Many adults today suffer from back pain intermittently or chronically thanks to our modern, primarily sedentary lifestyles. Spinal injuries are especially isolating when access to exercise and sporting opportunities become limited as a result and scuba diving with chronic back pain requires extra considerations. When done correctly however, diving can provide pain relief and escapism from chronic back pain. Here are our top tips for minimising the risk of further injury or aggravating existing conditions when diving:
Weights: Appropriate weight distribution varies between divers and injury types and adjusting the location of diving weights can significantly reduce back pain. Lower back injuries can be less painful with weights placed at the front of a weight belt rather than upon the lower back. Placing some weight on the tank also reduces the spinal load, as does placing weights in the pockets of a BCD rather than on a belt.
BCD: Traditional BCDs or a backplate and wing may be more comfortable for a diver suffering from back pain, depending on the shape of the spine and nature of the injury. When choosing, it is worth taking the time to try on both styles of buoyancy device and investigate different companies and sizes to provide the correct fit. If possible, hiring one from a dive operator in the style being considered for purchase is worth doing to test underwater comfort and fit.
Exposure Protection: Being cold can easily aggravate a back condition when shivering and muscle tensing begins as the body cools. It is essential to choose a wetsuit or drysuit and undersuit combination that will maintain good body warmth even after a full day of diving. The addition of a thermal undergarment under neoprene, such as those made by Lavacore, can make a significant difference to body temperature without the need for purchasing a thicker wetsuit. Fourth Element Arctics are excellent quality thermal undersuits for drysuit diving and offer exceptional warmth during and post-dive.
Zips and seals: If mobility and back strength are an issue, an exposure protection suit that allows for front-entry or zips that are easily reachable is helpful. Consideration should be given to the ease of entry and exit from the suit and, if purchasing a semi-dry or drysuit, whether the wrist and neck seals can be released with minimal tugging that could strain the back.
Fins and masks: Open heel fins with metal sprung fin straps allow for quick and easy removal of fins with minimal bending of the back required. A wide field of vision mask is also helpful for reducing the need to crane and twist the neck during a dive to fully enjoy the view.
Strong currents and surge can be challenging for divers with back injuries as they require almost constant adjustments of body positioning to be comfortable. Shore dives can also be difficult if they involve stepping over uneven ground and entering the water through surf. By contrast, shallow and calm dives are easy on the spine and also offer the opportunity to end the dive if back pain presents itself suddenly. Boat-based diving is also easier if calm days are chosen and the water entry and exit considerations below are used.
Water entry and exit
Explaining the injury and asking for help from a dive master or instructor before beginning a dive is worthwhile. A good staff member (or dive buddy) will be more than happy to assist with carrying dive kit to the water or boat edge to help minimise compression of the spine from the weight of that dive kit. Consideration should be given to alternative water entries other than giant strides and back rolls. Sitting at the edge of boat, jetty or equivalent before putting on the BCD, tank and weights can minimise back pain as does putting the kit on once in the water.
When exiting the water, kit should be removed and passed up to a dive buddy or staff member on the boat (or ashore) rather than the diver exiting with full kit on their back.
Body position and finning
Correct body positioning within the water and choosing an appropriate finning style can help minimise back pain. Scissor kicks from the hips are a great way to gain momentum but can cause back strain given the back naturally arches and tenses to accommodate that style of finning. An alternative finning technique to learn and use is frog kicking. A buddy or instructor check of body positioning is also useful to help correct any un-natural back arching and strain, whilst also assessing weight distribution in-water to minimise drag.
Maintaining body warmth post-dive is important for comfort and to minimise muscle strain. Carrying warm gear, including a thick woollen hat, to reduce the likelihood of shivering is essential as is taking a flask of hot drinks and some snacks. Wearing a warm hat between dives in a great way to reduce heat loss if a diver prefers to keep their wetsuit on, though changing into dry clothes is preferable to reduce heat loss.
Back pain is notoriously unpredictable and likely to occur without warning, especially with herniated disc injuries. It is advisable to carry a basic survival kit whilst diving at home that contains pain relief, anti-inflammatory drugs and a back brace if appropriate or recommended by a physiotherapist. When travelling overseas, it is also worth including those items are that hard to obtain in a foreign country when in considerable pain: an ice gel pack and a hot water bottle, a tennis ball for self-massage of tight muscles and an exercise band for stretching leg muscles without mobilising a painful spine. It is also worth finding the contact details of a local physiotherapist and massage therapist prior to any injury occurring.
To prevent future injuries and minimise the impact of existing ones, a long-term commitment to spinal care is needed. A physiotherapist can provide a daily stretching routine to maintain mobility and Pilates moves to improve core strength. Swimming is excellent for reducing back pain, though stroke styles need to be considered, and there is a wealth of information available about anti-inflammatory and collagen-rich foods to aid injury recovery.