Learning to swim with back pain: a qualitative study of swimmers with chronic low back pain

Purpose: Swimming is one form of exercise advised to people with chronic low back pain (CLBP), there is limited research, however, supporting this recommendation and describing the experience and use of swimming in this population. The aim of this study was to explore the experience of people who use swimming to manage CLBP.

Methods: Semi-structure interviews were conducted with 14 swimmers who were using swimming to manage CLBP. Thematic analysis was used to analyse the interview data, and the themes were mapped onto the capability, opportunity, motivation and behaviour (COM-B) model to understand the behavioural factors.

Results: Five common themes were developed during the analysis: (1) My back pain journey; (2) Learning to swim with back pain; (3) How swimming looks for me; (4) What I gain from swimming; and (5) Keep calm and carry-on swimming. The themes mapped onto all three COM-B domains.

Conclusions: The participants found that swimming was a valuable self-management tool for CLBP. The findings from the thematic and COM-B analysis indicate that learning to swim with CLBP can be a complex journey, influenced by several interrelated behavioural factors. In the absence of multi-professional support, inclusive swimming communities and accessible swimming venues, swimming participation rates may be affected.