Understanding Lower Back Pain Relief for Athletes
Move Away from Short-Term Pain Relief to Long-Term Recovery
80% of Americans will experience back pain in their lives.
Back pain can be so bad that it affects your ability to exercise, sleep, and even work. Indeed, back pain statistics show that it is the world’s leading cause of disability.
Almost a third of Americans believe that stress is the cause of their back pain. But get this: despite spending more than $50 billion every year on treating their back pain, as many as 90% of people with back pain will never know the primary cause.
While the statistics conclude that more than half of back pain sufferers are desk workers, research shows that the prevalence of lower back pain in athletes and young athletes is similar to that in the general population.
This article will help you answer five key questions:
Why do athletes experience lower back pain?
What can cause lower back pain in athletes?
How can I prevent lower back pain as an athlete?
How to treat lower back pain in athletes?
How can physical therapy help cure athletes' lower back pain?
The traditional approach to back pain doesn’t work
Here’s the problem that we have with the conventional approach to all types of pain in the lower back. When you experience back pain, the usual approach is to advise you to rest. Avoidance rather than activity. Because what is being treated is the pain itself.
“Rest up for a few weeks, and the pain will go.”
So, you rest up. The pain subsides. Then you get back to doing what you normally do, and the pain returns. Now you’re on that merry-go-round of ineffective treatment for lower back pain that is costing Americans upwards of $50 billion a year.
What we should be doing is focusing on the underlying cause of the pain – and there can be many contributory factors – as well as the injury itself, which may include:
Disc herniation
Stress fractures in the vertebral body
Damage to nerve roots in the lumbar spine
Damage to the sacroiliac joints
What are the most common causes of lower back pain in athletes?
Sports including gymnastics, dance, weightlifting, American football, running, ice hockey, wrestling, and rowing, have high incidences of lower back pain among athletes who practice them.
Such sports have a higher probability of injury or body trauma because of a fall or an isolated incident during practice or performance in which, say, an improper technique was used. These sports also require you to continually repeat motions like bending, twisting, and compressing, which can also contribute to pain in your lower back.
Much of sports medicine practices focus on these common causes, but this leads to neglect of other potential causes and risk factors. So, the underlying cause of your lower back pain is never discovered, and this can have a highly detrimental effect on your long-term recovery.
If the cause isn’t diagnosed correctly, the treatment given to relieve your back pain in the short term could be making your condition worse in the long term.
Underlying factors of lower back pain
If diagnosis and treatment of back pain were easy, Americans wouldn’t be spending so highly on it, and back pain would not be disabling to so many. The many other factors that can come into play when dealing with lower back pain include:
A lack of core strength or stability
Poor posture
Poor sleeping habits
The stress of daily life
Form of key muscle groups
Etc.
Physical therapy that focuses on the common causes of lower back pain, instead of taking a holistic approach, is unlikely to give the treatment and advice needed to deliver long-term recovery and improvement.
The Reload approach – Individualizing diagnosis and treatment of lower back pain
You fell badly while competing, and you now suffer from lower back pain. When we diagnose your issues, we go much deeper than this.
We spend 90 minutes discovering why. For example, we’ll want to find out what muscle groups were at play. Then we look at your life routines, to understand how they may also be affecting you. And we’ll look at your goals, to individualize our approach to your rehab.
Why do we spend so much time and effort in our initial consultation with you?
Because we understand that lower back pain is a symptom of many factors. The general advice that plagues so many diagnoses and treatment is misplaced and poor for most individuals. We develop rehab plans that are customized, not conventional:
Individual plans with milestones that help you by bridging the gap between your pain and your goals
Focusing on each underlying factor in your unique mix of causes, and not only alleviating the pain
Starting by understanding what you can and cannot do – for example, by analyzing your range of motion and assessing how each motion feels to create a practical plan
This approach enables us to help you not only develop your body to cope better with the causes of your back pain, but also to help you understand them and modify activities, improve your movement, and overcome pain by developing a strong physical foundation.
Lower back pain symptoms – Do you need to see a physical therapist?
In athletes, everyday aches and muscle soreness have been normalized. No gain without pain, eh? But some pains that you may consider to be normal should really be explored. You should consult your physician if you experience any of the following:
Soreness or pain for more than two weeks
Pain that is worsening over time
Pain that radiates to your legs or causes weakness in the lower body
Pain that affects your balance or walking
Even more serious problems that should be addressed immediately include:
Bowel or bladder problems, which could be caused by lower back issues
Leg weaknesses that make it difficult to walk (such as drop foot)
No respite from pain despite taking medication, when laying down/sitting up, or when changing position
Are you resigned to general advice for short-term pain relief?
Now we’ve established that general advice rarely ensures complete and long-term recovery from lower back pain, how do you know that you may be receiving treatment that is not going to help you for more than a few weeks – or, indeed, advice that could worsen your condition over the long term?
Have you received the following advice and treatment to alleviate your back pain?
Use heat or ice (or rest icing)
Spinal manipulation
Anti-inflammatory medication, such as steroidal anti-inflammatory
Standard exercises to address issues like:
Decreased range of motion and flexibility
Muscular imbalance
Poor core and pelvic strength
Perhaps your physical therapist suggested that you:
Properly warm up and stretch before practice or performance
Strengthen your core and pelvis
Perfect and watch your technique (for instance, if you’re a strength athlete /weightlifter, you want to make sure you’re not lifting with your back)
Start cross-training, which can help avoid repetitive motions that may be causing pain
Take time to rest and recover after training
This one-size-fits-all approach doesn’t cut it. As Ryan Chow, Reload’s founder, says when talking about broken healthcare:
“You can have a hundred different people with back pain and the same diagnosis, but those hundred people will have 100 different solutions.”
The Reload difference
At Reload, we focus on the whole self. Our goal is to help you achieve your long-term goals. So, we focus on equipping you with the knowledge and tools for long-term sustainability rather than short-term, temporary solutions based upon a general approach to lower back pain.
For example, a common piece of advice is to rest – but most times this period of rest is either unnecessary, elongated, damaging, or all three. So, you rest for too long, which harms real recovery. The pain may subside, but the body is still weak.
Generally, activity trumps inactivity. It’s better to return to moving within your personal tolerance levels and embrace activity over avoidance.
This said, you must also choose the right type of activity to support your recovery. This requires expert oversight to understand the specific movements required to best reach your goals with the appropriate frequency and load.
We also understand that the many different causes of lower back pain can depend on factors that include your age, physical condition, the physical activities you participate in, and your other daily activities. So, we don’t simply develop a rehab program for you. We help you understand your personal causes of pain and guide you through a process of recovery that we evolve as you progress.
The Reload difference in action
How does our approach really differ from the approach that most physical therapists would take? Here’s an example of one of our clients, who we’ll call ‘Nate’ (not his real name, of course).
Nate is an athlete who was deadlifting 315lbs in the gym, and, while he was doing so, felt a sharp pain in his back. The pain was so acute that he was forced to drop the weight. The pain hit down Nate’s back and into his glutes. His body began to tense.
Over the next few days, Nate’s hips and back tightened further. Getting up to walk became a struggle, and his posture began to arch and slouch.
As most people do in this situation – it’s scary to think that you are getting close to being paralyzed – Nate went to his doctor, who then sent him to ER. An X-ray/CT scan showed no damage, and Nate was prescribed rest and painkillers.
After a couple of weeks with no real improvement, Nate was given an MRI scan. This showed what the damage was. (Interestingly, a study published in the New England Journal of Medicine found that 64% of MRI scans of people with no back pain showed intervertebral disc abnormalities on the spinal cord.)
A traditional physical therapist advised heat treatment for Nate’s lower back. This helped to relax the muscles around the affected area – but what we know is that muscles tighten to protect a body in pain. The trouble is that the treatment created a negative loop, with the relief only a temporary respite to his pain and the problem not properly tackled.
When Nate came to us, our first step was to conduct a full evaluation:
First, we ruled out the red flag symptoms that would lead to a diagnosis of something far more significant.
Then we spoke to Nate about what had happened and how. We asked about what he had been told, and the treatment he had received.
Next, we discussed Nate’s mindset and how this was affecting him (to recover effectively, it’s crucial to go through some unlearning of negative, reinforced behaviors).
Having learned all that we could by talking to Nate, our next stage is to physically evaluate Nate’s condition by:
Taking a baseline of his movements, and assessing which movements he was guarding and which he was avoiding.
Measuring the pain that Nate felt during the full range of movement.
All of this led to:
Developing a strategy to help Nate reintroduce pain-free movements
Building and evolving a plan that helped Nate to rebuild confidence, make a change, and demonstrate recovery
Continually monitoring and adjusting Nate’s baselines of the hardest things he could do well
As Nate’s recovery gathered pace, we helped him relate exercises (the ‘what’) to his goals (the ‘why’) and welcomed him into the Reload community to advance his long-term success.
Are you seeking a long-term solution to your lower back pain?
How do you find a long-term, personalized solution to your lower back pain?
It all starts with a comprehensive 90-minute evaluation to assess your current range of motion and maximum stress. Using what we learn from this, we will design a unique plan according to your needs and determine the next steps according to the results. We will be there to help you execute your plan and set your expectations.
Do you want to treat your lower back pain and prevent further complications? Book an appointment to start with a comprehensive 90-minute body evaluation.
