Q. I just started the training packet that my college strength coach gave me but I have been having some low back pain. I’ve never had significant low back pain or remember “pulling” anything, so what could it be?
A. Low back pain can come from a variety of sources and I suggest that you have a physical therapist or orthopedic specialist take a look at it before continuing. Other than the acute muscle strain, the most common types of low back or lumbar pathology that I see with young athletes are congenital defects and stress fractures. Congenital defects explain the bony abnormalities, often present from birth, that tend to manifest themselves after significant activity as the athlete gets older. Spondylosis, which starts as an anterior slippage of a vertebra on top of another, is the most prevalent defect causing low back pain in high school and collegiate athletes. Some studies suggest that 1 out of 20 young adults have this diagnosis confirmed via x-ray.

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The other type of pathology that I commonly see in athletes is a stress fracture of the low back or lumbar vertebra. This is often the case in the athletes that have gone from limited activity to a significant training load. These athletes have a tendency to overtrain and need to be educated on the importance of taking time off and unloading the spine. Stress fractures are difficult to pick up with diagnostic imaging and may require a number of views and images to accurately assess.

Both of these problems can be managed with simple exercises and a proper stretching routine. When I review the training programs of the athletes that come into our gym, I usually find some gaping holes in proper strengthening of the “core” musculature. Often college programs have a significant amount of Olympic-style lifts that are geared at multi-joint strengthening of the big muscle groups. While this allows for the greatest strength gains of the extremities, it fails to consider the stability muscles that are needed not only for these types of lifts but also for the sport-specific movements that the athlete needs to perform. Several studies uniformly confirm the significance of the “core” musculature and the protection they offer, especially to the spine, before extremity (leg and arm) movement.

The “core” musculature is the generic term given to the muscles in the hips, abdomen, and low back. Most people think they are training the “core” by just doing some sets of crunches and sit-up variations. While this may get part of the “core” this is by no means conclusive. One of my favorite exercises that activates nearly all the important muscle groups involved in stabilization of the spine is what we call the “Crab Walk”. While holding a light medicine ball overhead (engaging the shoulders, cervical, and thoracic spine), stay low in a wide-stance squat (hips and knees), keep your stomach tight (abs, obliques, low back) and take slow, small steps laterally while maintaining this position. I usually go 10 yards in one direction and then 10 yards in the other before resting.

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