Low Back Pain In Young Athletes

Author: Dr Robert Speirs |

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Some very interesting information from an article by our friends at physiology-pedia.com:

In the United Kingdom there are a large number of children and adolescents who are participating in sport. The government is currently spending over £450 million on improving the quality of the Physical Education and sport activities that pupils are offered [1]  leading to high numbers of participants in sport, not only inside of school but outside as well, 96.7% of children aged 11-16 and 84.1% of children aged 5-10 participated in sport outside of school [2].
 
The young person with athletic potential is likely to have enhanced physiological and physical attributes compared to their peers [3]and can therefore be defined as a young athlete.
 
Low back pain (LBP) occurs in approximately 10% to 15% of young athletes[4] . Schmidt et al (2014) found that competitive adolescent athletes compared to aged matched individuals have increased prevalence of back pain[5].
 
LBP  is defined as pain localised between the 12th rib and inferior gluteal folds, occuring with or without leg pain [6].
 

There are significant differences between the nature of LBP in adults and young athletes [7]. The most common causes of LBP in young athletes are spondylolysis, spondylolisthesis, hyperlordosis syndrome (posterior element overuse syndrome) and discogenic pain[7].
The growing spine introduces certain variables that predisposes the back of the young to specific injuries such as pars interarticularis injury; reported to occur in up to 47% of young athletes [7].
It is of great importance for an athlete with persisting symptoms to undergo a thorough assessment [8].

The impact of the structural problems is considered alongside other aspects such as psychological, social and cultural issues [9]. This approach facilitates compliance with the rehabilitation process and promotes recovery [9], as there is evidence showing athletes with a prior back injury are 3 times more likely to develop LBP [10].

 

Young athletes are not immune to the injuries and conditions that plague adult athletes and need to be assessed and treated just as adults do. While the methods and techniques may vary depending on the age of the child, we need to be sure that we avoid the old tropes of "no pain, no gain" and "you're a kid, you can't be hurt".

 

References
  1. Jump up ↑ Department for Culture, Media and Sport, Department for Education. Getting more people playing sport, February 2013.
  2. Jump up ↑ Department for Culture Media and Sport. Taking Part 13/14 Annual Child Report. Statistic Release September 2014.
  3. ↑ Jump up to: 3.0 3.1 3.2 Armstrong N, Van Mechelen W. Paediatric Exercise Science and Medicine. Oxford University Press, 2008
  4. Jump up ↑ d'Hemecourt PA, Gerbino PG, Micheli LJ. Back injuries in the young athlete.Clin Sports Med. 2000 Oct;19(4):663-79.
  5. ↑ Jump up to: 5.0 5.1 5.2 Schmidt CP, Zwingenberger S, Walther A, Reuter U, Kasten P, Seifert J, Günther KP, Stiehler M. Prevalence of low back pain in adolescent athletes – an epidemiological investigation. Int J Sports Med. 2014; 35(8):684-9
  6. Jump up ↑ Krismer M, van Tulder M. Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific). Best Pract Res Clin Rheumatol. 2007; Feb;21(1):77-91.
  7. ↑ Jump up to: 7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 Micheli LJ, WoodR. Back pain in young adults. Significant differences from adults in causes and patterns. Paediatric and Adolescent Medicine1995;Vol 149
  8. ↑ Jump up to: 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 Standaert C. Low Back Pain in the Adolescent Athlete.Phys Med RehabilClin N Am.2008; 19(2):287-304
  9. ↑ Jump up to: 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 Purcell L and Micheli L. Low back pain in young athletes. Sports Health. 2009;1(3): 212-222
  10. Jump up ↑ Greene HS, Cholewicki J, GallowayMT, Nguyen CV, Radebold A. A history of low back injury is a risk factor for recurrent back injuries in varsity athletes. Am J Sports Med.2001;29(6):795-800.

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