Swim Your Way To Healthy Joints

Why We Love Swimming: A Chiropractic Perspective

Whether in pain or not, we often seek out effective ways to improve, maximize and maintain optimal musculoskeletal health. Swimming stands out as one of the most beneficial activities for both rehabilitation and general wellness. Here’s why:

The Science Behind Swimming’s Benefits

Swimming is unique among exercises because it combines cardiovascular conditioning, strength training, and flexibility work in a low-impact environment. The buoyancy of water reduces gravitational stress on joints while providing resistance for muscle strengthening—a combination that’s particularly valuable for those dealing with various musculoskeletal conditions.

Cardiovascular and Systemic Benefits

The aerobic benefits of swimming are well-documented. Regular swimming improves cardiovascular endurance, reduces blood pressure, and enhances overall heart health. A systematic review published in the International Journal of Aquatic Research and Education found that swimming programs significantly improved cardiovascular fitness markers, including VO2 max and resting heart rate, across various age groups.

Swimming also promotes better circulation, which aids in tissue healing and reduces inflammation—factors that are crucial for musculoskeletal recovery. The hydrostatic pressure of water acts as a natural compression garment, helping to reduce swelling and improve venous return.

Low-Impact on Joints, Big Impact on Health

The low-impact nature of swimming is perhaps its greatest asset from a chiropractic standpoint. Water’s buoyancy reduces body weight by approximately 90% when submerged to the neck, dramatically decreasing the load on weight-bearing joints. This reduction in compressive forces allows people with joint pain to exercise without exacerbating existing joint problems or creating new ones.

Research published in the Archives of Physical Medicine and Rehabilitation demonstrated that aquatic exercise programs resulted in significant improvements in functional capacity and pain reduction compared to land-based exercises, particularly in patients with chronic musculoskeletal conditions.

Conditions That Benefit from Swimming

Osteoarthritis Management

Swimming has shown remarkable efficacy in managing osteoarthritis symptoms. The Arthritis Foundation cites swimming as one of the best exercises for people with arthritis, and research supports this recommendation. A study in the American Journal of Physical Medicine & Rehabilitation found that patients with knee osteoarthritis who participated in aquatic exercise programs experienced significant improvements in pain, stiffness, and physical function compared to control groups.

The warm water typically used in therapeutic pools (82-88°F) provides additional benefits by increasing blood flow and reducing muscle tension, which can help alleviate the stiffness commonly associated with arthritis.

Chronic Low Back Pain

For patients suffering from chronic low back pain, swimming offers a unique therapeutic environment. The water’s support allows for movement patterns that might be painful on land, while the resistance provides gentle strengthening for core and back muscles. A randomized controlled trial published in Spine journal showed that aquatic exercise was as effective as land-based physical therapy for reducing pain and improving function in patients with chronic low back pain.

Fibromyalgia and Chronic Pain Conditions

Patients with fibromyalgia often find swimming particularly beneficial. The warm water helps relax muscles and reduce pain sensitivity, while the gentle resistance provides conditioning without excessive strain. Research in Rheumatology International demonstrated that aquatic exercise programs led to significant improvements in pain, fatigue, and quality of life in fibromyalgia patients.

Post-Surgical Rehabilitation

Swimming serves as an excellent bridge between early rehabilitation and return to full activity. The controlled environment allows for progressive loading of healing tissues while minimizing risk of re-injury. However, timing is crucial—patients must wait for complete wound healing and receive clearance from their healthcare provider before entering the pool.

Conditions That May Require Caution

While swimming offers numerous benefits, certain conditions require careful consideration and potentially modified approaches.

Shoulder Impingement and Tendinitis

Repetitive overhead motions in swimming strokes, particularly freestyle and butterfly, can aggravate shoulder impingement syndrome and rotator cuff tendinitis. The repetitive nature of swimming strokes can perpetuate poor movement patterns and increase inflammation in already irritated tissues.

For patients with shoulder conditions, we often recommend:

• Modified strokes that minimize overhead positioning

• Focus on backstroke and breaststroke with proper technique

• Shorter, more frequent sessions rather than long continuous swimming

• Integration of shoulder mobility and strengthening exercises outside the pool

• Modification when pain occurs with activity

Some Cervical Spine Conditions

Swimming strokes that require excessive neck extension or rotation can be problematic for patients with cervical spine conditions. The traditional freestyle breathing pattern, which involves significant neck rotation, may exacerbate cervical facet joint irritation or disc problems.

Modifications include using a snorkel to maintain neutral neck position or focusing on backstroke where the neck remains in a more neutral alignment. Again, note which activities cause irritation or pain and modify them.

Active Inflammatory Conditions

During acute flare-ups of inflammatory conditions, the increased circulation promoted by warm water exercise might temporarily increase inflammation. In these cases, we typically recommend waiting until the acute phase subsides before resuming aquatic activities.

Technique Matters: The Importance of Proper Form

One of the key factors in maximizing swimming’s benefits while minimizing risks is proper technique. Poor swimming form can negate many of the low-impact advantages and potentially create new problems. We often recommend working with qualified swim instructors, particularly for patients returning to swimming after injury or those new to the activity.

The Therapeutic Pool Advantage

While any swimming can be beneficial, therapeutic pools offer additional advantages with their controlled temperature, depth options, and often specialized equipment. Water walking, aqua jogging, and targeted exercises can be performed in these environments, providing alternatives for patients who may not be comfortable with traditional swimming strokes.

Conclusion: "Dive" into Self Care

Swimming represents one of the most versatile and effective exercises available for musculoskeletal health. Its unique combination of cardiovascular benefits, strength training, and joint-friendly movement makes it an invaluable tool in both treatment and prevention of various conditions.

Swimming can be a cornerstone of effective musculoskeletal care, providing a path to better health that’s both enjoyable and sustainable for individuals of all ages and fitness levels.

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References

Batterham SI, Heywood S, Keating JL. Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes. BMC Musculoskelet Disord. 2011;12:123.

Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsøe B. Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev. 2007;(4):CD005523.

Dundar U, Solak O, Yigit I, Evcik D, Kavuncu V. Clinical effectiveness of aquatic exercise to treat chronic low back pain: a randomized controlled trial. Spine. 2009;34(14):1436-1440.

Geytenbeek J. Evidence for effective hydrotherapy. Physiotherapy. 2002;88(9):514-529.

Hinman RS, Heywood SE, Day AR. Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial. Phys Ther. 2007;87(1):32-43.

Munukka M, Waller B, Rantalainen T, et al. Efficacy of progressive aquatic resistance training for musculoskeletal symptoms and related functional limitations in health care workers: a randomized controlled trial. Phys Ther. 2017;97(2):209-216.

Reichardt CS. Aquatic therapy and rheumatologic disease. Rheum Dis Clin North Am. 1990;16(4):915-929.

Silva LE, Valim V, Pessanha AP, et al. Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial. Phys Ther. 2008;88(1):12-21.