Water Workouts for Back Pain

While the couch may be calling your name when you have back pain, taking a dip, according to experts, may be the better place to recover. When done gently and safely, a water workout can actually help alleviate back pain and prevent it from getting worse.

“Back pain is often caused by multifactorial conditions made up of biochemical, psychological, and social components,” explains Jake Fisher, DC, CCSP, SCSCA, Sports Medicine Provider at Canyon Ranch Tucson. “A water workout is a low-impact activity that conditions and strengthens back and other muscles, to better support your spine. And unlike exercising on solid surfaces, working out in a pool provides your body with less weight-bearing loads, which takes stress off your back and helps you move more freely, minimizing your risk of injury.”

Being active in the water is beneficial at any age and fitness level, and workouts can be modified to suit different goals and conditions because it’s gentler on your body than hitting the gym, may feel easier at times, and can be just as effective. The goal for alleviating back pain is to build strength in the back, abdominal, and hip muscles, which are key to a healthy spine.

4 Reasons Water Workouts Matter

• You can simply do more. Water’s buoyancy supports your weight, up to 90 percent of it, putting less pressure on your joints and spine. You’ll be able to perform a wider range of movements to end range, and do them more easily in water because you won’t be fighting gravity.
• You’ll strengthen muscles with minimal risk of injury. To really test your muscles in the weight room, you might pick up a too-heavy barbell. “You will not need these heavy external loads like barbells in the pool because water provides greater resistance than air,” says Jake. Just moving will challenge your body.
• You’ll improve blood flow to your muscles. The hydrostatic pressure—or pushing forces—of water helps increase cardiac output, increase removal of metabolic waste products, and reduces the time it takes to get oxygen and nutrients to replenish fatiguing muscles. 
• You’ll lessen your perception of pain. Being in the water can lessen pain from peripheral edema and enhanced sympathetic nervous system activity, which may inspire longer and more frequent workouts.

Water Exercises to Try

Proper technique is essential to staying safe. “At least at first, it’s important to work with a trained instructor who can show you how to move appropriately, keeping proximal trunk stability while improving distal extremity mobility,” Jake explains. One of your main goals should be strengthening muscles around your core, which may help protect your back during your daily activities. 

Here are some basic water exercises to consider:

Four-way Hip Strength Exercise: While grasping the side of the pool with your arms, brace your core while performing your sets. Begin with a set of straight-leg hip flexion, by kicking your leg in front; extensions, to kick your leg back; adductions, to extend your straight leg out to the side; and abduction of the hip to extend a bended leg out—all to full range. “The deeper the water and force applied against the water, the greater the resistance will be. In turn your lumbo-pelvic region will acquire greater strength gains,” adds Jake.

Jogging or Running in Place: While stationary, start out lightly jogging in place. Progressively increase the tempo and knee drive to mimic running. This will help improve cardiovascular fitness, decrease pain, improve core strength, and hip mobility.

Jumping In Place: Start this exercise with the water at chest height and progressing to waist deep. Perform a few sets of repeated jumps. The deeper the water, the more it will help cushion when you land, thereby protecting your back, knees, and ankles.

Lap Swimming: Lap swimming can help ease back pain, but strokes and form matter. Keep your head and neck in line with your spine when you swim, and consider using goggles and a snorkel so that your face can remain in the water as much as possible. Start with the breast or back stroke, which involve less hyperextension than twisting, rotating moves—like the butterfly and freestyle strokes.

Water Aerobics: Water aerobics classes involve moves that often mimic land exercises like dancing, running, and jumping jacks. A good class should include a warm-up and a cool-down, including plenty of flexibility exercises, and be taught by an instructor with special training in aquatic fitness. Get the OK from your doctor before trying it, and inform your teacher of your condition so that she can modify exercises for you, if needed.

Water Walking: Once you’re in the water, start by simply walking around the pool to feel the tug of the water. Take long strides both forward, sideways, and backwards, starting in the shallow end and graduating to chest-high water. “As you increase depth and speed in the water, try to maintain normal walking gait and posture,” recommends Jake.

Tips For Any Water Workout

Whatever water workout you choose, here are some general tips to help you make the most of it while protecting your back from further discomfort:

Choose the Right Pool. You should be able to work out in different depths, as needed. Make sure the pool has an area where you can exercise in your own lane.

Check the Water Temperature. Water should be between 82 and 86 degrees, the recommended temperature for water workout exercises.

Always Warm Up First to Prevent Injury. A good warm up includes walking in the water or doing gentle, slow laps.

Stay Hydrated. Though you may not feel it, you will sweat during water exercise, so it’s important to drink water.

Consider Aquatic Equipment. Kick-boards, water webs, water weights, a water belt, and foam noodles are a few examples of tools that can enhance your workout by providing support and/or increased resistance. Set them on the side of the pool, within arm’s length, for easy access. Using a snorkel while swimming, even in an indoor pool, allows you to increase your focus on the movement of your body in the water.

Wear Water Shoes if You’re Concerned About Stability or Balance. They are made of water-resistant fabric and have soles with traction, allowing you to grip the pool floor more easily.

Protect Yourself from the Sun. If you are doing water exercise outside, wear waterproof sunscreen, as well as a hat and sunglasses (if possible) to protect yourself from harmful rays.

It’s best to consult with your physician before embarking on any kind of exercise program. Your doctor may recommend that you work with a physical therapist experienced in pool or hydrotherapy who can help design an exercise program that’s right for you. In some cases, that may include a combination of water exercises and land-based exercises, like yoga or aerobic stretches. 

Related Pathways: Optimal Health, Outdoor Escape

This article was originally published on July 16, 2021, and has been updated as of the above date.