Many people find that recreational swimming helps ease back pain, and there is research to back that up. But some strokes may be better than others.

An advantage to exercising in a pool is that the buoyancy of the water takes stress off the joints. At the same time, swimming and other aquatic exercises can strengthen back and core muscles.

That said, it does not mean that everyone with a case of back pain should jump in a pool, said Dr. Scott A. Rodeo, a team physician for U.S.A. Olympic Swimming at the last three Olympic Games. Back pain can have a number of potential causes, some that require more caution than others. So the first thing to do is to get a careful evaluation and diagnosis. A doctor might recommend working with a physical therapist and starting off with standing exercises in the pool that involve bands and balls to strengthen the core and lower back muscles.

If you are cleared to swim, and just starting for the first time, pay close attention to your technique. Work with a coach or trainer if necessary.

It may also be a good idea to start with the breaststroke, because the butterfly and freestyle strokes involve more trunk rotation. The backstroke is another good option, said Dr. Rodeo, who is co-chief of the sports medicine and shoulder service at the Hospital for Special Surgery in New York.

“With all the other strokes, you have the potential for some spine hyperextension,” Dr. Rodeo said. “With the backstroke, being on your back, you don’t have as much hyperextension.”

Like any activity, begin gradually, swimming perhaps twice a week at first and then progressing slowly over four to six weeks, he said. In one study, Japanese researchers looked at 35 people with low back pain who were enrolled in an aquatic exercise program, which included swimming and walking in a pool. Almost all of the patients showed improvements after six months, but the researchers found that those who participated at least twice weekly showed more significant improvements than those who went only once a week. “The improvement in physical score was independent of the initial ability in swimming,” they wrote.

###

By ANAHAD O’CONNOR