Back pain, we found it "everywhere".
Studies indicate that up to 80% of the population will suffer from back pain (more common in the lumbar region) at some point in their life and among the North American population, up to 95% will present it.
Athletes, unlike the general population, have greater flexibility, better physical condition, and higher pain thresholds. These factors could lead us to believe that the average athlete suffers fewer episodes of low back pain, however, the demand for load on the lumbar region in athletes is much higher, which is why they are often limited to carry out their activities sports
Low back pain in athletes can be the result of a specific trauma that directly or indirectly damages said area, or (in most cases) a consequence of repetitive microtraumas due to overuse in said anatomical region.
In an athlete, the symptomatology presented in low back pain is very different from the general population. There are many factors to take into account when it comes to a high performance athlete. The so-called injuries "Sports-specific injuries" are those that are directly related to discipline or position within a particular sport. As it is in American football players, who mostly have degeneration and damage of the intervertebral discs that initially translates into low back pain.
These types of conditions are often confused mostly with intervertebral disc problems associated with herniated discs. Which is a serious mistake! Not all spinal conditions are related to herniated discs. In fact, in athletes, overuse injuries and forced flexion-extension movements generate inflammation in the joint facets. Entity totally different from disc herniation.
We are going to mention the most common causes of pain in the lumbar region:
- Muscle contractures and sprains: both are directly related to an overload and forced movements at the level of the spine. They generate muscle spasm that are identified with a type of direct pain on palpation and can limit the patient for their sports practice and for activities of daily life according to their intensity.
- Facet syndrome: It is the name given to the inflammatory process produced in the facet joints in the spine. These small joints, support up to 70% of body weight. As we mentioned before, they are affected in most cases by overuse and repetitive microtraumas.
- Spondylolysis and spondylolisthesis: entity related to
- of the spine, where an area called
"Pars interarticularis". In this pathology we identify a typical gait with a stiff-legged leg on the side that is most affected.
- Degenerative intervertebral disc disease: The intervertebral disc acts as a shock absorber between the vertebral bodies, and is composed mostly of water. With overuse and age, the intervertebral disc becomes dehydrated and no longer performs its function. This triggers multiple reactions within the anatomy of the spine generating intense pain and chronic functional limitation.
- Herniated disc: generally associated with a loaded trauma to the spine and in flexion. It begins with a rupture of the peripheral layer of the disc which generates the "exit" of its contents compressing the nerve root that emerges from the spinal cord. This is how the low back pain radiates to one of the pelvic limbs.
The pathologies related to the spine are very complex. As we can see, depending on the type of population and physical activity they can be very diverse.
Whether it's lifting heavy objects like weights, or running posture; the back muscles in the lumbar area, can manifest a sharp pain to muscle spasms that increase as you age.
The importance of knowing how to identify them in a timely manner and seek proper medical attention may be the key between returning to sport quickly or going through prolonged times under rehabilitative treatment or suggestion of changes in your running technique or lifting.
Dr. Alejandro Abner Barragán López
Specialist and Subspecialist in: Orthopedics-Arthroscopy-Sports Surgery.
Graduated from La Salle University, Mexican School of Medicine.