Back pain in sport: how it happens and what you can do to help

Back pain in sport: how it happens and what you can do to help


Well, most of the causes are the same as those which affect the general population, but there are a few specific ones affecting a sporting population,
which I’ll mention. But in general, the two biggest causes are involving the facet joints,
which are these paired joints at the back of a spine which provide stability and control
movement. They get a lot of strain in extension and rotation and so they’re prone to injury
and pain. The second equally common problem is a disc problem which can prolapse or herniate
and can pinch the nerves here and cause sciatica and pain down the leg. That gets
worse towards the middle decades. The third is the sacroiliac joint here which is either
side and has very strong powerful ligaments which can also be affected and that can occur
in almost any sport particularly runners, jumpers, asymmetric sports like kayaking or
canoeing. The fourth, one very specific one really for the very active junior or adolescent
athlete, rugby player, or fast bowler in cricket is the stress injury of the bone here. That
little bridge of bone between the joints. And that can eventually wear through and cause
a stress fracture. And that can lead to more chronic problems so it’s something to watch
out for. And really the rest of the problems which perhaps are more common in the sports
person are muscle and ligament strains; which are ubiquitous but can become quite a nuisance. Firstly, exercise is very important. There
are some specific exercises and particular regimes which can be very helpful in recovery
as therapy. And then there’s general kinds of exercise which look after the spinal column
and the torso and help maintain stability in the long term. And also, general exercise
will help promote weight loss and general fitness. So that’s a very important part of
any care of the back. Secondly, very specific therapies which aim to mobilise and manipulate
the joints can help in the more acute phases of back pain. And they are practised by physiotherapists,
osteopaths and chiropractors particularly in this country. Thirdly, there are approaches
which involve needling the muscles. And that can be called dry needling or acupuncture.
And that can help settle down muscle tension and relieve pain. A very important part is
advising you, the patient, how to look after your back. That’s all about posture. Back
care. And in relation to the sports person, it may involve modifying technique or the
activity involved. And then the long-term looking after your posture in everyday
life is probably the most important thing. And here we teach what stems from the Alexander
Method or Alexander Technique. Then there are also more invasive treatments. There are
injections. One can inject the facet joints and a sacroiliac joint, one can inject anti-inflammatory
medicine and steroid around the disc and the nerve, and then there are treatments which
deal with more chronic pain arising from the from the facet joints like radiofrequency denervation.
And of course, as a last resort, there’s always surgery. Well, it’s difficult. So far, it’s been shown
despite all efforts and studies that teaching people how to use their back properly, teaching
correct lifting and handling, for example, in industry doesn’t seem to prevent the onset
of first-time back pain. And since almost all of us, say 80% are at some time in our
lives going to get back pain, it looks as if it is just a hazard of everyday life and
perhaps our upright activity. So as one factor we do know is that about 60% to 70% of disc
problems which are related to degeneration of a disc is hereditary. So, choose your parents
wisely. The other thing that isn’t very important of course is care of your back. A lot of us
do not really listen to our back or are aware of how we use up our back until it actually
starts hurting. And that’s often too late. So, teaching youngsters about correct posture
and correct sitting, maintaining strength, mobility and fitness, all these are really
important. And one of the things that we teach here which has been shown to be very effective
in the treatment of back pain is the Alexander Technique; which we call optimal body use.
And it’s really trying to get people back into knowing and listening to their bodies and
adopting the posture which feels good for their spine and their muscles. Well, making sure you have good coaching.
Get advice on your technique. One of the reasons that the stress injury in the bone occurs
is based on the overload principle. Either excess frequency, excessive intensity or a
combination of both. Say, for example, you’re a 14-year-old fast-paced bowler, looking at
your technique could help. If you have a front side-on action, there’s a lot of twisting
and extension and rotation in the spine. We know that that’s a higher risk factor for
this particular bone stress injury called spondylolisis. So, changing the technique–
not always easy– is one thing. Furthermore, talking to a coach or cricket teacher, therefore
reducing the number of overs you bowl in a week or in a match, that reduces frequency.
And furthermore, coming off the pace a bit, just slow down, give your back a chance to
recover, go down to the medium pace or try your hand at spin bowling if that’s possible,
so you are not putting such unloads for your back. All these things can make a difference.
Perhaps most importantly is, as a young person who’s very actively engaged in sport, you
need to listen to your back don’t ignore the symptoms.

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