Back Injuries

The back is a vital component part of the human body, consisting of the bones and muscles which allow us to stand upright, walk and lift. The spine consists of small bones called vertebrae that are stacked on top of one another, separated by soft tissue, referred to as disks. The lower back consists of five (lumbar) vertebrae that are connected by stabilizing ligaments, allowing for flexibility and movement. The majority of back sports injuries occur in the muscles, ligaments and vertebrae in the lower back. Almost all athletes experience back pain at some point during their athletic careers.

According to the 2012 Midwest Orthopaedics at Rush/Illinois Athletic Trainers Association survey of Illinois certified athletic trainers, back injuries were reported among the top five most common high school sports injuries.

What are common back injuries among young athletes?

The most common back injuries among young athletes are ligament sprains or muscle strains in the lower back. These injuries can occur from overuse, improper mechanics, insufficient conditioning or stretching and trauma.

However, more serious injuries, such as spondylolysis and spondylolisthesis can occur that may mimic a sprain or strain, so it is always important to see a sports medicine or orthopedic specialist if you experience persistent lower back pain.

Spondylolysis is a stress fracture to a vertebra, usually the fourth or the fifth, in the lower back, typically due to excessive stress and pressure on the lower back. When the stress fracture weakens the spine too much, it may cause spondylolisthesis, in which the vertebra begins to slip and shift out of place. Some sports and activities may put the athlete at higher risk for development of these conditions. High risk sports include swimming/diving, gymnastics and wrestling.

Which athletes most commonly get back problems?

Athletes who participate in sports in which significant force is exerted on the lower back such as running, cycling, football and skiing are more prone to back injury, as well as athletes in sports that involve twisting such as golf, tennis, baseball and gymnastics.

What are the symptoms of back injuries?

The athlete will feel pain in his or her lower back which worsens with activity. In some cases, the symptoms of spondylolysis and spondylolisthesis are not obvious and may feel like a muscle strain. Pain may spread across the lower back and worsen as the back is arched. If the spondylolisthesis becomes more serious, the slipping vertebra may begin to press against the nerves and stiffen the lower back and hamstring muscles. Pain radiating down the leg or numbness in the leg or foot may represent a lumbar disc problem.

What is the recommended treatment for back injuries?

Typically, the recommended treatment for back pain is rest from activity, ice and anti-inflammatory pain medications. Heating pads may also be helpful in relieving pain. If symptoms persist, physical therapy may enhance recovery. Additional treatment may include: electric stimulation, massage, stretching and exercises to strengthen the abdominals and back.

In some cases of spondylolysis and spondylolisthesis, a brace may be needed to stabilize the lower back. In severe cases of spondylolisthesis, surgery may be necessary if the vertebra continues to shift and does not respond to standard treatment. If an athlete's vertebra slips more than 50 percent, he or she may be encouraged to participate in a sport that is less stressful on their back. Athletes with this condition should be examined periodically by an orthopedic physician to ensure the disk does not slip further.