Lumbar Spine Injuries in Sports: Review of the Literature and Current Treatment Recommendations

Abstract

Low back pain is one of the most prevalent complaints of athletes at all levels of competition. The purpose of this literature review is to provide an overview of sport-specific injuries and treatment outcomes that can be used by healthcare providers to better recognize injury patterns and treatment options for different groups of athletes. To our knowledge, no prior comprehensive review of lumbar spine injuries in sports is currently available in the literature, and it is essential that healthcare providers understand the sport-specific injury patterns and treatment guidelines for athletes presenting with low back pain following an athletic injury. Injury mechanisms were found to vary significantly by sport, although some broad recommendations can be made with regards to optimal treatment for these injuries and return to play. Additionally, it was found that certain treatments were more beneficial and resulted in higher rates of return to play depending on the specific sport of the injured athlete. Healthcare providers need to be aware of the different injury patterns seen in specific sports in order to properly evaluate and treat these injuries. Furthermore, an individualized treatment plan needs to be selected in a sport-specific context in order to meet the needs of the athlete in the short and long term.

Sex- and Sports-Specific Epidemiology of Traumatic Lumbar Spine Injuries Sustained During Sporting Activities: Male Snowboarders and Female Horseback Riders at Greatest Risk

“…In our study, among male patients participating in sporting events, snowboarding, weightlifting, and football were the leading causes of traumatic lumbar spine injuries. Snowboarding has been shown in other studies to have a high incidence of traumatic lumbar spine injuries, 1,14,15 which our findings support. In a study on snowboard-related spinal injuries conducted by Ball et al, 1 an incidence rate of 5.73 per 100,000 visits was identified for snowboarders, with lumbar spine injuries accounting for 69.4% of these injuries.…”

“…Snowboarding has been shown in other studies to have a high incidence of traumatic lumbar spine injuries, 1,14,15 which our findings support. In a study on snowboard-related spinal injuries conducted by Ball et al, 1 an incidence rate of 5.73 per 100,000 visits was identified for snowboarders, with lumbar spine injuries accounting for 69.4% of these injuries. It is thought that in snowboarding, these traumatic lumbar spine injuries are most often due to falls leading to a large axial force on the spine; these more often occur due to falling from a large height after attempting large aerial jumps.…”

“…However, lumbar spine injuries can encompass a wide range of conditions from muscle strains to herniated discs, fractures, and spinal cord injuries. 5 Despite a high prevalence of low-back pain in athletes, [1][2][3][4] there is limited literature regarding national estimates of traumatic lumbar injuries in sports. Our study showed that the rate of traumatic lumbar spine injuries is, fortunately, low (6.05 per million persons per year).…”

“…L ow-back pain is one of the most common complaints of athletes at all levels of competition, with some estimates that 30% of athletes experience an episode of acute low-back pain due to sports. [1][2][3][4] Lumbar spine injuries associated with athletic activities range from minor muscle sprains to catastrophic vertebral fractures with spinal cord injuries. 5 The ability to appropriately differentiate between benign muscle strains and more severe injuries is critical to determine treatment, which can range from rest and bracing to significant surgery and rehabilitation.…”

Is There a Relationship Between Workload and Occurrence of Back Pain and Back Injuries in Athletes?

“…Repetitive flexion and extension loadings of young Functional Spinal Units causes MRI and histological changes in the growth zones and endplates that are most likely first signs of fatigue and an explanation for the spine injuries in adolescent athletes ( Thoreson et al, 2017a ). In spite of the fact that back pain and/or injury is one of the most prevalent diagnosis in athletes, the mechanism of back problems is poorly understood so far ( Ball et al, 2019 ). Research studies conducted on athletes with back pain highlight physiological and biomechanical mechanisms as influential, whereas psychological factors are often neglected.…”