Adults aren’t the only ones who suffer from back pain. Children and teens especially participants in competitive sports are likely to experience upper or lower back pain. In fact, one study found that as many as one in three adolescents ages 10 to 18 experienced back pain in the past year.
Dr. Smurawa, M.D. from Children’s Health Andrews Institute for Orthopedics and Sports Medicine shade light on back pain in teens and children. He points to the repetitive twisting and straining associated with competitive sports a major cause contributor to back pains in teenagers and children.
He further elaborates that back pain in adolescents is usually caused by a structural injury to the spine. However, simple muscle strains which often occur in adults are less likely to happen in children and teens.
Causes of lower back pain in teens
Teens are more likely to develop lower back pain typically caused by overuse, such as repetitive bending, hyperextension (bending backward). This is common in many sports including dancing, football, gymnastics, soccer, volleyball, and weight lifting. The common injuries resulting from repetitive movements include stress fracture of the spine (spondylolysis), muscle strains in the lower back, ligament sprain, Growth plate injuries and tendon inflammation.
Spondylolysis occurs when small cracks appear in a vertebra or other part of the spine, a common cause of low back pain. Less common causes of lower back pain in children may also include disc herniation, infection, traumatic back injury and tumors.
Common symptoms
You or your child might notice one-sided dull lower back pain, pain that worsens with arching the back or twisting, discomfort during or after sports. Additionally, a victim may experience persistent pains despite rest and tenderness when pressure is applied to the lower spine. These symptoms are usually gradual and may fluctuate with training intensity.
Risk factors
Dr Smurawa advises parents to be vigilant with young athletes during growth spurt. An athlete’s flexibility and muscle balance can decrease during rapid growth spurt. This leads to instability of the spine thus increasing teens risk of back injury and pain.
It’s worth paying attention to changing biomechanics and high load training placed on an immature skeleton. Now here’s something many people overlook, low energy availability. When an athlete isn’t eating enough to match their training demands, it affects bone health and healing processes.
Single sport specialization for a young age, poor core or lumbar-pelvic control and history of previous back pain or stress injury can also predispose teenagers to future back injuries.
Management of lower back pain
Finally, lower back pains can be managed basing on the following essential pillars:
- Load management.
Initially athlete need to relax or modify activities that aggravate the symptoms, typically spinal extension and rotation movement. However, this doesn’t mean full rest; pain free cross training is usually encouraged.
- Rehabilitation.
A progressive rehab plan includes core stability and lumbo-pelvic control training, strengthening of the glutes and lower limbs, mobility work and gradual reintroduction of sport specific tasks.
- Education and monitoring.
Athlete and families have to be trained load management and energy intake, early warning signs of overload and the importance of maintaining sleep, nutrition and recovery.
- Return to sports.
A gradual return is only recommended once pain has resolved during daily and sporty task, strength and control have normalized then specific drills can be performed without symptoms. Your physiotherapist will guide this basing on objective criteria.
Can these injuries be prevented?
While not all back pain can be prevented, key steps to reduce the risk have to be considered. They include, balancing training load and avoiding rapid spikes, ensuring adequate energy intake to match training demands. Additionally, prioritize strength and control especially in in the core and hips then embrace rest and recovery particularly during growth spurt.
Luckily, early screening including nutritional factors like energy availability, most athlete make a full recovery.
References:
1. Dr. Smurawa, M.D. Children’s Health Andrews Institute for Orthopedics and Sports Medicine (21 June 2019) Back Pain in Children and Teens.
2.Kraft DE. Low back pain in the adolescent athlete. Pediatr Clin N Am. 2002;49:643–53. doi: 10.1016/s0031-3955(02)00007.
3.Zetaruk M. Lumbar spine injuries. In: Micheli LJ, Purcell LK, editors. The Adolescent Athlete. New York: Springer; 2007. pp. 109–40.
Written By:
Joackim Barasa,
Physical Therapist,
Chiropractic & Physiotherapy Health Centre
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