Back Pain Sports

Back Pain in the Young Athlete

Why
does my back hurt?

Back
pain in the young athlete is very common. It has been reported that up to 75%
of adolescents will experience back pain by the time they reach 18 years of
age.  As more youth sporting activities
are performed year-round, there is a greater risk of sports-specific repetitive
activities over-loading the athletes back.
Too much activity applied too quickly to the back can cause pain.  In athletes less than 10 years of age, back pain
is uncommon, for many reasons. However, as the athletes grow, add more muscle
mass, generate more force and speed and training more (frequency, intensity and
duration) the risk of back pain increases. In general, a gradual change in
sporting activities and training will minimize the risk of developing back
pain. The good news is >90% of back pain in adolescence is muscle-based and
due to overloading the muscles.

Like
many orthopaedic injuries the commonly recommended treatment is the
“RICE” treatment, which partially applies here. Rest, ice,
compression (hard to do for back injuries) and elevation (also hard to do) is
recommended for the first 4-6 weeks after back pain develops. This is
especially true when the athlete can relate the onset of back pain to an event
in their sports. Over-the-counter pain medications (acetaminophen, ibuprofen or
naproxen) can be helpful for pain control. Pain which came on without a known
injury or activity, fevers, numbness in legs, bowel or bladder difficulties or
other neurological symptoms is more concerning and should be evaluated by a
physician early.  Depending on the amount
of pain, the athletes level of participation and upcoming events a course of
physical therapy can be helpful.  A
course of paraspinal muscle strengthening, core strengthening and stretching
can speed up recovery.  Back braces are
not recommended, in general, because they can cause the back muscles to become
too weak.  Similarly, narcotics and
muscle relaxers are not recommended, except in extreme situations.
An evaluation for back pain is appropriate if the back pain has been present for longer than 6 weeks, there is lower extremity numbness or weakness, or bowel or bladder problems develop.

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