Dual Impact of Swimming on Intervertebral Disc Health: Biomechanical, Clinical, and Translational Perspectives

Intervertebral disc degeneration (IVDD) is a major contributor to chronic low back and neck pain. Current treatment strategies include conservative pain management and surgical intervention based on clinical presentation. Physical exercise plays an increasingly important role in conservative care, offering both preventive and therapeutic benefits. Among available exercise options, swimming is often considered beneficial due to its low impact nature and supportive biomechanical properties. Its buoyancy reduces spinal load, while water resistance and rhythmic movements help improve core strength, flexibility, and controlled spinal loading. These factors contribute to improved spinal health and support recovery after injury or surgery. However, swimming, especially at a competitive level, also involves repetitive spinal motions such as hyperextension and rotation, potentially increasing the risk of spinal strain or degeneration. This review examines the complex relationship between swimming and IVDD, highlighting both potential benefits and risks. It also discusses stroke-specific considerations, rehabilitation relevance, and personalized recommendations. A translational approach incorporating wearable sensors and intelligent feedback systems is proposed to guide future individualized interventions.