Low Back Pain in the Youth Athlete

At Complete Game Physical Therapy, we have performed injury risk screens over the last two weekends for Storm Club Lacrosse, a local girls lacrosse program.  During the screening, we identified several athletes who required further evaluation for lower back pain.  This screening, along with a couple baseball players who see me due to lower back problems, made me think about the prevalence of lower back pain in youth athletes.

Though low back pain is more often associated with an older, sedentary population, it is actually quite common in youth athletes.  An estimated 10-15% of young athletes will experience low back problems.  With over 30 million kids participating in sports, this is no small number.  Here is a brief review of common causes of lower back problems in youth athletes and some prevention strategies to help reduce the likelihood of low back pain occurring.

Posture

Though the exact role of posture in relation to lower back pain has been debated, it is certain that poor posture will lead to problems.  A good way to think about posture is through a comparison to the alignment of your car.  You may be able to get away with your car being out of alignment for a while, but eventually misalignment will cause problems. 

Posture problems can generally be simplified to either overly extended or rounded.  Over extended (or lordotic posture) is often associated with athletes and, in particular, gymnasts, figure skaters and cheerleaders.  Rounded posture is what we commonly think of as slouched posture.  It is especially common in kids who spend a great deal of time playing video games, on computers/phones or watching television.  Either way, I like to simplify posture and tell my patients to just think of keeping your ear, shoulder and hip in line when standing and sitting.  You can also do some gentle shoulder blade pinches to help remind you to maintain good posture, especially when sitting for long periods.

Flexibility

Flexibility can certainly be an issue with youth athletes.  Combine the sitting we mentioned above with the possibility of recent growth spurts where muscle length may not keep up with bone growth and you end up with muscle tightness.  It is particularly common in two muscle groups: the hip flexors and the hamstrings.  

Hip Flexor Stretch

This can be particularly helpful with an athlete with more extended posture.

Hamstring Stretch

This can be helpful with an athlete with rounded posture.

Strength

Strengthening is also important, as many athletes with back pain tend to have weak core musculature.  I will review two exercises:  the pelvic tilt and back bridge

Pelvic Tilt

This exercise is accomplished by gently pressing the lower back down into the floor as you lay on your back.  The pelvic tilt has fallen out of favor with some who prefer to teach more of a neutral isometric exercise.  The pelvic tilt can, however, be very useful, especially with the athlete with extended posture.

Back Bridge

This is a great exercise to strengthen the core and glutes which can help take pressure off your lower back.

The exercises and stretches listed above may be helpful in reducing the likelihood of experiencing lower back pain and keep an athlete on the field.  This information is by no means, however, a complete review of lower back pain.  If you (or your athlete) are having lower back pain, you should be evaluated by a medical professional.

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