Solutions for Back Pain in Athletes

Back pain in athletes' presents in several different patterns relating to the origin of the pain source. In spite of advances in imaging and other diagnostic testing most often the diagnosis is made by the clinician analyzing the pain patterns, (i.e. when it hurts). Pain while sitting or difficulty standing up straight after sitting, and pain with a cough or sneeze or lifting heavy items all indicate the pain maybe from an injury to the intervertebral disk. Pain that hurts more with standing than sitting is often associated with sacroiliac dysfunction or one of the joints that connects one vertebra to the next, the facet joint. Pain bending backwards also indicates the facet joints while muscle and ligament injuries might hurt more with exertion.

The correction of these injuries starts with a careful evaluation by a qualified practioner who takes the time to listen to the complete history of the injury and the symptom presentation. This must be followed by a thorough physical evaluation to analyze the mechanical cause of the pain including assessment of joint flexibility, strength =
and postural alignment. With an accurate diagnosis and specific focused treatment the resolution of back pain is usually immediate but addressing the cause of the injury with therapeutic exercise is the key to preventing its re-occurrence. This takes time. Pain is the last aspect of an injury to appear and the first to go away but the injured
tissue needs time to mend and more importantly you have to alter the faulty mechanics that caused the stress to build up in the first place. If you go to a healthcare provider who says the treatment of low back pain is rest alone you are in the wrong place.

While complete rest from any activity that provokes pain is essential for a short period of time to gain control of the symptoms, prolonged total rest does not fix athletic injuries [unless you break a bone]. The key to rehab is that it's active. After controlling the symptoms the next step is finding the best PAINFREE cross training modality to maintain your fitness. Often biking, swimming or water running can be resumed relatively quickly after the symptoms associated with your daily activities are controlled with physical therapy treatment. The long-term permanent fix for back pain is a three-prong attack.

1. Instruction in safe and effective strength and flexibility exercises to address the mechanical cause of the pain. This is not simply "core work" prescribed by a trainer in the gym but more sophisticated exercises that create true stabilization of the spine and address your specific strength, flexibility and alignment problems. These exercises must be done DAILY, before and after all workouts and at night before bed.

2. Instruction in proper use of your body during daily activities. Most low back pain in athletes is not entirely caused by athletic activity. In fact the source of most back pain in athletes is caused by the same mechanisms that create back pain and damage in sedentary people as well: poor use of our bodies during daily activities and not necessarily during sport. Specifically poor sitting posture, lying on the sofa, [even for twenty minutes at night to watch the news] and propping up in bed to read or watch TV are the main culprits in the cause of back pain. Car, work and recreational sitting postures all need to be corrected for permanent resolution of back pain.

3. Clinical treatment is often the cornerstone to getting the pain under control. Physical therapy modalities and hands on treatment will speed up the process by controlling the symptoms while you are instructed in the correct exercises necessary to change the mechanics. One of the most important roles of the Physical Therapist is to act like your coach during the rehab process. Left to our own devices athletes will always do too much too soon when coming back from injury while the Physical
Therapist has the expertise to progress your program and interpret any lingering symptoms.

While low back pain can be acute stopping you in your tracks or chronic and continually robbing you of the enjoyment of your workouts and competitions you need not feel hopeless, the experienced therapists at Forster Physical Therapy know how to get you back quickly. And if you do the work of rehab even a diagnosis of a disk injury need not commit you to a lifetime of pain and disability.

Remember all LATC members qualify for a free injury evaluation so use your membership benefits to address any injuries or pain you may be experiencing. Don't wait because their is an old sports medicine idiom that says for everyday you workout in pain it takes two days to get better!

Call for your free injury evaluation now at 310-656-8600 to learn more about our staff and programs.

Happy training!

Robert Forster, PT