Swimmer's neck and upper back pain
Why swimming can aggravate the neck and upper back, how common it is according to a 2025 review, and what to adjust in the pool.
Swimming is gentle on the joints, but the neck has to rotate repeatedly to breathe in front crawl, or hold the head up for breaststroke and open-water sighting. A 2025 systematic review and meta-analysis of 94 studies found shoulder injuries were the most commonly reported problem in swimmers, with neck problems reported in around 17% of studies. Neck pain from swimming is usually a movement and load problem and often responds well to small changes.
When to get urgent help
Call 999 straight away if neck pain comes with any of these. They can be signs of a stroke, meningitis or another emergency.
- Sudden severe headache unlike any you have had before
- Dizziness with double vision, slurred speech, facial droop, difficulty swallowing or weakness in an arm or leg
- Neck stiffness with a high temperature, severe headache, rash or dislike of bright light
What it can feel like
- A stiff or achy neck during or after swimming, sometimes on one side only
- Tightness between the shoulder blades or at the base of the neck
- Neck discomfort when turning to breathe, or when lifting the head to sight in open water
- Occasionally pain that spreads to the shoulder or a headache at the base of the skull
Common contributors
- Repeated rotation to one side to breathe, or holding the head lifted in breaststroke or when sighting
- A sudden rise in swim volume or a new programme, especially for triathletes returning to the pool
- Stiffness in the upper back and shoulders, which can force the neck to do more work
- A tight wetsuit around the neck and shoulders can add to the load in open water
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- Alternate breathing sides if you comfortably can, and try to keep your head in a neutral position as you swim
- Take short breaks and avoid long stretches of head-up breaststroke if it provokes your neck
- A University Hospitals Sussex leaflet suggests keeping the neck moving gently, with simple range-of-motion exercises, and avoiding long periods in one position
- Build up swim volume gradually, and add strength and mobility work for the upper back and shoulders
- Warmth can ease stiffness. If you use over-the-counter pain relief, ask a pharmacist
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Neck pain after a significant fall, accident or blow
- Numbness, tingling or weakness spreading into the arms or hands
- Unexplained weight loss or a history of cancer with new neck pain
Consider seeing your GP if:
- A sudden severe headache, dizziness with double vision, slurred speech, facial drooping or weakness. Call 999
- Neck pain after a fall or a dive into shallow water, or numbness, tingling or weakness in the arms or hands
- A stiff neck with a high temperature, severe headache, rash or dislike of bright light. Call 999
- Neck pain that is not improving after a few weeks
Where an osteopath fits in
There is limited good-quality research showing that hands-on treatment changes the course of neck pain in swimmers, so I do not claim that osteopathy treats it.
What an osteopath can usefully do is examine your neck, upper back and shoulders, watch how you move, and advise on stroke-related adjustments, mobility and strengthening. A 2025 Cochrane review found that manual therapy combined with exercise may reduce neck pain compared with no treatment, but showed little or no difference in pain compared with a sham (placebo) treatment, and the certainty of the evidence was low. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
Why does my neck hurt when I swim front crawl?
The neck rotates repeatedly to breathe, often to one side. Stiffness in the upper back and shoulders, head position, and a rise in volume can all add to the load. Alternating breathing sides and keeping the head neutral can help.
Is neck pain common in swimmers?
A 2025 systematic review of 94 studies found shoulder injuries were reported most often, followed by knee problems, with neck problems reported in about 17% of the studies.
Free 5-minute exercise sheet
A simple, printable sheet of gentle exercises and stretches, about five minutes a day, based on NHS physiotherapy leaflets. It is general information, not a personal treatment plan, and it is not suitable if you have any of the urgent signs listed above.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
- Li and Liu, Journal of Sports Medicine and Physical Fitness 2025: Musculoskeletal injuries in swimmers, systematic review and meta-analysis
- University Hospitals Sussex NHS Foundation Trust: Self-treatment of acute neck pain
- Cochrane review (Chacko et al., 2025): Manual therapy with exercise for neck pain
- NHS: Stroke
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.