Search

Search Results

• Spinal Deformities and Injuries in Competitive Swimming: A Systematic Review

  Dániel Arany

  Mónika Szigethy

  Katalin Biróné Ilics

  Ferenc Ihász

  Katalin Nagyváradi

  Views:

  19

  Competitive swimming is traditionally considered a low‑impact sport; however, repetitive stroke mechanics, high training volumes, and stroke‑specific lumbar loading patterns may contribute to spinal malalignment, lumbar intervertebral disc degeneration (LDD), and low back pain (LBP). Emerging evidence suggests that these risks may be particularly relevant for adolescent and young adult swimmers who undergo early and intensive training. Our study systematically reviewed the literature on spinal posture, lumbar disc degeneration, and low back pain in competitive swimmers aged 6–25 years, and identified key risk factors and preventive strategies.

  A systematic search of Google Scholar, Scopus, and PubMed was conducted in accordance with PRISMA guidelines. Eligible studies included cross-sectional, case-control, and cohort designs published between 2005 and 2024 that involved competitive swimmers with ≥2–3 years of training and ≥3 weekly sessions. Outcomes of interest were spinal posture abnormalities, MRI-confirmed LDD, and LBP prevalence. Eight studies met the inclusion criteria. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT).

  Across studies, swimmers exhibited a higher prevalence of postural deviations—including hyperkyphosis, hyperlordosis, trunk asymmetry, and anterior pelvic tilt—compared with non-athletes. MRI-based studies consistently report elevated rates of LDD among swimmers, particularly at L4–L5 and L5–S1, with degeneration present in up to 68% of elite swimmers, compared with 29–31% of controls. LBP was identified as the second most common musculoskeletal complaint among swimmers, with an increased risk associated with greater training exposure and strokes that involve repetitive lumbar flexion–extension (e.g., butterfly, breaststroke). Contributing factors included early specialization, muscular imbalances, and technical inefficiencies. Methodological limitations included small sample sizes and predominantly cross-sectional designs.

  Competitive swimming is associated with increased rates of spinal postural abnormalities, lumbar disc degeneration, and low back pain in youth and young adult athletes. Early screening, core stabilization, stroke technique optimization, and training load management are essential to mitigate spinal stress. Longitudinal research is needed to clarify causal pathways and inform evidence-based prevention strategies.