Background: Physical exercise is a cornerstone in clinical guidelines for managing low back pain. Swimming is frequently recommended as a therapeutic modality because water buoyancy minimizes spinal axial loading while enhancing joint mobility and muscular strength. Aim: To examine the biomechanical characteristics of different swimming strokes and discuss their implications for chronic low back pain (CLBP) management. Methods: A focused literature search was conducted across PubMed/MEDLINE and the Consensus AI platform using the terms "swimming" and "lumbar" or "low back pain," initially yielding 23 studies (8 and 15, respectively). Exclusion criteria comprised general therapeutic exercise, postoperative protocols, hot baths, comparisons with alternative exercise techniques, and duplicate records. Ultimately, 7 English-language studies published within the last five years were selected for final synthesis, comprising clinical trials (2), systematic reviews (2), narrative reviews (1), and scoping reviews (2). All AI-assisted findings were manually verified against primary sources. Results: Biomechanical demands vary significantly across swimming strokes. Front crawl and backstroke involve greater rotational and lateral trunk movements, whereas breaststroke requires larger ranges of lumbar flexion and extension. During freestyle swimming, breathing introduces additional rotational demands that influence spinal kinematics, particularly when lumbopelvic coordination is compromised. Clinical evidence suggests that swimming, especially when integrated into multimodal rehabilitation programs, reduces pain and improves physical function in individuals with CLBP, with no clear increase in the risk of lumbar degenerative conditions compared to sedentary populations. Conclusions: Swimming represents a valuable therapeutic option for CLBP when proper technique and individualized prescription are considered. Patients with extension intolerance, for example, require technical modifications to avoid repetitive lumbar hyperextension. Although the literature remains heterogeneous, swimming significantly enhances flexibility, strength, and functional capacity.
© Copyright 2026 XVth International Symposium on Biomechanics and Medicine in Swimming Proceedings. Alle Rechte vorbehalten.