Is swimming good for sciatica?

Sciatica or sciatic pain refers to pain or neural symptoms (pins and needles, numbness) that travel along the sciatic nerve, and emanates from the gluteal region (lower back, hips and buttocks) into the lower limb (down the back of the leg and into your foot and toes).

It usual affects just one side, and most people experiencing sciatica make a favourable recovery.

While bed rest was once prescribed this has now been replaced with active treatments, such as walking, jogging, cycling and swimming, to name a few.

What causes sciatica?

When something touches the sciatic nerve, usually a slipped spinal disc or an overgrowth of bone.

How does swimming improve/help sciatica?

Depending on the irritability of someone’s sciatica, swimming will mostly be ‘calming’ for the individual. A reduction in pain intensity and symptoms may occur. The mechanisms of this reduction in symptoms is unknown.

However, we can reason that the very act of ‘moving’ in a ‘supported’ environment such as the water could enhance a sciatica sufferer’s self efficacy. An increase in self efficacy may assist with reducing the symptoms being experienced by the swimming athlete.

How does swimming aggravate sciatica?

The chief mechanism by which swimming may aggravate sciatica is through an increase in neural tension/neural load. When a swimmer tumble turns and places their chin on their chest, this increases neural tension in the spinal tract which can result in heightened irritability of an athlete’s sciatica.

If we think about a 30- or 60-minute swim this may involve scores of repeated ‘chin to chest’ neurally loaded positions which may increase symptoms. In tandem with neck flexion on turning, a rounded back (lumbar flexed spinal position) can also serve as a neurally loaded position for the swimmer.

This position adopted in tumble turns and to a lesser extent touch turns can also heighten sciatica symptoms.

Lastly if a swimmer is highly toned in the front of their thighs (quadriceps) and hips (hip flexors), this can require the swimmer to try and ‘swim up and out of their hips’ which increases work being done at the already extended spine.

How can sciatica symptoms be treated?

This tightness pattern can be treated via stretching or manual therapies in order to assist the swimmer and reduce the risk of flaring sciatica symptoms.

Anterior hip tightness can be tested for with an orthopaedic test called the Thomas test. To perform the Thomas test the athlete sits on the edge of a plinth and hugs one knee maximally into their chest. The other leg hangs passively down. If the ‘hanging leg’ is ‘hinging’ above neutral it may be deemed a positive test for anterior hip tightness.

The athlete can then perform stretching or manual therapies to reduce the tone in this region. The result of this intervention being reduced anterior hip tightness and a better position in the water with the pelvis that places less load on the lower back when swimming.

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