Lower back pain in Athletes

Lower Back Pain

Introduction:

Both the sedentariness and very high levels of physical activity have been related to low back pain in adolescence. Low back pain in an athletic population is not uncommon, and its occurrence has been well documented in various sports including football, golf, gymnastics, running, soccer, tennis and volleyball. Two major attributed reasons for low back pain amongst athletes are acute microtrauma, microtrauma / repetitive stress or from combination of these two mechanisms. Especially athletes with lower extremity overuse or acquired ligamentous injuries weresignificantly more likely to require treatment for low back pain during the ensuing year. Various other factors associated with low back pain in athletes could include poor muscle endurance, altered muscle firing rates, muscular imbalance, in flexibility or leg length discrepancy.

Hence lower back pain is a significant problem not only for athlete adults but also for young generation, however the relationship between lower back pain during youth and the duration for types of competitive sports differs.

Epidemiology:

Evidence-based research studies conclude that extensive exposure to competitive sports activities during youth was associated with low back pain with the severity varying with the sports. In the growing individual, especially during the rapid growth phase, the skeleton mainly the growth zones and apophyses is more vulnerable to acute trauma and injuries stemming from over use than in the adult skeleton. Further, injuries affecting the intervertebral discs, end plates or ring apophysis also contribute to the degenerative process early.

The effects of intensive physical loading on and injuries to lower back during the adolescent growth spurt varies a lot. At this age, the low-back structures are liable to develop anatomic changes, which may contribute to low back pain and degeneration in adulthood.

With regard to muscular influences on LBP, the hip musculature plays a significant role in transferring forces from the lower extremity up toward the spine during upright activities and thus theoretically may influence development of LBP. For endurance and delayed firing of hip extensor group- the glut (GluteusMaximus), abductor muscle (gluteusmedius) have previously been noted with individuals with lower extremity instability and low back pain.

Gender specific strength differences have also been noted, significant asymmetry in hip extensor strength in female athletes with reported low back pain in the previous year.

Hence, from above literature it is clear that even sports player are prone to develop lower back pain.

Treatment Options:

The general categories of treatment for low back pain are medications and therapies. Nonsteroidal anti-inflammatory medications, skeletal muscle relaxants have the strongest evidence of benefits yet physiotherapy treatments show a significant role to focus on muscle imbalances or any early degenerative changes if occurring. Pain management includes superficial heat, modality-based treatments, LASERs for healing purpose and various Spinal manual therapies along with a curated and tailor-made exercise program for the athlete.

Dr. Mansi (PT)