Approximately 80% of people will experience lower back pain in their lifetime. Given the high speed, force, and movement demands required in sport, it’s no wonder that athletes also have a high incidence and prevalence of back pain.
Luckily, most episodes of lower back pain are not medical emergencies and typically clear up in 4-12 weeks. Once red flags are ruled out, conservative management, such as physical therapy, is recommended.
Common Sports Back Injuries
Common back injuries that we treat include but are not limited to…
Spondylolysis is defined by a stress fracture of the pars interarticularis (back). This condition is actually quite common in the asymptomatic population and not correlated well with pain – meaning you could have spondylolysis and not even know it.
The most common cause of spondylolysis is repetitive stress with or without the presence of an energy deficit. The pain is typically experienced with extension (bending backwards) or rotation of the spine.
Treatment typically consists of activity modification with a break from high impact activity, followed by core stability and full body exercise with a neutral spine, followed by a gradual reintroduction and strengthening of the core in functional ranges of movement. Afterward, patients will return to impact activity such as running, jumping and sport. This process usually takes 12+ weeks. Bracing and/or surgery may be recommended in more severe cases.
Sciatica is most commonly caused by irritation of a nerve root, causing symptoms such as pain, numbness, burning, or tingling down the leg and in more severe cases, weakness. The nerves that are most commonly irritated start in the lower back and travel down the legs, including the sciatic nerve. Those nerves allow us to move our legs, but also allow us to feel sensations such as touch, temperature, and pressure. The irritation of a nerve root is often caused by it being compressed from a disc in the lower back.
Disc herniations occur when the inner layer of a disc (nucleus pulposus) pushes out past the outer layer of a disc (Annulus Fibrosus). Disc herniations may heal over time, with larger herniations actually being more likely to heal.
You may have a disc herniation without even being aware of it as MRI findings of a disc herniation are actually very common in the asymptomatic population. Research has reported almost as high as 1/3 of asymptomatic 20-year-olds having a disc herniation and that number increasing as we age.
Muscle strains are characterized by an overstretching of one or more of the muscles that run along the spine. This injury may occur with bending, lifting, and/or twisting of the back while you are fatigued or while performing motions that you are not accustomed to. Symptoms will typically improve in two weeks and function should be completely restored in 4-6 weeks with physical therapy.
Chronic Low Back Pain
Chronic low back pain is defined by persistent pain that is not associated with a structural cause. Many factors may contribute to the pain such as quality of sleep, nutrition, psychological factors, and social factors.
Most people will experience lower back pain in their lives and luckily it is not a medical emergency in most instances. Red flags for serious pathology requiring emergency medical intervention should be ruled out by a medical provider. While many seek out chiropractic care for short-term relief, physical therapy is recommended for the long-term management of chronic lower back pain.
Back Pain & Injury Treatment
If you are experiencing back pain, weakness, or loss of function, make an appointment with one of our doctors at Herlong Sports Physical Therapy!
Maryland is a direct access state, which means that you do not need a referral to see a physical therapist.
Appointments at HSPT are one-on-one, 45-minute sessions with a licensed Doctor of Physical Therapy who will develop an individualized program specific to you based on the best research evidence and your unique values, preferences, and circumstances.
Session frequency can range anywhere from one session every other week to three or more sessions per week, depending on the injury.