Last Updated on Wednesday, 02 March 2016 09:19
By Dr. Rob LaPrade
http://drrobertlaprademd.com
Question: I play forward on my high school varsity hockey team, and sometimes when I get checked my lower back goes into a painful spasm. What causes this and is there anything I can do to prevent it?
Answer: The back pain you are describing can have a number of different causes. Lower back pain can be from either the back itself (a bony or soft tissue problem), or from a problem in some of the deep organs in the lower part of the torso near the back (especially the kidneys).
In a young athlete like you, one of the most common causes of recurrent low back pain is a condition where a stress fracture or a congenital lack of bone healing occurs in a bony ring at the back one of the lumbar vertebrae (in the spine at the level of your lower back). This is called spondylolysis. Patients who have spondylolysis often have stiffness and cannot bend and touch their toes and tend to have tight hamstrings. Athletes with this condition often have been exposed to repetitive extension and/or loading of the back, and may experience low back pain with more of this kind of stress, such as when they attempt to lie on their stomachs and read with their upper torso propped up. If spondylolysis is the cause of your back pain, it is can be diagnosed with x-rays or other imaging, and usually responds to a treatment plan that involves minimizing stresses to this part of the lower back, physical therapy, and sometimes the temporary use of a brace.
Another source of your back pain could be a bulging or herniated intervertebral disc. The discs normally act as flexible spacers between the vertebral bodies of the spine, allowing motion that is required for bending the spine, and providing a cushioning effect with pounding activities. While it is very rare for a disc to rupture out of its casing and pinch a nerve at your age, a disc that can bulge out and push against a nerve root can cause significant searing pain. Patients who have a bulging or herniated disc usually have pain when bending forward, such as when they tie their skates. The usual treatment for patients who do have a bulging or herniated disc is to give it some time to quiet down and to do appropriate back related exercises. Approximately 90% of patients who do have a herniated disc are able to do well without surgery.
Overall, the best way for hockey players to prevent low back injuries is to participate using proper training techniques. The most common causes that we see for low back pain, in high school, collegiate, and professional players, are due to lack of proper technique when lifting in the weight room. It is important to make sure your knees are bent, and not your back, while performing weightlifting exercises. This will minimize the chance of injuring one’s low back and losing time from competition and potentially leading to further long term problems down the line.
In summary, low back pain can be caused by several different conditions and therefore it is important to seek medical attention to obtain an accurate diagnosis and develop an appropriate treatment plan.
Robert F. LaPrade, M.D., Ph.D. is a complex knee surgeon at The Steadman Clinic in Vail, Colorado. He is very active in research for the prevention and treatment of ice hockey injuries. Dr. LaPrade is also the Chief Medical Research Officer at the Steadman Philippon Research Institute. Formerly, he was the team physician for the University of Minnesota men’s hockey team and a professor in the Department of Orthopaedic Surgery at the U of M. If you have a question for the Hockey Doc, e-mail it toeditor@letsplayhockey.com.
