Pain guide · Neck pain
Neck pain in swimmers usually comes from turning the head too far to breathe, swimming with the head lifted to look forward, head-up breaststroke or lifting the head to sight in open water, and from swimming more than usual. It's common in masters swimmers, though the swimming evidence is thin: one small video study of 61 masters swimmers. The National Health Service (NHS) says most neck pain lasts a few weeks.
Small changes help: breathe with your body roll, keep one side of your face in the water, swim breaststroke face-in, and use backstroke or a snorkel while turning hurts (our suggestions, untested). Any neck injury from a dive or a fall is an emergency, so never dive into shallow water, and arm weakness or a sudden severe headache needs a 999 call, accident and emergency (A&E) or a same-day general practitioner (GP) appointment, as the warning signs say. This guide covers those signs, what to change in the pool, how much pain is fine and a three-stage plan with a 3D demo of every move.
Exercise is for pain that has been checked or is clearly mild and settling.
Location narrows the likely causes; it does not diagnose.
Ordinary neck pain from holding and turning the head. This guide covers it, and our neck pain guide goes further.
Read: Neck pain →Stiff and sore to turn, often on waking, so you can't turn to breatheA stiff (wry) neck. Don't swim front crawl until you can turn.
Read: Stiff neck and wry neck →Across the tops of the shoulders and up into the neck, worse after long setsThe upper trapezius and levator scapulae muscles.
Read: Tech neck →Down one arm, with tingling, numbness or weaknessChanging as you move your neck: a pinched nerve in the neck.
Read: Pinched nerve in the neck →Aching, tingling or heaviness in the arm, worse with the arm overheadPossibly thoracic outlet syndrome; the NHS lists lots of swimming among its causes.
Read: Thoracic outlet syndrome →A headache starting at the back of the head after swimming, with a stiff neckA headache from the neck. A sudden, severe headache is a 999 call.
Read: Headaches from the neck →Goggle pressure (our note): loosen or change them.
Neck arthritis.
Read: Neck arthritis →After hitting the bottom, the wall or another swimmerA possible neck injury: the warning signs come first, then our whiplash guide.
Read: Whiplash →The shoulder, made worse by the stroke rather than by moving your neckOur shoulder pain when swimming guide covers it.
Read: Shoulder pain when swimming →Between the shoulder bladesUpper back pain. The NHS asks for a GP check for pain between the shoulders.
Read: Upper and mid back pain →In 61 masters front crawl swimmers, 55 recalled occasional or frequent neck pain over 5 years, more often in those who swam further each week. In 88 masters swimmers, 22% had neck pain lasting more than 10 days in a year; butterfly carried 4 times the risk of a neck injury in 341 elite swimmers; and 48% of triathletes in a survey had had neck pain. Neck pain is common in everyone, and the video study's authors note that some of it would happen anyway.
The swimming evidence is one small video study: all 4 masters swimmers who over-rolled to breathe, and 4 of 5 who swam with the head extended to look forward, had neck pain. No trial has tested changing how you breathe or hold your head.
Swim England's advice is a head in line with the body, eyes forward and down, the head joining the shoulders' rotation only to breathe with one side of the face in the water, and in breaststroke the head rising with the shoulders and the eyes down in the glide. It warns that head-up breaststroke can strain the neck and back over time. In college swimmers, an eyes-forward head position went with other stroke faults, and swimmers' necks turn about 5 degrees further to their breathing side, an adaptation rather than a fault.
A head-first dive into water that's too shallow can break the neck. In 160 people treated after shallow-water dives in northern Germany, 97.5% were men, average age 24; two-thirds were completely paralysed on admission, and 17% could walk by the end of their treatment. In 34 people hurt diving into swimming pools, 70% of the fractures were low in the neck.
The National Institute for Health and Care Excellence (NICE) counts diving among the dangerous ways to injure the neck. The Royal Life Saving Society UK allows a dive only into water at least 1.5 m deep with 7.6 m clear ahead, from a standing start, and RoSPA (the Royal Society for the Prevention of Accidents) warns that open-water depths change with the tide and that you can't always see what's under the surface. A review of the spine in swimming notes that the catastrophic neck injuries come from diving into shallow pools.
Not without warning signs: 87.6% of 1,211 adults without symptoms had disc bulges on neck magnetic resonance imaging (MRI), including most people in their 20s. After a dive, a fall or a collision, health professionals use set rules to decide who needs imaging, and NHS inform's lists say who should call 999.
The NHS says most neck pain lasts a few weeks, and NHS inform expects most new neck problems to improve within 8 weeks, with the biggest change in the first couple of weeks; if yours hasn't, it suggests talking to a healthcare professional. No study has followed swimmers' neck pain, and no one can promise a date.
For neck pain that lasts, a Cochrane review of 27 trials found moderate-quality evidence that strength training for the neck, shoulder blades and arms reduces pain by a moderate to large amount, while stretching alone may not help. In 48 women with long-lasting trapezius pain, 10 weeks of strength training for that muscle cut their worst pain by about 79%, while leg cycling gave only a small, short-lived drop. In 198 workers, 2 minutes a day of band training, 5 days a week, cut neck and shoulder pain by 1.4 points out of 10 at 10 weeks, and in 180 women office workers, neck training with head lifts and dumbbell shoulder work reduced pain over a year.
None of these trials was in swimmers, and general exercise wasn't a substitute for the specific strength work.
Swim England's technique advice (breathe with the body roll, one side of the face in the water, face-in breaststroke) fits the one video study, where over-rolling to breathe and swimming with the head extended went with neck pain. In a lab study of 18 elite swimmers, breathing to one side gave the most uneven hip roll and a centre-mounted snorkel the most even. No trial has tested any of these changes for neck pain, so the snorkel, backstroke and breathing to your comfortable side are untested suggestions.
The NHS advises against a collar and says to keep the neck moving. NHS inform's exercise advice starts with 2 to 3 repetitions, little and often, adding 1 or 2 every few days towards about 10.
For the exercises, this guide uses the neck hub's rule, from NHS inform's neck exercise advice: rate your pain from 0 to 10. During exercise, 0 to 3 is minimal and 4 to 5 is acceptable; 6 or more is too much. If it goes higher, do fewer repetitions, move more slowly or rest longer between movements.
Exercise should not make your neck worse overall. Soreness from a new exercise should ease quickly, and your neck should be no worse the next morning. Stop any exercise that makes your symptoms worse or causes new pain.
Arm symptoms are the exception, as in our neck pain guide: if an exercise sends pain, tingling or numbness further down your arm, or the extra symptoms last more than an hour afterwards, make the movement smaller or leave it out. Stop and get checked for dizziness, double vision, slurred speech, trouble swallowing or any of the warning signs.
In the pool (our suggestion): turn to breathe only as far as is comfortable, using more body roll, and swim backstroke or use a snorkel if you need to.
In the pool, this guide's rule is adapted from one expert commentary written for competitive swimmers coming back after shoulder surgery, so treat it as a sensible guide rather than a tested rule. If the sore area is back to its usual level by the next morning, the next swim can be the same or a little longer.
Soreness that lasts more than an hour after swimming, or into the next day: take a day off swimming, then repeat your last session rather than adding to it. Sore in the warm-up but gone within the first few hundred metres: repeat the same session, and if it comes back during that swim, stop, take 2 days off and come back a little shorter (the protocol cuts 300 yards, about 275 m). Sore in the warm-up and still sore after the first few hundred metres: stop for the day, take 2 days off and come back a little shorter.
Start at the first stage. Each move opens a full guide with a 3D demo.
The first days to about 2 weeks. Keep the neck moving little and often, as NHS inform advises. Swim only if you can turn your head comfortably, and then backstroke, breaststroke with your face in, or front crawl breathing to your comfortable side or with a snorkel (our suggestions). The doses are the neck hub's unless a source is named.
3D demoNeck CARs (controlled articular rotations)Beginner · No equipment2 to 3 slow reps each direction, every hour or two, building towards about 10 · NHS inform's dose, as our neck pain when cycling guide uses it. Separate turns, tilts and nods before full circles, as the move page says
Harder: Rabbit pose (Sasangasana)
3D demoChin tuckBeginner · No equipment5 to 10 slow reps with a 5 s hold, 2 to 3 times a day
Easier: Lying chin tuck · Harder: Isometric neck holds (four-way)
3D demoLying chin tuckBeginner · No equipment5 to 10 gentle holds of up to 10 s, once or twice a day · As in the neck pain when cycling guide
Harder: Chin tuck
3D demoThoracic rotationBeginner · No equipment6 rotations per side, moving with the breath · The move page's dose. Breathing in front crawl comes from rolling the body, not just turning the neck (our reasoning)
Easier: Side-lying open book · Harder: World's greatest stretch
3D demoShoulder rollsBeginner · No equipment10 to 15 slow circles each way, once or twice through · The move page's dose
Move on when: You can turn your head comfortably both ways, these stay within the pain rule, and 20 minutes of swimming in the changed way leaves your neck no worse the next morning.
About weeks 2 to 6: endurance in the neck and shoulder-blade muscles, as in the neck trials, with upper-back rotation for breathing. The doses are the neck hub's unless a trial or the move page is named.
3D demoIsometric neck holds (four-way)Beginner · No equipment3 to 5 holds of 5 to 10 s each direction, light effort · Build towards 5 holds of 10 s at about half effort
Easier: Chin tuck · Harder: Chin tuck with head lift
3D demoChin tuck with head liftIntermediate · No equipment3 to 5 holds of 5 s, building to 10 holds of 10 s · Head lifts were the endurance exercise in a 12-month neck pain trial
Easier: Chin tuck
3D demoBand rowBeginner · A band + An anchor point3 sets of 10 to 15, stopping 2 to 3 reps short of failure · The move page's dose
3D demoBand lateral raiseBeginner · A band2 minutes a day, 5 days a week, progressing the band · The trial dose in workers with neck and shoulder pain, as our neck pain when cycling guide uses it
Harder: Dumbbell lateral raise
3D demoProne Y-T-W raisesBeginner · No equipment5 to 8 of each shape, 2 rounds · As in the neck pain when cycling guide. Keep the neck long, as the move page says
Easier: Wall angel · Harder: Bent-over reverse fly
3D demoSide-lying open bookBeginner · No equipment8 to 10 slow openings each side, pausing 2 s at the end · The move page's dose
Harder: Thoracic rotation
Move on when: 30 minutes of front crawl breathing to your comfortable side leaves your neck no worse the next morning.
From about week 6, two or three days a week, then ongoing: neck and upper-body strength, following the exercises our neck pain guide takes from a trial in women with trapezius muscle pain, while two-sided breathing and the other strokes come back by the written steps below.
3D demoDumbbell shrugBeginner · A dumbbell3 sets of 8 to 12, pausing a second at the top · The neck hub's sets and reps, as in the neck pain when cycling guide, with the move page's pause
Harder: Snatch shrug
3D demoSupported single-arm dumbbell rowIntermediate · A dumbbell + A bench or box3 sets of 8 to 12 each side
Easier: Incline ring row · Harder: Bent-over barbell row
3D demoBent-over reverse flyIntermediate · A dumbbell3 sets of 10 to 12
Easier: Prone Y-T-W raises · Harder: Barbell rear-delt row
3D demoDumbbell lateral raiseBeginner · A dumbbell3 sets of 10 to 12 · Start light
Easier: Band lateral raise · Harder: Smith machine upright row
3D demoIsometric neck holds (four-way)Beginner · No equipment3 holds of 10 s each direction at moderate effort
Easier: Chin tuck · Harder: Chin tuck with head lift
Move on when: Our suggestion: keep adding distance, about 10% a week, while the pain rule holds; then two-sided breathing in short sets; then longer sighting practice in open water. Butterfly and head-up drills come back last, if at all.
Our 3D figure can't show these changes. Swim England's technique advice and one small video study are the evidence; the rest are our suggestions, untested for neck pain.
No trial has tested a return after neck pain in swimmers. These steps are our suggestion.
The NHS says don't wear a collar unless a doctor tells you to. Stretching alone may not help long-lasting neck pain. A torn neck artery is rare, but one was reported in a young professional swimmer after stretching on land: forcing your neck to crack, or stretching it hard to the end of its range, isn't needed.
| Habit or position | Why it matters | Instead |
|---|---|---|
| Front crawl while you can't turn your head to breathe | The NHS says not to drive or cycle while you can't move your neck; forcing the turn to breathe is the same problem (our suggestion). | Backstroke, or front crawl with a centre-mounted snorkel, until you can turn comfortably. |
| Turning the head on its own to breathe, or lifting it to look forward | In one small video study, swimmers who over-rolled to breathe or swam with the head extended had neck pain, and Swim England says the head should join the shoulders' rotation only to breathe. | Breathe with the body roll, one side of your face in the water, eyes down. |
| Head-up breaststroke and heads-up drills | Swim England warns that head-up breaststroke can strain the neck and back over time. | Your face in the water and eyes down in the glide; prescription goggles if you lift your head to see. |
| Lifting your whole head to sight every few strokes in open water | It tips the neck back more than you need (our reasoning; untested). | Lift your eyes just above the surface every 6 to 10 strokes, then turn to breathe. |
| Butterfly while the neck is sore | Butterfly carried 4 times the risk of a neck injury in elite swimmers. | Other strokes within the pain rule. |
| Pulling your head into a stretch | Pulling on the head at the end of the range is a lot for a sore neck or an irritated nerve, as our neck pain guide explains. | Let the head's weight do the work, as in the upper trap release.Try: Upper trap release |
| The doorway chest stretch with tingling in the arm | Our neck pain guide lists arm tingling with the arm out to the side as a reason for care with this stretch. | Shoulder-blade strength with the arms low.Try: Band row |
| Behind-the-neck pulldowns | A cautious swap while the neck is sore, as our neck pain guide says. | Pull down to the front.Try: Lat pulldown |
| Cracking your own neck, or forcing stretches to the end of the range | Forcing a crack isn't a treatment, and a torn neck artery was reported in a young swimmer after stretching on land. | Gentle movement within comfort. |
| A soft collar | The NHS says don't wear a collar unless a doctor tells you to: it's better to keep your neck moving. | Gentle movement, little and often. |
| Diving head first into water whose depth you haven't checked | Shallow-water dives break necks and can paralyse, mostly in young men. | Go in feet first; dive only into water at least 1.5 m deep with 7.6 m clear ahead. |
Deep neck holds and shoulder-blade strength in under 20 minutes: one of the best-supported kinds of exercise for a stiff, sore neck.
18 minBeginner11 movesA band, An anchor pointA 12-minute routine for a stiff upper back and rounded shoulders: chin tucks, wall angels, Y-T-W raises and open books.
12 minBeginner8 movesA foam roller, A wallEight gentle neck and shoulder stretches for desk stiffness, done standing or seated in ten minutes.
10 minBeginner8 movesA wallA 30 to 45-minute beginner pool swim: a shoulder warm-up on the side, easy lengths, a main set of repeats with rests, and an easy swim down, any stroke.
35 minBeginner5 movesOther / check instructionsA 30 to 45-minute open-water session for a first triathlon at a lifeguarded venue: get in slowly, float to settle, sight, start, round a buoy, then warm up.
40 minBeginner5 movesOther / check instructionsUsually from turning your head too far to breathe, swimming with your head lifted, head-up breaststroke or lots of sighting in open water, and from swimming more than usual. In one small video study of masters swimmers, those who over-rolled to breathe or swam with the head extended had neck pain. Neck pain is common anyway, so the pool isn't always the cause.
Breathing turns the head to one side again and again. Swim England's advice is to let the head join the shoulders' rotation, keep one side of your face in the water and not lift your head. While it's sore, breathe to the comfortable side, use more body roll, or try backstroke or a snorkel for some lengths (our suggestions).
Swimming with the head held up keeps the neck tipped back for the whole swim, and Swim England says head-up breaststroke can strain the neck and back over time. Put your face in the water, let your head rise with your shoulders to breathe and look down in the glide; prescription goggles help if you swim head-up to see.
Once the neck has settled, some two-sided breathing evens out your body roll and is Swim England's standard technique. While it's sore, breathe to the comfortable side. No trial has tested breathing changes for neck pain.
Not front crawl until you can turn your head comfortably: the NHS says not to drive or cycle while you can't move your neck, and the same goes for turning to breathe (our suggestion). Backstroke, or front crawl with a snorkel, may be comfortable sooner.
It can: a centre-mounted swim snorkel lets you swim front crawl without turning your head, and gave the most even body roll in a lab study. It hasn't been tested for neck pain, so treat it as a short-term option (our suggestion).
It can be, if you can breathe without forcing your neck. But strengthening has better evidence: neck and shoulder-blade strength training reduced long-lasting neck pain by a moderate to large amount, while general exercise barely changed neck muscle pain in a trial.
Gentle movement little and often to start, then neck and shoulder-blade strength and endurance: head lifts, 2 minutes a day of band work and dumbbell shoulder exercises all helped in trials in office workers. The plan adds upper-back rotation, so you breathe with your body rather than your neck.
The NHS says most neck pain lasts a few weeks, and NHS inform expects most new neck problems to improve within 8 weeks, suggesting you talk to a healthcare professional if yours hasn't. No study has followed swimmers' neck pain, so no one can promise a date.
Not without warning signs: 87.6% of adults without symptoms had disc bulges on neck MRI. After a dive, a fall or a collision, health professionals use set rules to decide who needs imaging.
No. Head-first dives into shallow water break necks, mostly in young men: in one series, two-thirds were completely paralysed on admission and 17% walked again. The Royal Life Saving Society UK allows a dive only into water at least 1.5 m deep with 7.6 m clear ahead, from a standing start.
After hitting the bottom, the wall or another swimmer, call 999 if the person is unresponsive, has severe neck pain or can't move their head, and get tingling in the arms or legs checked. A sudden, extremely painful headache, or a stiff neck with a fever and a rash, is a 999 call. Pins and needles or weakness in an arm needs a GP soon, or the same day if it's getting worse.
Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.
