Low Back Pain in Young Athletes

Abstract

ContextLow back pain in young athletes is a common complaint and should be taken seriously. It frequently results from a structural injury that requires a high degree of suspicion to diagnose and treat appropriately.Evidence AcquisitionA Medline search was conducted from 1996 to May 2008 using the search terms “low back pain in children” and “low back pain in athletes.” Known texts on injuries in young athletes were also reviewed. References in retrieved articles were additionally searched for relevant articles. Sources were included if they contained information regarding diagnosis and treatment of causes of low back pain in children.ResultsLow back pain is associated with sports involving repetitive extension, flexion, and rotation, such as gymnastics, dance, and soccer. Both acute and overuse injuries occur, although overuse injuries are more common. Young athletes who present with low back pain have a high incidence of structural injuries such as spondylolysis and other injuries to the posterior elements of the spine. Disc-related pathology is much less common. Simple muscle strains are much less likely in this population and should be a diagnosis of exclusion only.ConclusionYoung athletes who present with low back pain are more likely to have structural injuries and therefore should be investigated fully. Muscle strain should be a diagnosis of exclusion. Treatment should address flexibility and muscle imbalances. Injuries can be prevented by recognizing and addressing risk factors. Return to sport should be a gradual process once the pain has resolved and the athlete has regained full strength.

Magnitude of physiological curvatures of the spine and the incidence of contractures of selected muscle groups in students

“…Asymmetric contractures also occurred frequently in the cited studies, which caused a twisting of the shoulder girdle or the pelvis. The occurrence of an asymmetrical distribution of the tension in the selected muscle groups has been documented by many authors [7,14,15,17,24]. There are also some sport disciplines in which hypermobility of the joints is, in fact, desirable, such as artistic and sports gymnastics, or acrobatics [3].…”

Minimally invasive direct pars repair with cannulated screws and recombinant human bone morphogenetic protein: case series and review of the literature

“…W hile lumbar spondylolysis in the general adult population may reach as high as 5%-7% in select studies, 3,6,7,12,16,19,31,32,38,45,46,67 the actual incidence of spondylolysis in pediatric patients presenting with axial low-back pain may approach 50%.…”

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FOCUS

Neurosurg Focus 43 (2):E6, 2017W hile lumbar spondylolysis in the general adult population may reach as high as 5%-7% in select studies, 3,6,7,12,16,19,31,32,38,45,46,67 the actual incidence of spondylolysis in pediatric patients presenting with axial low-back pain may approach 50%.3,36 Numerous prior studies have described the presentation and management of lumbar spondylolysis, most commonly presenting at L-5 in up to 95% of cases and followed by L-4 in 5%-15%. 12,36,37,56 The vertebral segments of greatest lordosis and flexibility in the lumbar spine are the L4-5 and L5-S1 motion segments, where the points of greatest facet overhang occur and the greatest biomechanical forces are applied to the posterior elements.

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Painful Spinal Conditions in Young Children and Adolescents

“…Also, back pain is common among 10% to 25% of athletes and is more prevalent in gymnasts and players [2]. The prevalence of back pain in young children during the young age is more common [3]. Symptoms (red flag) that trigger an indepth investigation include inflammatory back pain, worsening…”