OBJECTIVE: To map the extent and characteristics of research investigating relationships between swimming and low back pain, and summarize these relationships.
DESIGN: Scoping review.
LITERATURE SEARCH: MEDLINE, EMBASE, CINAHL, and SPORT Discus were searched from inception to February 2023.
STUDY SELECTION CRITERIA: We included primary studies and reviews that reported an association between swimming and low back pain, including any age group. Hydrotherapy studies were excluded.
DATA SYNTHESIS: We extracted study characteristics (including population, swimming exposure and comparator type) for qualitative synthesis. We also extracted measures of association, including 2 x 2 data when available.
RESULTS: 3093 articles were identified, and 44 studies included. Only one randomized controlled trial and one longitudinal cohort study were included. Most studies were cross-sectional (37/44; 84%), included competitive athletes (23/39; 59%), and did not primarily focus on the association between swimming and low back pain (41/44; 93%). The reported associations between swimming and low back pain were highly variable regardless of whether the comparison was to other sports (odds ratio: 0.17 to 17.92) or no sport (odds ratio: 0.54 to 3.01)
CONCLUSION: We could not identify any clear pattern of association between swimming and low back pain. There is an urgent need for high-quality studies that directly assess the association between swimming and low back pain, including randomized controlled trials and cohort studies, especially given that swimming is a commonly recommended exercise for management of low back pain.