Butterfly Back

Butterfly Back

Article by J.Miller, Z.Russell


Butterfly Back

Understanding and Managing Swimmer’s Low Back Pain


Swimming, a popular sport and recreational activity, offers numerous health benefits. However, it can also lead to specific types of injuries, particularly in the lower back region. This phenomenon, often referred to as “Butterfly Back,” arises primarily in swimming styles like the butterfly and breaststroke. In this article, we will explore the causes, prevention, and treatment of low back pain from a physiotherapist’s perspective, ensuring a deeper understanding for swimmers and the general public alike.

The Mechanism of Butterfly Back

Swimmers, especially those practicing the butterfly and breaststroke, frequently experience low back pain. This pain results from the unique demands these strokes place on the body. When swimmers are positioned horizontally in the water, forces of gravity and buoyancy interact differently than on land. These forces, combined with the undulating movements of the lumbar spine during these strokes, can lead to stress on spinal joints.

Tightness in the hip flexors or an inadequate body roll during swimming can also contribute to lumbar spine stress. These compensatory mechanisms can exacerbate the strain on the lower back, increasing the risk of injury.

butterfly back
Butterfly Back

Common Associated Conditions

Several conditions are commonly associated with swimmer’s back, including:

In addition to these, swimmers might also experience related injuries such as shoulder impingement, rotator cuff syndromes, and knee pains like Breaststroker’s Knee and Medial Collateral Ligament Stress Syndrome.

Prevention and Management

To minimise the risk of developing Butterfly Back, swimmers should focus on:

  1. Proper Technique: Ensuring correct stroke technique to reduce undue stress on the back.
  2. Strength and Flexibility Training: Building core strength and improving hip flexor flexibility to support the lumbar spine.
  3. Regular Assessment: Seeking regular assessments from a physiotherapist for personalised advice and injury prevention strategies.

Treatment Approaches

Effective treatment for Butterfly Back includes:

  • Physiotherapy: Tailored exercises and manual therapy to alleviate pain and restore function.
  • Rest and Recovery: Allowing adequate recovery time following intense training sessions.
  • Modifying Training Regimes: Adjusting training to reduce strain on the back.

The Role of Recent Research

Recent research highlights the importance of core stability exercises and hip flexor stretches in managing and preventing lower back pain in swimmers. Studies suggest that a holistic approach, incorporating both physical and psychological aspects of rehabilitation, is most effective in treating swimmer’s back.

What to Do? Seeking Professional Advice

If you’re experiencing low back pain related to swimming, it’s crucial to consult a physiotherapist. They can provide a comprehensive assessment, personalised treatment plan, and guidance on technique modification to prevent future injuries.


Butterfly Back, a common ailment among swimmers, requires attention to technique, strength, and flexibility to prevent and manage effectively. With the right approach and professional guidance, swimmers can continue to enjoy the benefits of the sport while minimising the risk of injury.

Remember, your physiotherapist is your partner in maintaining a healthy, active lifestyle. If you’re facing any discomfort or pain while swimming, don’t hesitate to seek their assistance.

Article by Zoe Russell

Sports Physiotherapy FAQs

sports physiotherapist brisbane

Sports Physiotherapy is the specialised branch of physiotherapy which deals with injuries and issues related to spokespeople. Practitioners with additional formal training within Australia are Sports & Exercise Physiotherapists.

What is Sports Physiotherapy?

Sports injuries do differ from common everyday injuries. Athletes usually require high-level performance and demands placed upon their bodies, which stresses their muscles, joints and bones to the limit. Sports physiotherapists help athletes recover from sporting injuries and provide education and resources to prevent problems. Each sports physiotherapist usually has sport-specific knowledge that addresses acute, chronic and overuse injuries. Their services are generally available to sportsmen and women of all ages engaged in sports at any level of competition.

Members of Sports Physiotherapy Australia (SPA) have experience and knowledge of the latest evidence-based practice, professional assessment and diagnosis of sports injuries, and effective hands-on management techniques and exercise protocols to assist recovery and prevent future damage. SPA members have access to the most recent advances in sports physiotherapy. You'll be pleased to know that most PhysioWorks physiotherapists and massage therapists are particularly interested in sports injury management.

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