Swimming and its effect on scoliosis

Is swimming good for scoliosis? The short answer

Swimming is a gentle form of exercise, and many people with back problems feel comfortable in the water. The buoyancy takes the load off the joints, which is why water is a popular place for rehabilitation. At the same time swimming is repetitive and often one-sided, so the result depends on which stroke you swim, how well you swim it and how much you swim.

• In favour: movement in water is pleasant, relieves the joints and suits rehabilitation.
• To watch: asymmetrical movement overloads one side of the body, and in front crawl, breaststroke and butterfly the spine is not in its natural position.
• Not a replacement: swimming is not a treatment for a scoliotic curve. If you suspect scoliosis, have the back checked (see the last sections).

Swimming is OK, but…! 

As we mentioned in the beginning, swimming is very popular mainly in summer and it’s often recommended to relieve back pain or if you suffer from scoliosis. Moving while being in water feels very nice, the buoyancy relieves stress on all joints and it is a great place for rehabilitation. However, if we have some bad swim practice habits, the asymmetrical movement in the body causes overexerting one side of the body. This can cause a worsening of back pain or even developing a scoliotic curve. Overexertion of muscle chains always causes some kind of imbalance – this applies also for other sports that require a backbend (for example rhythmic gymnastics or artistic gymnastics), not just swimming. While swimming (the crawl, breaststroke or butterfly) the spine is not in its natural position, the lower back and the neck muscles are overexerted and the body remains hyper-extended. That’s why it is very important to learn proper swim techniques and not to overexert the body on one side.

Which swimming stroke is best for scoliosis?

The healthiest style for the back and spine is backstroke. You swim on your back, the arms are lifted alternately out of the water in a backward circular motion and the legs are extended and kicking. The spine does not get into an unnatural position, the muscles are not in tension, the trapezius is not flexed, the movement of arms and legs is symmetrical and you strengthen the core muscles.

The strokes you meet most often in public pools are less suitable:

• Front crawl – improper stroke mechanics can lead to pain in the neck or trapezius muscles. Breathing to only one side, which is common, builds up a muscular imbalance over time; breathing to both sides is often left out.
• Breaststroke – the same overloading of the neck and trapezius muscles if the technique is poor.
• Butterfly – like crawl and breaststroke it keeps the body hyper-extended, with the lower back and neck muscles overloaded.

This does not mean you should swim nothing but backstroke. The advice is to learn several strokes properly, to alternate them and not to load the body on one side only. With backstroke, just mind the pool wall behind your head :)

Risk factors in swimming

Swimming in general causes joint hypermobility and spinal hypermobility and that’s one of the biggest risk factors for children who suffer from scoliosis. Hypermobile joints are joints that move beyond the normal range with little effort. In people with joint hypermobility syndrome, ligaments that hold joints together and keep them from moving too much are more loose than usual. Loose ligaments can’t protect the joints as much as they should and this can cause pain. Muscle pain may occur mainly in the areas where muscles need to be strengthened more in order to compensate for loose ligaments. If we stop strengthening those muscles, the joints will certainly become loose. Muscle overexertion can lead to a tendon pain because of the ligaments overexertion. With hypermobile joints there is also an increased risk of injuries (such as dislocations, ligament or muscle tears and inflammation in the joints). Excessive movement can cause partial or complete dislocation. 

What is the correct way of swimming?

How should we swim not to harm ourselves? Firstly, it is essential not to overexert our bodies and swim with moderation (approximately 20 – 30 minutes per day). The more we overexert our body by moving asymmetrically, the bigger is the risk of developing a scoliotic curve. Professional swimming (like any other sport played professionally) in long-term perspective is not healthy for our back. Technically speaking any movement (sport) is good, but it needs to be performed with moderation and the asymmetrical movement should be avoided as much as possible. If we are not able to avoid it, we should compensate for this imbalance, for example, by regularly exercising Spiral stabilization. 

Secondly, it is very important to know the right swimming technique that won’t overexert our muscles and it won’t cause any imbalance or muscle tension. The crawl or breaststroke can be seen in public swimming pools very often – unfortunately neither of them is good mainly because improper stroke mechanics can lead to pain in the neck or trapezius muscles. Besides that, breathing to both sides during the front crawl stroke is often left out which leads to a muscular imbalance. The healthiest style for our back and spine is definitely the backstroke when the swimming stroke is performed on the back with the arms lifted alternately out of the water in a backward circular motion and the legs extended and kicking. This way the spine doesn’t get into an unnatural position, the muscles are not in tension, the trapezius is not flexed, the movement of our legs and arms is symmetrical and you strengthen your core muscles. The only downside is that you need to be careful not to hit the border of the swimming pool :)

Swimming and other sports for children

The same logic applies to every sport: any movement is good, but it should be done in moderation and ideally varied. Many sports load only one part of the body – in swimming, for example, the muscles around the neck and lower back are often overloaded – and sports with one-sided equipment handling, such as floorball, hockey or tennis, load one side of the body more. Climbing, running and ball games support all-round movement. If a child sticks to one sport long term, compensatory exercise helps keep the body in balance. More in the article Which sport to choose for your child?

When to see a physiotherapist or a doctor

Swimming will not tell you whether a child has scoliosis. If you notice that one shoulder or shoulder blade sits higher than the other, that the waist is more indented on one side or that the back looks uneven, check the back at home with the Adam's forward bend test and read how to recognize scoliosis in children. Uneven shoulders without a rotation of the spine are described on the page Scoliotic posture.

If you only suspect scoliosis or poor posture, we recommend seeing a physiotherapist; the exact curve is determined by a doctor, usually with an X-ray at an orthopaedic clinic. A scoliotic curve can worsen quickly, so waiting to see whether a child grows out of it is not a good strategy.

Spiral stabilization as a compensation

Spiral stabilization is a rehabilitation method developed by Dr. Smíšek since 1979. It works with spiral muscle chains and uses an elastic cord, and our articles recommend it as the most suitable compensation for one-sided load, including sport. You can read how the method works in Spiral stabilization, how to pick exercises in How to choose exercises, and browse the exercise library.

Frequently asked questions

Is swimming good for scoliosis?

Swimming is gentle on the joints and many people with back problems like it, but the effect depends on the stroke, the technique and how much you swim. The risks are asymmetrical movement and an overloaded neck and lower back; backstroke is the most spine-friendly stroke. Swimming is not a treatment for scoliosis.

What swimming stroke is best for scoliosis?

Backstroke. The spine stays in a natural position, the muscles are not in tension and the movement of arms and legs is symmetrical. Front crawl and breaststroke are less suitable, mainly because they can overload the neck and trapezius muscles, so it is best to learn several strokes and alternate them.

Can swimming fix scoliosis?

Swimming is not a way to correct a scoliotic curve. Moving in water is pleasant and good for rehabilitation, but a plan for a specific curve should come from an orthopaedist and a physiotherapist.

Is swimming bad for scoliosis?

Not by itself. It can become a problem when you swim the same one-sided style for a long time, with poor technique or too much, because that overloads one side of the body and the neck. Moderation, backstroke and variety reduce that risk, and one-sided load can be compensated with exercise.

How long should you swim if you have scoliosis?

This article recommends moderation: about 20 to 30 minutes a day at most. Competitive swimming, like any elite sport, is not good for the back in the long run.

Can you swim with scoliosis?

Movement in water is usually comfortable, and swimming is often recommended for back pain and scoliosis. Ask your physiotherapist or doctor about your own case, and watch the stroke, the technique and the amount.