Objective To explore the biomechanical study of acupuncture combined with five-step reduction method on swimming athletes with lumbar disc herniation through MicroRNA-27a. Methods 80 patients with lumbar disc herniation meeting the requirements were selected and randomly divided into four groups, blank control group (Con group), acupuncture group (ZC group), five-step reduction massage group (TN group), and acupuncture combined five-step reduction method group (ZT group), 20 people in each group, two courses of treatment for a total of one month. After the treatment, the therapeutic effects of acupuncture, five-step reduction massage, acupuncture combined with five-step reduction massage were evaluated. Observation indicators include low back pain JOA scale, McGill pain scale, quality of life QOL scale, gravitational moment and muscle moment. At the same time, the peripheral venous blood of each group of patients was collected before and after treatment, and the expression levels of miR-27a signaling pathway-related genes were detected by fluorescence quantitative PCR. Results Before treatment, there was no significant difference in basic information such as age, course of disease, gender, etc. Among the groups of patients (P>0.05), which was comparable; after intervention treatment, compared with the blank control group, the JOA, McGill, QOL, gravitational moment and muscle moment of patients in the acupuncture group, five-step reduction massage group, acupunctu recombined five-step reduction method group were significantly improved (P<0.05), and the improvement effect in the combined treatment group was more significant (P<0.01); Fluorescence quantitative PCR results showed that after intervention treatment, compared with the blank control group, miR-27a in the venous blood of the acupuncture group, five-step reduction massage group, and acupuncture combined with five-step reduction massage group were significantly up-regulated (P<0.05), and the combination treatment group was up-regulated more significantly (P<0.01). Conclusion Acupuncture combined with five-step reduction can improve the biomechanics of swimmers" lumbar disc herniation through the MicroRNA-27a signal pathway.