Why do teenage athletes get back pain? Surprisingly, it's a very common complaint.
Especially, if you're a rower, cross-country skier, football player or
gymnast. It is typically a matter of overuse, and in certain sports, activities
asymmetrically develop one set of muscles over the other. In rowers and in
cross-country skiers it's a very repetitive motion and there may be
asymmetric utilization of back extensor muscles over the abdominal muscles.
Reduced range of motion of the hips and legs can cause extra stress on the back
muscles leading to overuse injuries. For gymnasts and football players, repetitive
extension can cause more than muscle issues. Stress fractures of the pars
interarticularis can occur causing back pain. Especially with that extension
activity. For young athletes, disc herniations are not as common as middle-aged
athletes, but they're still up to a 20 to 30 percent incidence of a disc finding
for those under the age of 21. So, whether it's an overused muscle issue, a stress
fracture to the back, or a disc herniation steps need to be taken to
identify treatments and concerns. If the athlete has wide areas of numbness,
significant muscle weakness, and an inability to perform important bodily
functions, like controlling their bladder and bowels, a visit to the emergency room
is necessary to rule out very bad problems like an infection, a tumor, a
broken bone, or a very large disc herniation. Usually, the athlete will not
be able to play, and in this scenario it's a rare hidden problem. Get these athletes
medical attention as soon as possible. For very motivated athletes, coaches and
parents sometimes do not know there's an issue until there's a significant
decline in performance. In this scenario, questions need to explore potential for
the serious conditions described before. If there's no serious concerns, some
activities restrictions, some use of over the counter
anti-inflammatory agents, and some manual therapies such as ice massage,
will usually heal a soft tissue sprain or strain condition. If there is no
improvement within a week or two, the coach, trainer, or parent should obtain a
medical evaluation. At this point, the medical team will make a decision on
whether to pursue more aggressive evaluations including x-rays or possible
MRI studies. X-rays can identify the spondylolysis condition.
MRIs can further identify problems related to the disc or provide clues as
a development of the stress fractures to the lower back. Depending on the findings
different options can be pursued. If there is a so-called spondylolysis
stress fracture, immobilization and a brace, stopping playing activities up to
six to nine months may also be necessary. If there's a disc herniation causing
nerve irritation, activities modifications, avoiding contact sports,
and giving it about four to eight weeks will usually allow these to heal. Luckily,
most episodes of back pain in adolescent athletes are of a soft tissue
nature, and with proper restrictions, and stretching, and therapy most athletes
will be able to return back to full activities within two to four weeks.
Remember, if there's a significant decline in performance, make sure to
check and ask questions about the pains. If there's a significant complaint of
uncontrolled weakness, inability to control major bodily functions
the athletes should be sent to an emergency room right away. If you'd like
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