Low Back Pain in the Athlete
Ok, so lately I have had an influx of athletes who are in excellent sport specific shape but have mild to moderate back pain with sporting activity. So the question is “Why do these exceptional athletes, who are in fantastic shape, have back pain?” Well, at least in my practice there are the following consistencies.
1) Overtraining: One of my first questions to athletes with back pain is “Do you have an organized training schedule and how often do you take rest days?” The usual answer is “I don’t have an organized training schedule (aka periodization training schedule PTS) I just go out and train as often as possible.” Most, if not all athletes that do not have a strength coach overseeing every part of their PTS usually train improperly due to overtraining or lack of rest frequency. What ends up happening is that the athlete starts to overuse or stress tissue to the point that it cannot heal properly and soon after the tissue (usually muscle tendon tissue) is damaged. Muscles of the low back are highly susceptible to stress injuries. So when stress injuries to the back are present the best treatment is rest and physical therapy to promote proper healing.
2) Compensation: Sport specific training is all the rage these days such as movement pattern training, core training, functional training etc, and these techniques are great, but many times the athlete is compensating around problems that are not always evident when observing this type of training. I find that many athletes have imbalances and compensate for weaker muscles while doing this type of training. It is imperative that one do manual muscle testing of all muscle of the lower extremities, pelvis and trunk to determine if one or more muscles are weak. Many times I find different prime movers compensating for weaker accessory muscles. This places an increased strain on the muscles themselves and the joints above and below the muscles in questions. So make sure to do your checks and balances of all muscles even if the athlete exhibits exceptional prowess.
3) Flexibility: Wow, I cannot believe how many athletes I come across with poor flexibility. Flexibility is key to healthy muscles and joints. Longer muscles promote proper energy transfer through the body and therefore cause decreased stress to the anatomy and therefore decrease stress to the back.
4) Poor Training Technique: This happens all too often. The athlete, without a strength coach or skills coach, will go and do lifts or sports specific techniques with poor technique. This will more than likely overload the surrounding back anatomy, therefore causing failure of the anatomy to resist injury. The best thing to do prevent this is to properly educate the athlete and make sure that they understand what they should and shouldn’t do when training. Make sure they have a developed and proper PTS that individually meets their needs and that dictates what safe lifts are and techniques they should do on their own.
Though there are many reasons, avenues and pathologies which cause back pain in athletes, in general the above reasons are consistent with our mild to moderate cases. I hope this was helpful. I look forward toward your comments.
For further information on Athletic Training or Physical Therapy please contact COR Clinic through www.corclinic.com or 480.272.74638. Thank you.