Well, most of the causes are the same as those which affect the general population, but there are a few
specific ones affecting a sporting population, which I'll mention. But in general, the two
biggest causes are involving the facet joints, which are these paired joints at the back
of a spine which provide stability and control movement. They get a lot of strain in extension
and rotation and so they're prone to injury and pain. The second equally common problem
is a disc problem which can prolapse or herniate and can pinch the nerves here and cause
sciatica and pain down the leg. That gets worse towards the middle decades. The third
is the sacroiliac joint here which is either side and has very strong powerful ligaments
which can also be affected and that can occur in almost any sport particularly runners,
jumpers, asymmetric sports like kayaking or canoeing. The fourth, one very specific one
really for the very active junior or adolescent athlete, rugby player, or fast bowler in cricket
is the stress injury of the bone here. That little bridge of bone between the joints.
And that can eventually wear through and cause a stress fracture. And that can lead to more
chronic problems so it's something to watch out for. And really the rest of the problems
which perhaps are more common in the sports person are muscle and ligament strains; which
are ubiquitous but can become quite a nuisance.
Firstly, exercise is very important. There are some specific exercises and particular
regimes which can be very helpful in recovery as therapy. And then there's general kinds
of exercise which look after the spinal column and the torso and help maintain stability
in the long term. And also, general exercise will help promote weight loss and general
fitness. So that's a very important part of any care of the back. Secondly, very specific
therapies which aim to mobilise and manipulate the joints can help in the more acute phases
of back pain. And they are practised by physiotherapists, osteopaths and chiropractors particularly
in this country. Thirdly, there are approaches which involve needling the muscles. And that
can be called dry needling or acupuncture. And that can help settle down muscle tension
and relieve pain. A very important part is advising you, the patient, how to look after
your back. That's all about posture. Back care. And in relation to the sports person,
it may involve modifying technique or the activity involved. And then the long-term
looking after your posture in everyday life is probably the most important thing.
And here we teach what stems from the Alexander Method or Alexander Technique. Then there
are also more invasive treatments. There are injections. One can inject the facet joints
and a sacroiliac joint, one can inject anti-inflammatory medicine and steroid around the disc and the
nerve, and then there are treatments which deal with more chronic pain arising from the
from the facet joints like radiofrequency denervation. And of course, as a last resort, there's always surgery.
Well, it's difficult. So far, it's been shown despite all efforts and studies that teaching
people how to use their back properly, teaching correct lifting and handling, for example,
in industry doesn't seem to prevent the onset of first-time back pain. And since almost
all of us, say 80% are at some time in our lives going to get back pain, it looks as
if it is just a hazard of everyday life and perhaps our upright activity. So as one factor
we do know is that about 60% to 70% of disc problems which are related to degeneration
of a disc is hereditary. So, choose your parents wisely. The other thing that isn't very important
of course is care of your back. A lot of us do not really listen to our back or are aware
of how we use up our back until it actually starts hurting. And that's often too late.
So, teaching youngsters about correct posture and correct sitting, maintaining strength,
mobility and fitness, all these are really important. And one of the things that we teach
here which has been shown to be very effective in the treatment of back pain is the Alexander
Technique; which we call optimal body use. And it's really trying to get people back
into knowing and listening to their bodies and adopting the posture which feels good for
their spine and their muscles.
Well, making sure you have good coaching. Get advice on your technique. One of the reasons
that the stress injury in the bone occurs is based on the overload principle. Either
excess frequency, excessive intensity or a combination of both. Say, for example, you're
a 14-year-old fast-paced bowler, looking at your technique could help. If you have a front
side-on action, there's a lot of twisting and extension and rotation in the spine. We
know that that's a higher risk factor for this particular bone stress injury called
spondylolisis. So, changing the technique-- not always easy-- is one thing. Furthermore,
talking to a coach or cricket teacher, therefore reducing the number of overs you bowl in a
week or in a match, that reduces frequency. And furthermore, coming off the pace a bit,
just slow down, give your back a chance to recover, go down to the medium pace or try
your hand at spin bowling if that's possible, so you are not putting such unloads for your
back. All these things can make a difference. Perhaps most importantly is, as a young person
who's very actively engaged in sport, you need to listen to your back don't ignore the symptoms.