and freestyle.
Based off this, it is important at first to select exercises and movement strategies that involve low back flexion (slumping). Yes, that means sitting with bad posture is okay for a swimmer with low back pain if it relieves their pain!! Then after pain starts to decrease, moving towards activities that involve more low back extension (arching). For a swimmer with low back pain, it is common to have extension based pain.
Exercise #1 Hip Hinge With A Dowel
When evaluating Johnny, he tended to move through his low back excessively during functional movements. Especially when leaning forward and backwards. This movement strategy may increase the strain in the low back. By using a dowel, you are limiting the amount of extension your low back will go into and keeps your back in a neutral position as you move through your hips. The dowel also does an excellent job giving feedback to Johnny, letting him know if he is moving through his back exceissely.
For holding the dowel, place one hand over your low back, which will help give tactile feedback to know if you are extending your low back. Hip hinges are a great starting point, you can progress to single leg deadlifts, lunges, or other functional movements while using the dowel.
Exercise #2 Hip Flexor Stretch
In a recent study, it was found that in swimmers with low back pain not only move through their low back more during dolphin kicks, but also have increased tightness of their hip flexors. To see if you have hip flexor tightness, you can complete the Thomas test.
Tight hip flexors limit hip extension. If you are limited in hip extension, it is natural to move more through your low back when swimming to try and get into an optimal kicking position.
Johnny was instructed to complete this hip flexor stretch for 3 sets of :30 seconds. An important cue for this stretch to is squeeze your glute BEFORE pushing your hip forward. Without squeezing the glutes, you run the risk of stretching the hip joint itself, which is something a swimmer does not need.
Exercise #3 Plank Series
Often times with low back, the muscles around the spine become inhibited, or weaker, as a result of the pain. In other blogs, inhibition was discussed in the context of swimmers shoulder, the same concept applies for the low back too. The muscle that may become inhibited in this case may be the transverse abdomininis and multifidus. A plank series of
- :30 seconds push up plus
- :30 side plank on R
- :30 second plank on L
- :30 Bridge
Is a great way to get abdominal muscles firing again. What is also great about this plank series is that all of these exercises are completed in a neutral position. Exercise that forces Johnny’s low back to arch may run the risk of increasing his pain, which will inhibit the abdominal muscles all over again. It is important to make sure during these exercises that the core is doing the work and not the low back.
After mastering the plank series, Johnny would go on to begin movements that involved arching his back but doing so in a gradual, progressive manner.
Exercise #4 Cat Cow
You may associate the cat cow with yoga, but its also an amazing initial exercise for swimmers with low back pain. The goal of the cat cow to help is start exposing your back to low back extension again. It is also a great movement to relieve tightness in the back.
A helpful cue is to tilt your hips forward and backwards. You should arch your back to the point at which you start to feel a little discomfort or tightness.
The Wrap Up:
After completing this exercises for a couple of weeks, Johnny started to feel much better. After each of these exercises were progressed, Johnny was feeling close to 100% and was able to go on and crush the his conference championship meet. Having low back pain can be intimidating, especially in swimmers. But it does not have to be…
If you are a swimmer and dealing with low back pain, reach out and lets get it sorted out.
Please note: This is NOT medical advice. If you are dealing with an injury, please see a licensed medical professional.