Scoliosis and Swimming: What You Should Know

What you should know about scoliosis and swimming is that some patients will be approved for swimming, or certain swimming strokes, while others might have it restricted. All exercise needs to be approved by a patient’s treatment provider, but when customized and approved, can increase treatment efficacy in a number of ways.

Scoliosis varies widely in severity, and when deemed safe, swimming can offer therapeutic benefits: increasing core strength, disc health, and pain relief. While the front stroke is generally considered safe for scoliosis patients, the butterfly stroke is often restricted due to the unnatural arching of the spine, as is competitive swimming.

Scoliosis patients benefit from regular exercise, but certain activities are restricted and/or require modification.

Being Diagnosed with Scoliosis

Being diagnosed with scoliosis means the spine is not aligned and balanced as it should be; it means the spine’s biomechanics can be disrupted and the entire body can be affected.

A healthy spine isn’t just important for posture and movement, but also nerve health and function.

Scoliosis ranges widely in severity from mild cases to moderate and severe scoliosis, and the larger the size of the spine’s unnatural curve, and the more rotation there is, the more noticeable and severe its effects are likely to be.

Severe and/or atypical cases can come with activity restrictions due to the strain the spine and its surroundings muscles and nerves are under.

Scoliosis and Exercise

We haven’t always fully understood the place of exercise in the lives and treatment of scoliosis patients, but there are now entire rehabilitative scoliosis-specific exercise-based approaches to treatment that, when combined with the power of corrective bracing, can offer corrective potential.

Activities generally considered unsafe for scoliosis patients include those that expose the spine to compressive force, stress from repeated shock from impact, exacerbate the condition’s asymmetrical effects, and/or place the spine in an unnatural position.

Being diagnosed with scoliosis means proactive and customized treatment is necessary, and the best time to start treatment is always now; with progressive conditions like scoliosis, the timing of treatment can directly affect progression and treatment outcome.

Mild cases can benefit from treatment that works towards prevention: preventing progression, increasing symptom severity, potential complications, and the need for surgical intervention.

Being diagnosed with scoliosis means the spine’s health and function need to be preserved and protected, and awareness of the types of activities that are deemed safe, unsafe, and/or should be approached with caution is important.

While weight lifting, football, gymnastics, tennis, and horseback riding, and competitive swimming aren’t commonly deemed appropriate for scoliosis patients, walking, road cycling, certain yoga poses, and recreational swimming can offer certain therapeutic benefits.

Swimming Benefits for Scoliosis

When swimming is deemed an appropriate activity for a scoliosis patient by their treatment provider, the potential benefits may outweigh the potential risks, and certain swim strokes can offer a number of therapeutic benefits.

To be clear, recreational swimming differs from competitive swimming; competitive swimming is restricted to scoliosis patients because of the repeated arching of the spine, flattening of the thoracic curve, and the lack of gravity’s destabilizing effect.

While the anti-gravity effect of swimming offers pain relief and smooth restriction-free movement, competitive swimming involves prolonged exposure to buoyancy and lack of gravity that, over time, can have a destabilizing effect on the spine and its surroundings.

The spine needs stability, particularly a scoliotic spine facing the rigors of progression, adverse spinal tension, and treatment, and a common focus of treatment is on improving the level of spinal support provided by its surrounding muscles.

Swimming casually once or twice a week for shorter periods of time can provide short-term pain relief, symmetrical muscle engagement, and improve overall health and fitness, making the body more responsive to treatment and patients better able to handle the challenges of treatment.

Increasing Core Strength

Increasing the strength of core muscles can mean more support and stability for the spine, and it can also reduce pressure on the spine’s internal structures and surroundings.

Swimming can help with symmetrical muscle development, counteracting a common effect of scoliosis: muscular imbalance.

Scoliosis can cause the development of muscular imbalances due to the spine’s unnatural curvature and rotation pulling the spine’s surrounding muscles in different directions; the muscles on one side of the spine are working harder to maintain balance, while muscles on the opposite side can become weak and atrophy due to lack of use.

A muscular imbalance is a common source of scoliosis pain causing sore and strained muscles, muscle weakness, and muscle spasms.

Activities that are commonly restricted for scoliosis patients are those that overuse one side of the body because they can exacerbate a scoliosis muscular imbalance; a focus of nonsurgical scoliosis treatment is improving the spine’s surrounding muscle strength and balance.

The front stroke is associated with symmetrical muscle development as it works the back and body’s muscles evenly, and can offer core strengthening without impact.

Improving Disc Health

The spine’s vertebrae are separated by an intervertebral disc, and the health of spinal discs are key to the spine’s overall health and function.

Swimming recreationally may offer benefits to the spinal discs as exercise increases circulation, and this makes nutrients needed for repair more readily available to the discs and their surroundings.

Pain Relief

Scoliosis pain can involve the muscles and/or nerves that surround the spine and localized back pain.

Scoliosis is more commonly painful for adults who are no longer growing (scoliosis becomes compressive once skeletal maturity is reached), and compression can cause back pain, muscle pain, and/or nerve pain radiating into the extremities.

Scoliosis introduces compressive force to the back, exposing the spine, its internal structures, and surrounding muscles and nerves to excessive and uneven pressure, and activity that relieves pressure can offer pain relief and support healthy movement patterns that can be lost due to pain.

Swimming is a low-impact exercise that offers relief from the pressure of gravity for temporary pain relief.

Gentle recreational swimming can offer benefits for scoliosis patients because the water’s buoyancy helps relieve spinal pressure, facilitating symmetrical muscle engagement for strengthening purposes and counteracting muscle imbalances.

Swimming Risks for Scoliosis

As mentioned, there are a number of activity restrictions and modifications that scoliosis patients may face, and when it comes to swimming with scoliosis, recommendations are for recreational swimming only, over the strain of Swim as a competitive sport.

In addition, the front stroke should be the stroke of choice, while the butterfly stroke, for example, is often restricted due to the repeated unnatural arching of the spine, and the back stroke can also flatten the thoracic curve.

The butterfly stroke involves simultaneous lifting of the arms over the head and arching of the thoracic spine, and this can increase adverse spinal tension and further strain the spine.

A scoliotic spine is already exposed to uneven pressure and strain, and swim strokes that involve repeatedly placing the spine in an unnatural position can exacerbate the condition’s effects and potential progression.

In addition to the repeated unnatural arching of the spine, the butterfly stroke and back stroke can flatten the thoracic spine’s healthy curve, further increasing adverse spinal tension.

As an approved activity, recreational swimming can help relieve pain, improve posture, and improve overall fitness, but deep diving and twisting motions should be avoided; the focus should be on maintaining smooth neutral-spine positions.

Conclusion

When it comes to swimming with scoliosis, the literature is mixed; in addition, as no two cases of scoliosis are the same, activity restrictions and recommendations can vary from patient to patient.

Swimming offers some therapeutic benefits, when used as a general exercise to engage the back and core muscles symmetrically, which can provide short-term pain relief and overall fitness improvements.

Competitive swimming, however, is commonly restricted because it involves prolonged exposure to unnatural arching of the spine and/or flattening of the thoracic spine (the largest spinal section).

Cultivating a healthy activity level is key to a spine- and scoliosis-friendly lifestyle, so don’t hesitate to reach out for guidance on approved scoliosis activities and common restrictions.