By Mr Ahmed-Ramadan Sadek, Neurosurgeon · 16 min read

What happens to the spine as we age

The discs between the bones of the spine slowly lose water and height with age, and the small facet joints at the back can develop arthritis. These changes show up on MRI in most adults. A large review of scans in people with no back pain found disc degeneration in 37 in 100 people aged 20, rising to 96 in 100 at age 80. Disc bulges rose from 30 in 100 to 84 in 100 over the same ages.^[2] The authors concluded that many of these findings are part of normal ageing and are not linked with pain. Our degenerative disc disease and annular tear guides explain these terms.

So the question is not whether a sport will stop your spine ageing. It will not. The useful question is whether a sport speeds up these changes, slows them, or makes no difference, and whether it causes pain or injury along the way.

This guide looks at sport. Our sport and exercise for your spine guide covers how much activity UK guidelines recommend and how to get going again after a flare-up. If your back is under strain at work, our Is my job bad for my back? guide covers manual and desk work.

Sport by sport

Running

Running is the activity with the most encouraging evidence for the discs. In a study led by Daniel Belavý, people who had run regularly for years had discs that looked better hydrated and larger on MRI than people who did not exercise. When the researchers measured everyday movement, the benefit was linked with fast walking and slow running at about 2 metres a second (a gentle jog), not with high-impact tasks, slow walking or sitting still.^[3]

Other studies agree in part. In a small study of men aged 44 to 62, long-term runners had about 20% more disc height and less disc wear on MRI than inactive men, but there was no clear difference in disc water content, which is the opposite of the Belavý finding on hydration.^[4] A 2026 systematic review of 39 studies (4,152 people) found that running was the only type of activity linked with better disc health, but rated the certainty of that evidence as very low.^[5] Another review found that discs shrink a little straight after a run as water is squeezed out, recovering afterwards, and that the long-term benefit seen in comparison studies has not yet been confirmed in long follow-up studies.^[6]

The first trial to test running directly, in 40 adults with long-standing back pain, is small and its results are only described as ideas for future research.^[7] An older study of former elite athletes found no sign of faster disc wear in competitive runners.^[8]

In practice: running looks safe for the spine for most people, and may be good for it. A steady jog seems to be the kind of loading the discs like best. If you are new to it, a run-walk approach lets you build up over weeks rather than days.

Walking

Walking is the simplest way to load the spine in the way discs seem to prefer.^[9] In the WalkBack trial, 701 adults (average age 54) who had recently recovered from low back pain were given either a gradually increasing walking programme with education, or no treatment. The walking group went a median of 208 days before their next episode of back pain that limited their activity, compared with 112 days in the control group. There were more minor leg and foot problems in the walking group.^[10]

For people who already have long-standing back pain, walking or running gives a small benefit compared with doing nothing, although other forms of exercise did better in trials.^[11] Our walking for back pain guide has a step-by-step plan.

Swimming

Swimming takes weight off the spine, which many people with back pain find comfortable, and the NHS lists it among activities that may help ease back pain.^[1] But the evidence about competitive swimming and the discs conflicts:

• A study of 100 elite swimmers found disc wear was about as common as in non-sporting young adults, and swimmers reported slightly less back pain.^[12]
• Two other studies found more disc wear in elite or university swimmers: 68 in 100 elite swimmers compared with 29 in 100 recreational swimmers in one,^[13] and about three times the odds of disc wear compared with non-athletes in the other.^[14]
• A later analysis of the athletes in the second study found swimmers had larger discs than non-athletes, which may be a healthy adaptation.^[15]
• A 2024 review of 4 studies found 3 linked competitive swimming with more disc wear, but the studies were too different to combine.^[16]

These studies looked at elite swimmers training for many hours a week, with a lot of repeated twisting, arching and bending of the spine.^[16] They tell us little about recreational swimming. One point to bear in mind as you age: swimming does not seem to strengthen bones, so it is worth combining it with weight-bearing activity such as walking.^[17]

Cycling

There is very little research on cycling and the ageing spine. Trials of cycling as a treatment for back pain are too few to draw conclusions.^[11] Back pain is common in keen cyclists: a review reported it in more than half. Cyclists with back pain tend to sit with the lower back more bent, and lower handlebars increase that bend.^[18] Raising the handlebars or having a bike fit may help.

Like swimming, road cycling does not load the bones much. Reviews have found low bone density in the lower spine of adult road cyclists, which matters more as you get older. Mixing cycling with walking, running or strength work may help.^[19][17]

Weightlifting and gym training

Heavy lifting over a long career is linked with more disc wear. In a study of former elite athletes, weightlifters had the most disc degeneration and bulging throughout the lower back.^[8] Retired heavyweight lifters had lower discs than other men of their age.^[20] In top athletes followed for 15 years, disc wear worsened most often in weightlifters and ice hockey players.^[21]

Yet that wear does not clearly translate into more back pain. The retired lifters reported back pain at some point in 23 in 100, compared with 31 in 100 ordinary men.^[20] In another study, former weightlifters did not report back pain more often than former shooters, although their worst pain was more intense.^[22] In gym lifters today, injury rates are lower than in contact sports, at roughly 1 to 4.4 injuries per 1,000 hours of training, but the lower back accounts for 23 to 59 in 100 of injuries, most often during squats or deadlifts.^[23]

Strength training also matters for ageing bones. UK guidelines advise muscle-strengthening activity on at least 2 days a week for adults, and strength and balance work for older adults.^[24] In the LIFTMOR trial, 101 women with an average age of 65 and low bone density did 8 months of closely supervised heavy lifting twice a week. Bone density in the lower spine rose by about 3%, while it fell slightly in the home exercise group. There were no new spinal fractures, and the only problem reported was one minor episode of back spasm.^[25][26] This was a small, supervised programme in carefully selected women, so if you have osteoporosis, build up heavier lifting with expert guidance.

Rugby and other contact sports

The neck takes the brunt in rugby, especially for front-row forwards (props and hookers) who scrummage. An MRI study found front-row players had more early wear in the neck than men of the same age, along with a narrower spinal canal, which may put them at risk of temporary spinal cord injury during play.^[27] Retired professional players, studied around 6 years after they stopped playing, reported long-standing neck pain more often than other men (51 in 100 compared with 32 in 100), had narrower spinal canals and more narrowing where the nerves leave the spine, and 10 had needed neck surgery for wear compared with none of the comparison group.^[28]

Catastrophic neck injury, causing paralysis or death, is rare. In France, the rate fell from about 2 per 100,000 players a year in 1996 to 1 per 100,000 in 2013, after rule changes to how scrums engage and a requirement for front-row players to be certified.^[29][30] A review of scrum research noted that the risk per scrum is high even though the overall injury rate is moderate, and that repeated scrummaging may lead to early wear in the neck.^[31]

If you are an older player, or a former front-row forward with neck pain, arm pain or tingling, see our guides on cervical radiculopathy and cervical myelopathy. Our whiplash and neck injury guide covers sudden neck injuries.

Football and heading

For the lower back, football looks fairly kind. In a study of young athletes, footballers had better hydrated discs than non-athletes.^[15] Former elite footballers, though, had more disc wear in the lowest two levels of the lower back.^[8] In professional players, about 1 in 4 men and a similar share of women have low back pain at any one time.^[32]

For the neck, older studies found earlier wear in former players. In 43 former Norwegian internationals, neck wear started 10 to 20 years earlier than in other men, although it was not especially high in the players who headed the ball most.^[33] A small study found more neck wear in veteran amateur players and suggested heading as the cause.^[34] These were small studies. Today the main concern about heading is brain health rather than the neck, and suggested ways to reduce it include fewer headers in young players, lower ball pressure and neck strengthening exercises.^[35]

Golf

Back pain is common in golfers. A 2018 review found it was more common in older and heavier golfers, and that a previous episode of back pain was the best predictor of future pain. The evidence did not support the idea that particular swing styles cause back pain.^[36] For most older golfers, the evidence gives no reason to overhaul the swing. Staying fit and building up practice gradually is a sensible approach.

Tennis and racket sports

Serving combines arching, twisting and side bending, and elite junior tennis players have strikingly busy MRI scans even when they have no pain. In one study of 33 such players, 28 had an abnormal scan, and 9 had stress injuries of the pars, the thin bridge of bone at the back of the vertebra.^[37] In a larger study of 98 players aged 11 to 26, only 4 had a normal scan, and about 30 in 100 had pars abnormalities.^[38] We found no good studies of the lower back in older recreational players.

Cricket fast bowling

Fast bowling is one of the best studied causes of lower back stress fractures in young people. A review reported rates of lumbar stress injuries in fast bowlers as high as 67 in 100.^[39] In one season of monitoring 65 junior elite fast bowlers, 15 (23 in 100) developed a bone stress injury, and every one of them had shown swelling in the bone on an earlier MRI.^[40] England and Wales Cricket Board data on 142 young male fast bowlers found that stress injuries picked up by MRI screening were caught earlier, all were managed without surgery and the players returned sooner. Over 5 years, 51 to 67 in 100 stayed free of another injury.^[41]

Gymnastics, dance and spondylolysis in young athletes

Spondylolysis is a stress fracture of the pars. Our spondylolysis guide covers symptoms and treatment. It is common in the general population, and estimates vary with the method:

• About 4 in 100 children at age 6, rising to 6 in 100 by adulthood, on X-ray.^[42]
• 3 to 7 in 100 adults, as quoted in a large study of Spanish athletes.^[43]
• About 12 in 100 adults aged 40 to 80 when CT scans were used, with no link to back pain.^[44]

Among 3,152 Spanish elite athletes, the overall rate was 8 in 100, not much higher than the general population, but it reached 27 in 100 in throwing sports, 17 in 100 in artistic gymnastics and 17 in 100 in rowing.^[43] In young athletes who see a doctor with back pain, a spondylolysis is found much more often: 30 in 100 in one US clinic,^[45] and about 42 in 100 when 9 studies were pooled.^[46] In a review of 80 studies of adolescent athletes, spondylolysis was the most common cause of back pain identified.^[47]

Gymnastics places big demands on the growing spine. In elite male gymnasts, 75 in 100 had reduced disc signal on MRI compared with 31 in 100 non-athletes.^[48] In young top athletes from wrestling, gymnastics, football and tennis, 50 to 85 in 100 reported back pain, and male gymnasts had the most.^[49] The spine is the second most commonly injured area in dancers, with spondylolysis among the causes.^[50] A young athlete with back pain that lasts more than a couple of weeks, especially pain on arching backwards, should be checked by a doctor or physiotherapist rather than training through it.

Rowing

Rowing has some of the highest rates of back pain in sport. A review of athletes in Olympic sports found the highest point prevalence of low back pain in rowers.^[51] Spanish elite rowers had spondylolysis in 17 in 100.^[43] Rowers with back pain tend to have more rounding of the lower back at the start of the stroke, and fatigue increases this, more so on rowing machines.^[52] The strongest risk factor for back pain in rowers is having had it before. Age, sex, training volume and years of rowing were not clearly linked in a 2025 review.^[53]

Horse riding

Back pain is very common in riders. Point prevalence ranged from 28 to 88 in 100 across studies in a 2024 review, higher than in the general population, with workload and stable duties as risk factors.^[54] In elite riders, 88 in 100 had had back pain compared with 33 in 100 non-riders, but their MRI scans showed no more disc wear and no pars fractures.^[55]

The bigger risk for the spine is a fall. In a hospital series of 32 riders with spinal fractures from riding, most fractures were at the junction of the upper and lower back, and 22 in 100 had a lasting effect on their ability to work.^[56]

Yoga and Pilates

Both are good options for many people with back pain, and our yoga and Pilates guides go through the evidence. One caution for the ageing spine: in people with thin bones, forceful forward bends and twisting poses have been linked with spinal compression fractures. In one case series, 9 people with a median age of 66 developed these fractures after starting yoga poses that bend the spine forwards.^[57][58] These are case reports, not proof of risk, but if you have osteoporosis, choose a class that avoids loaded forward bending.

Martial arts

Martial arts cover everything from tai chi to full-contact fighting. In judo, a review found that serious injuries are rare but, when they happen, usually affect the brain and spine, mainly from being thrown. Long-term problems most often affect the lower back, fingers and ears.^[59] In young judo athletes, changes on X-ray or MRI were found in 65 to 91 in 100 depending on weight class, but many athletes with these changes had no back pain.^[60]

Findings in wrestlers and boxers conflict. Retired wrestlers reported back pain at some point in 59 in 100, compared with 31 in 100 ordinary men, and had more old spinal fractures.^[20] But in another study, former wrestlers and boxers had lower odds of back pain than non-athletes.^[8]

Elite and recreational athletes compared

Elite athletes in sports that load the spine heavily do show more changes on scans. In 308 university athletes, disc wear was about three times more likely in baseball players and swimmers than in non-athletes.^[14] In top athletes followed for 15 years, more than 90 in 100 had disc wear, and most of the changes were already present when they were young, which suggests the growth spurt is a vulnerable time.^[21]

Back pain in active athletes is common, but the estimates vary widely:

• Lifetime: 63 in 100 on average across sports (range 36 to 88),^[61] or anywhere from 1 to 94 in 100 in an earlier review.^[51]
• At any one time: 42 in 100 on average (range 18 to 80).^[61]
• Teenage athletes: 42 in 100 in the past year.^[47]

Later in life the picture changes. In a study of 937 former elite athletes, back pain was less common than in non-athletes, with no difference in sciatica, back-related hospital stays or disability pensions.^[8] In another group, former top athletes had more changes on X-ray than non-athletes but did not report more back pain.^[62] The same research group found no link between back pain and MRI changes at 15 years.^[21] The risk factors for back pain in athletes that come up again and again are a previous episode, high training volume, sudden increases in load and many years in the sport.^[61]

For recreational players the message is reassuring. Most of the worrying scan findings come from young athletes training at the highest level. There is little research on people who play sport for fun into later life, and what there is does not suggest that ordinary sport harms the spine.

At a glance

Activity	What the research suggests	Strength of evidence
Running	Linked with healthier looking discs; no sign of faster wear	Low: mostly comparison studies
Walking	Fewer recurrences of back pain in a large trial	Moderate: one large trial
Swimming	Comfortable for many; elite training linked with more disc wear in some studies, not others; little bone benefit	Low and conflicting
Cycling	Back pain common in keen cyclists; low bone density in road cyclists	Low
Weightlifting	More disc wear at elite level, but not more back pain; supervised strength work helps bones	Low; one small trial in older women
Rugby	Earlier neck wear and more neck pain in former forwards; catastrophic injury rare and falling	Low to moderate
Football	Discs often look healthy; earlier neck wear in older studies	Low
Golf	Back pain common, linked with age, weight and past pain rather than swing	Low
Tennis	Many scan changes and pars injuries in elite juniors	Low: small studies of juniors
Fast bowling	High rate of lower back stress fractures in young bowlers	Moderate
Gymnastics and dance	More disc changes and spondylolysis in young athletes	Low
Rowing	Among the highest rates of back pain in sport	Low to moderate
Horse riding	Back pain common, discs not worse; falls can cause fractures	Low
Yoga and Pilates	Helpful for back pain; avoid loaded forward bends if you have osteoporosis	Moderate for back pain; case reports for fractures
Martial arts	Serious injuries rare; findings on back pain conflict	Low

What helps the spine age well

Putting the research together, the loading that suits discs best seems to be movement that is steady, upright and moderate, like walking and jogging. Loading that is static, twisting, bent forwards under weight, very fast or high impact is more likely to be harmful, and too little movement is also bad for discs.^[9] Practical steps that follow from this:

• Aim for the UK guidelines: at least 150 minutes of moderate activity a week, strength work on at least 2 days, and balance work if you are older. Any activity is better than none.^[24]
• Mix it up. Combine something that loads the spine upright, such as walking or jogging, with strength training and something you enjoy.
• Include weight-bearing activity for your bones, especially if your main sport is swimming or cycling.^[24][19]
• Increase training gradually. Sudden jumps in load are a common factor in athletes’ back pain.^[61]
• Treat a past episode of back pain as a reason to build up carefully, not to stop. It is the strongest predictor of future episodes in golfers, rowers and athletes in general.^[36][53][61]
• Choose activities you can keep doing. NICE advises that exercise for back pain should take your needs, preferences and abilities into account.^[63]

Returning to sport after back pain or spine surgery

After an episode of back pain, NICE advises carrying on with normal activities as far as you can.^[63] The NHS advises staying active and stopping any exercise that clearly makes your pain worse.^[1] Most people can get back to their sport by building up gradually. In athletes, exercise reduces pain and improves function, although trials have not yet shown how it affects return to sport.^[64]

After spine surgery, timing depends on the operation and on your recovery. In athletes after surgery for a slipped disc in the lower back, about 8 in 10 returned to sport, but only about 6 in 10 returned at the same level, and results were similar for athletes treated without surgery.^[65] Elite athletes who are free of symptoms after common neck operations usually return to play safely.^[66] Mr Sadek usually advises waiting at least 6 months after spine surgery before contact sport. Our sport and exercise guide has more detail, and your own surgeon and physiotherapist will tailor the plan to you.

When to get help

See a GP if back pain does not improve after a few weeks, stops you doing your usual activities, wakes you at night or is worse at night, or comes with weight loss, a lump or a change in the shape of your back. In many areas you can refer yourself to NHS physiotherapy.^[1]

Ask for an urgent GP appointment or contact NHS 111 if you have back pain and feel hot, cold, shivery or generally unwell, or if severe pain starts suddenly or gets worse quickly.^[1]

Call 999 or go to A&E if you have the symptoms listed at the top of this page, including back pain that started after a serious accident such as a heavy fall or collision.^[1] Our warning signs page explains these symptoms.

Frequently asked questions

Further reading

• Sport and exercise for your spine
• Walking for back pain
• Pilates and reformer Pilates for back pain
• Yoga for back pain
• Spondylolysis and spondylolytic spondylolisthesis
• Degenerative disc disease
• Is my job bad for my back?

References

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This article is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist before making any change to your treatment.

Last checked: October 2026