Neck Pain from Swimming: Common Causes for Triathletes
- 7 days ago
- 5 min read
Neck pain from swimming is often related to technique errors, reduced neck mobility, breathing mechanics, or muscle fatigue. Understanding these contributing factors can help swimmers and triathletes address pain while improving efficiency in the water.
This article explains common stroke technique mistakes, breathing-related neck strain, and overuse patterns that can contribute to discomfort. It also outlines when symptoms may require further evaluation.
A Triathlete Physical Therapy assessment can help identify the underlying cause of neck pain and create a personalized recovery plan.
What Causes Neck Pain from Swimming Freestyle (Front Crawl) and Breaststroke
Neck pain from swimming, sometimes called “Swimmer’s Neck”, is usually caused by overuse or decreased neck mobility.
Because a lot of your neck muscles also attach to the shoulder, it’s common to have pain in both areas. Pain may start in your shoulder and radiate to the neck or vice versa.
For triathletes, neck pain from swim training can sometimes carry over into cycling and running, especially during longer training sessions or races.
An assessment by a Triathlete Physical Therapist can help determine where your neck pain is coming from and what you need to do to resolve it.
Common Stroke Technique Mistakes
Poor swimming technique can lead to unnecessary strain and contribute to neck pain. Most technique faults leading to neck pain are characterized by not keeping the neck in a relatively neutral position.
Cleaning up your swim technique can be a way to solve your neck pain while improving your swim efficiency for races. A triathlon or swim coach can help with evaluating and improving your swim technique.
Freestyle (Front Crawl)
The most common technique faults that contribute to neck pain during freestyle are under- or over-rotating your body, looking too far forward, and using your shoulder versus your latissimus dorsi (lats) to pull.
Under-rotating your body will cause your neck to need to rotate more while breathing. Normal range of motion for neck rotation is about 90 degrees, or being able to turn your head to line your chin up with your shoulder. However, constantly turning your head as far as it will go while breathing can irritate the joints over time. The goal is to rotate your body enough so that your neck doesn’t have to turn as far.
Over-rotating your body while swimming decreases your swimming efficiency and can also be an indicator of decreased neck mobility. If your neck isn’t able to turn very far to breathe, you have to compensate by rotating your body further. If that is what’s causing you to over-rotate, improving your neck mobility first will likely improve both your neck pain and swim technique.
Looking too far forward while swimming brings your head up and takes your neck out of a neutral position. This decreases your swimming efficiency and can put excess strain on the back of your neck. Keeping your neck in a neutral position decreases the amount of work your neck muscles have to do to keep your head in position.
This also applies to using a kickboard during training. Instead of lifting your head all the way up to look at the end of the swim lane, do a slight chin tuck and look at the end of the kickboard. Kicking with your head in the water and only lifting your head to breathe can also help to decrease strain on your neck.
And when sighting during open water swimming, only lift your head enough to bring your eyes above the water to see where you’re going instead of lifting your entire head out of the water.
Finally, using your shoulders to pull instead of your lats can cause increased muscle tension and fatigue of the muscles that attach to both your shoulders and neck. It also decreases swim efficiency by relying on smaller shoulder muscles instead of the large lat muscles.
Breaststroke
The two technique faults that contribute the most to neck pain during breaststroke are also looking too far forward and using the shoulders instead of the lats to pull.
Even when your head is out of the water during breaststroke, you still want to have your neck in a relatively neutral position with your head facing a few feet in front of you instead of straight ahead. This helps prevent excessive "head bobbing" if you put your face in the water each stroke and reduces strain on the neck if you keep your head above the water.
And as with freestyle, using your larger lat and chest muscles during breaststroke to pull you forward is more efficient and will decrease overuse and fatigue of the smaller shoulder muscles.
Breathing Patterns and Neck Strain
Improper breathing mechanics can also increase strain on your neck muscles and contribute to pain.
The main muscles that help with breathing in are the diaphragm and the external intercostals, which are attached to the ribcage. They help to expand your ribcage to let air fill your lungs.
As you get tired during exercise, your body can start using accessory muscles to help with breathing. These include the sternocleidomastoid and scalenes, which attach from your ribcage to your neck.
While using these accessory muscles to breathe is normal during intense exercise, some might rely on them to help during easy efforts or even at rest. This can lead to overuse and increased neck tension during long swim efforts.
Learning to relax your neck and focus on expanding your ribcage while breathing during easy efforts can go a long way towards decreasing strain on your neck.
Muscle Fatigue and Overuse
Even with good technique, swimming places repetitive demands on the muscles that support your neck and shoulders. During a typical swim session or race, your neck may rotate hundreds of times while breathing, and the muscles around your shoulders are constantly working to help stabilize and move your arms through the water.
Improving the strength and endurance of your lats, upper back, and the muscles around your shoulder blades can help distribute the work required for swimming more evenly. This helps reduce the amount of work the smaller muscles in the neck and shoulders need to do, which can improve both neck pain and swimming efficiency.
If you’re unsure what you need to work on, a Triathlete Physical Therapist can perform an assessment to pinpoint what you need to improve as well as create a personalized plan to fix it.
When Neck Pain Needs Medical Attention
While most cases of neck pain from swimming are related to technique, mobility restrictions, or muscle fatigue, there are situations where further evaluation may be necessary. If your neck pain starts getting worse or interfering with your day-to-day life, seeing a Triathlete Physical Therapist for an evaluation is a good next step.
Physical therapists are trained to screen for signs and symptoms that may indicate a more serious condition. If your symptoms appear to be something other than a swimming-related musculoskeletal issue, a physical therapist can help direct you to the appropriate provider for additional testing or treatment.
This can help you get to the right provider faster while avoiding unnecessary tests, procedures, or appointments when physical therapy is the most appropriate first step.
However, if you have any of the “5 D’s” listed below along with your neck pain, you should seek immediate medical attention:
Dizziness
Diplopia (double vision)
Drop attacks (legs suddenly giving out)
Dysphagia (difficulty swallowing)
Dysarthria (difficulty talking)
You don't have to stop swimming to address neck pain. If you're a triathlete located in Nevada and dealing with neck pain during swimming, remote physical therapy for triathletes can help you identify the cause and build a plan that keeps you training while you recover. Schedule a virtual assessment below and get back to swimming pain-free.
