Low Back Pain In Athletes


Athletes are at greater risk of sustaining a lower back injury due to intense physical activity.  Whether the sport is skiing, basketball, football, gymnastics, soccer, running, tennis, golf, weight training, or all around physical fitness, the spine undergoes a lot of stress,   pressure, twisting, turning, flexion, extension, and even bodily impact. The strenuous activity puts stress on the spine that can cause injury to even the best and most fit athletes.

Even though the entire spine is used when playing sports, it is estimated that five to ten percent of all athletic injuries are related to the lumbar spine. Many cases of low back pain in athletes can be traced to a specific event or trauma; others are brought about by repetitive minor injuries.

It is sometimes hard for an athlete to consider changing their routines. It is also hard to accept the fact that a serious injury may exist.   Many of these. athletes live by the motto, No Pain, No Gain. All athletes who suffer from low back pain should seek Chiropractic advice. Some injuries may require a reduction in activity, stopping activity, getting treatment in order to deal with the injury and speed up recovery so the athlete can return to normal activities sooner.

Learn more about Low Back Pain in Athletes:

  • Spinal Mechanics & Anatomy
  • Causes of Low Back Pain in Athletes
  • Diagnosis
  • Treatment options for Low Back Pain

The lowest part of the spine is called the lumbar spine. This area usually has five vertebrae. However, sometimes people are born with a sixth vertebra in the lumbar region. The base of your spine, called the sacrum , is a group of specialized vertebrae that connects the spine to the pelvis. When one of the bones forms as a lumbar vertebra rather than part of the sacrum, it is called a transitional, or sixth, vertebra. This occurrence is not dangerous and does not appear to have any serious side effects.

The lumbar spine's shape has a lordotic curve, shaped like a backward "C." If you think of the spine as having an "S"-like shape, the lumbar region would be the bottom of the "S."

The vertebrae in the lumbar spine area are the largest of the entire spine. So the lumbar spinal canal is larger than in the cervical or thoracic parts of the spine. The size of the lumbar spine allows for more space for nerves to move about.Low Back Pain is a very common complaint for a simple reason. Since the lumbar spine is connected to your pelvis, this is where most of your weight bearing and body movement takes place. Typically, this is where people tend to place too much pressure, such as when lifting up a heavy box, twisting to move a heavy load, or carrying a heavy object. These activities can cause repetitive injuries that can lead to damage to the parts of the lumbar spine.

Even though low back pain can sometimes be treated without major disruption to a person's life, athletes are often reluctant to seek medical help. Many of them deny or minimize complaints in order to avoid consequences, such as: having to decrease activity in order to recover, losing a position or being removed from a team, missing a competition, or letting the team down. Some athletes simply do not want to take time out of their schedule  for treatment; they hope it will recover on its own.

Many athletes-from the weekend warrior to the elite professional athlete-buck up their strength, pop some over-the-counter pain medication, and tolerate the pain for the sake of the game and personal enjoyment. But avoiding medical help can lead to further and more serious injury. Without medical help, the anatomic damage can sometimes lead to permanent exclusion from sporting activities.

There are many causes of low back pain. The most common causes in athletes are back strain, spondylolysis, spondylolisthesis, and herniated discs.


The CHIROPRACTIC term used to describe common back strain is musculoligamentous strain. This term refers to all injuries of the lumbar spine's soft tissue. Soft tissues are the muscles, nerves, ligaments, tendons, and blood vessels around the spine. These are probably the most common types of sports injuries. Back strains are diagnosed by exclusion, which means the diagnosis is offered after all other causes of pain are ruled out. These injuries are usually self-limiting. In other words they do not continue to spread and get worse; they generally heal in time.


Sciatica is an inflammatory process involving the large Sciatic nerve.  Sudden impact to the gluteal region such as being tackled in football, or cross-checked in hockey can cause the Sciatic nerve root to become swollen.  Also, any quick jarring movements to the lower Lumbar spine can start Sciatic symptoms.  Please see webpage titled SCIATICA .


A crack in the bony ring of the spinal column is called spondylolysis. If the crack occurs on both sides of the bony ring, the spine is free to slip forward, a condition called spondylolisthesis. So far there is no definitive cause of spondylolysis. Most physicians agree that the bone defect appears in children mainly due to sports activities that put repeated stress on the pars interarticularis. The spondylolysis appears in younger and older adults as the result of excessive stresses on the spine, eventually causing a stress fracture.

Spondylolysis in athletes is most commonly found in those who participate in sports that have frequent hyperextension of the lumbar spine, such as gymnastics, pole-vaulting, and football. Weightlifters also have a higher incidence of the disorder due to excessive stress on the spine.

Spondylolysis does not always produce noticeable symptoms. When it does, chronic low back pain is the most common symptom. The pain can stem from mechanical (structural) or compressive (pressure on nerves) pain.

Spondylolisthesis occurs when the weakness caused by the spondylolysis causes one vertebra to slip forward over the one below it. Most cases of spondylolysis in athletes do not lead to vertebral slippage. But if slippage does occur it may continue. This situation requires more aggressive treatment-perhaps even surgery. The chance of progression is probably more worrisome in teenagers than adults.

Many cases are non-symptomatic and do not cause any nerve problems. Sometimes the slipped vertebra can press into the space of the spinal canal. This leaves less room for the nerve roots. The neural pressure can lead to low back, buttock, and leg pain, as well as numbness in the foot. Surgery may be suggested if the problem is severe. Conservative Chiropractic care begins with stabilizing the vertebrae above and below the injured segment.


Many sports produce high amounts of pressure on the spine. Over time, these repeated stresses add up and begin to affect the discs in the spine.

A herniated disc occurs when pressure to a disc's outer fibers (annulus) is so great that it rips, and the nucleus ruptures out of its normal space. If it rips near the spinal canal, the bulging disc can push out of its space and into the spinal canal, placing inappropriate pressure on the spinal cord and nerve roots. If a disc bulges substantially, or fragments into pieces that lie in the canal, then irritation of the nerves can be severe.

The compression to the nerves caused by herniation can lead to feelings of numbness, pain, a change in reflexes, and tingling in the arms or legs. In addition, if a disc ruptures, it releases chemicals that can irritate and inflame the nerve roots, which leads to extreme discomfort. Sometimes a herniated disc is referred to as "slipped disc," though the disc does not actually slip.


Young athletes may also suffer from low back pain that is caused by growth-related problems, such as scoliosis and Scheuermann's kyphosis. These problems may or may not be related to athletic activity. But they can affect an athlete's ability to perform up to his or her standards.


Scoliosis is a condition that is related to growth. It appears usually just as the teenage growth spurt of puberty begins and may progress through the growth phase. The growth spurt begins at about age 11 in girls and age 13 in boys. Scoliosis is usually painless, but it may cause back discomfort with activity. The condition is genetic, which means it runs in families. It is more common in girls than boys. If the condition progresses, it can be serious. It may require treatment with a brace, or even surgery.

Learn more about adolescent idiopathic scoliosis .

Scheuermann's Kyphosis

Scheuermann's kyphosis is a developmental type of kyphosis. The vertebrae are normally rectangular-shaped and stacked on top of one another, like building blocks, with a soft cushion (disc) in between each one. If they wedge closer together in a triangular shape, as with Scheuermann's kyphosis, it causes the spine to curve more than normal. Sometimes this deformity is described as "round-back posture" or "Hunch back. "

Evaluating Low Back Pain is more difficult in athletes rather than the average patient.  Most athletes are used to being in a certain amount of pain at all times.  Chiropractors will start their evaluation with a complete and thorough history including date of onset, previous history of similar pain, amount and type of physical activity, previous treatments, medications, painful radiations, history of weight loss, change indiet, etc.  History taking of athletes is very specific in order to come up with differential diagnoses of the condition.

Physical Exam

Your CHIROPRACTOR  will examine your entire spine looking for signs of unusual curves, a rib hump, a tilted pelvis, and tilting of the shoulders. Your muscle strength will be tested, as well as your reflexes, sensation, and ability to perform specific movements. You may have to undergo further tests if your CHIROPRACTOR feels there is need for more information.


Chiropractic treatment begins with the full history and comprehensive physical examination of the patient.  Ranges of motion, Reflexes, Sensory neural tests, muscle strength testing, palpation, and a wide variety of Orthopedic tests.   The Chiropractor will assess this information and formulate a specific treatment plan to suit the needs of the patient.  Sometimes, x-rays, ultrasound, CT scan or MRI is necessary to rule out conditions that may require medical intervention.  Most Chiropractic treatment for Low Back Pain involves spinal manipulation to restore normal biomechanics of the Lumbar spine.  Low Volt current or TENS, and Ultrasound is used to reduce swelling and inflammation around the area of complaint.  Specific stretching and strenthening exercises are given to the patient to help with spinal corrections.  Patients are advised to ice at home to help reduce inflammation.  Treatment length and frequency depends on the patient and the spinal condition involved.  Chiropractors may refer patients that are not responding to treatment to an Orthopedic surgeon for further evaluation.  Bed rest and a decrease in physical activity is almost always suggested to help recovery time.

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