Back pain in young athletes
Back pain (recurrent or persistent) is NOT normal for teenagers (or kids, adolescents). There can be many causes of back pain, but I am going to focus on a relatively common one.
A few of my teenage/adolescent patients have a condition called spondylolisthesis. This is typically a result of stress fractures. This bony fatigue causes a ‘slippage’ of the connection between the vertebral bodies (spinal bones).
This slippage pulls the spinal cord forward and can potentially create a bend in the spinal cord.
It is important to find out if spondylolisthesis has already healed and is stable OR if it is active (potential for further slippage). The best way to determine if the condition is active is to get BONE SCAN (and/or a flexion/extension functional radiograph, MRI or C/T scan).
The worst-case scenario for active slippage is surgery. This condition can occasionally become urgent (especially if increasing leg weakness, bowel/bladder dysfunction or other neurological symptoms appear).
For athletic teenage or adolescents, aquired spondylolisthesis can be caused by growing combined with sports (including gymnastics, football, basketball, weightlifting, wrestling/grappling, soccer, volleyball), especially sports requiring repetitive extension and jumping/landing on hard surfaces.
For treatment, I focus on treating/releasing the muscles and soft tissues around the spine that contribute to hyperextension (will vary depending on athlete). Stretches, exercises, recovery and training technique and surface variation can also help.
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A further breakdown of details and severity of spondylolisthesis can be found here.