Of all sports injuries, lower back pain is among the most common.
Repetitive spinal flexion, extension and axial loading exerts increased levels of stress on the spine, leading to athletes either competing through immense discomfort or being side-lined for weeks at a time.
Sports like gymnastics require athletes to move into positions that involve repetitive hyperextension during vaults and flips while dramatic rotation movements also occur in the process of dismounting.
Football carries its own risks in terms of back pain. Research shows that injuries are primarily soft tissue-based but more chronic issues can arise the longer the athlete plays.
Skiers and snowboarders, meanwhile, can suffer back issues that are more traumatic in nature when jumps fail. In such cases greater axial loads are placed on the spine.
Ultimately though, rehabilitating back injuries is patient-dependent, says James Olasunkanmi, previous men's academy and women's first team rehab physiotherapist at Crystal Palace Football Club, now based at Ultra Sports Clinic.
“This means that the purpose or goal will vary depending on the individual you have in front of you,” he says.
There are, however, some key principles that should be addressed in all rehabilitation programmes.
These include regaining range of motion, focusing on strengthening the surrounding musculature, and providing education on ways to modify activity, manage flareups and reduce the likelihood of back pain returning in the future.
James says there are different injuries relating to back pain and, as such, recovery times vary.
“However, for the most prevalent type, mechanical lower back pain, this will typically last from a few days to a few weeks. More chronic issues may be persistent for up to 12 weeks or longer depending on the severity of the injury.”
He points to three basic stages of back rehabilitation, which do differ from patient to patient:
Acute phase: Rehabilitation may be focused on reducing pain, the source of inflammation or irritation, and regaining range of movement.
Rehabilitative phase: Treatment seeks to address any areas that may have caused the back pain in the first place. This may include strengthening the spinal musculature, core stability and providing education on flareup management.
Maintenance phase: During this stage, treatment and advice are offered to help maintain all the rehabilitative principles that were worked on in the previous phase, focusing on providing regular education on activity modification and regular movement throughout the working day.
James advises that patients should only potentially be cautious of certain movements during the acute phase, where the focus is on reducing aggravating factors.
“Excessive bending, heavy lifting or reaching may be avoided in this phase to help reduce pain. However, as symptoms improve it is important to be confident with all regular activities associated with your daily life and return to full functionality.”