Back Pain

18 July 2017

Lower back injuries plague 30% of athletes

Athletes are at risk for problems involving their back bones and discs, particularly if they start intense training regimens.


Few people know about sprinter Usain Bolt’s struggles with back pain, something which held him back from breaking his own 200 meter record in the 2012 Olympic Games.

And, closer to home, in 2010 Caster Semenya had to withdraw from the Commonwealth Games in Delhi, also due to back pain.

Back injuries are common, especially among competitive athletes.

Nearly one in three athletes playing professional or varsity-level sports experiences a back injury, a research review finds.

"Competitive players stress their lumbar [lower] spine for hundreds of hours a month, thereby predisposing themselves to specific injuries that should be recognised by health care practitioners," said lead author Dr Wellington Hsu, an orthopaedic spine surgeon at Northwestern Memorial Hospital in Chicago.

The human spine has 24 bones, or vertebrae. They're stacked on top of each other, separated by flat, round cushioning disks. When people walk or run, these disks absorb shock, the authors explained.

Surgery not the answer

Athletes are at risk for problems involving their back bones and discs, particularly if they start intense training regimens when they are between 10 and 24 years old, the researchers noted.

One common problem for these young athletes is known as symptomatic lumbar disk degeneration. People with this condition have deterioration in a disk, resulting in a smaller space between the bones of the spine.

In extreme cases, this condition is treated surgically. But the review authors said there is little evidence supporting the success of this procedure among athletes.

Elite athletes between 20 and 35 years old may be at greater risk for another painful back problem known as lumbar disk herniation, the researchers warned. This occurs when the soft centre of a disk pushes through its exterior due to wear and tear, or a sudden injury.

Generally, this condition improves within six weeks, and eight out of 10 elite athletes are able return to their sport without surgery, the review found.

Rehab more successful

Young gymnasts, wrestlers, weightlifters and divers are at particularly high risk for a condition called spondylolysis, a stress fracture, the authors said.

This occurs when a small connecting bone in the lower back breaks, which could cause a spinal bone to disconnect and slip forward.

Others prone to lower back injuries are athletes of all ages who lift heavy weights without supervision or without lower back protection while training for extreme sports, the researchers added.

The review appears in the Journal of the American Academy of Orthopedic Surgeons.

Players should be assessed individually

Surgery should be a last resort for athletes with lower back issues, said Hsu. He pointed out that rehab success rates are high for back injuries.

Nonsurgical treatment for pain may include medication and psychological counselling. Physical therapy can also help athletes gain flexibility and strengthen their core and back muscles.

"Expectations regarding surgical outcomes should be tailored for elite athletes depending on sport, and to sport-specific demands," Hsu said in a journal news release.

Recovery time depends on the sport and its physical demands, the researchers said. They cautioned that players should be assessed individually following a rehab programme to determine if they are ready to return to their sport.

Read more:

Fix that back pain

Lower back pain may lead to disability

10 tips to avoid work-related backache


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Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics.

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