An Athlete's Guide to Keeping Back Pain at Bay

In sports and other physical endeavors, the body is the most important piece of equipment. Its strength, flexibility, agility, and stamina make every competition or exercise possible, but it is no doubt fragile. Consistent training and competing can be taxing on the body, leading to pain, injuries, and dysfunctions that can start small but grow into chronic, lifelong issues. One of the most likely body parts to become affected by repeated exercise is the back.

While back pain can affect every single kind of athlete, from the pros to casual gym-goers, there are certain participants who have a higher likelihood of developing back injuries that can contribute to pain now and later in life. Athletes who frequently undergo blunt force contact (such as football players, hockey players, or boxers) and those who use repeated back movements or arching (such as gymnasts, cheerleaders, cyclers, weightlifters, golfers, and divers) are at an especially heightened risk for developing lingering back pain.

But the fact is that virtually all physical activities rely on the back for balance, strength, and support, so it is one of the most at-risk body parts. Participating in sports and other physical activities shouldn’t be off limits just because it may result in back pain. There are a few things you can do to keep the pain at bay while you exercise, train, and compete. In this guide, we’ll go over some of the main causes of back pain in athletes as well as some prevention and treatment options to keep you feeling your best.

Data shows that muscle strains, ligament sprains, and soft tissue contusions are the most common causes of back pain in the general adult population, accounting for some 97 percent of all back pain. Those injuries are also the most common among athletes at every age. Athletes who put the body through routine physical trauma, repetition, and overuse are at a higher risk of developing less common back conditions, such as spondylolysis and herniated disks. Here are some of the possible triggers for back pain in athletes.

• Muscle or Ligament Strain – Also known as a pulled muscle, a muscle strain occurs when a muscle is overstretched or torn. When this happens to a ligament, it’s referred to as a ligament strain. One of the most common places to experience a strain during exercise is the lower back. Athletes tend to experience strains when their muscles are tired, overused, or pushed too hard during training. Although most strains are able to fully heal, severe ones can put athletes out of commission for weeks or months, and patience is a key factor in treatment of back muscle strains.
• Soft Tissue Contusions – A soft tissue contusion is simply the medical term for a bruise. As one of the most frequent back injuries on the whole, it’s also a routine occurrence among athletes who endure kicks, falls, and blows day in and day out. In most sports, bruising comes with the territory, but severe bruising should be properly treated by a medical professional. Ice and compression can help.
• Spondylolysis and Spondylolisthesis – Simply put, spondylosis is a stress fracture or crack of the vertebrae. Though we still don’t know exactly what causes it, researchers believe that this condition likely occurs in childhood as a result of strenuous activity or exercise. In youth athletes, the spine is still developing and has weak points that cause damage during repetitive hyperextension and rotation movements. In extreme cases, the crack or fracture weakens the bones and causes vertebrae to shift or slip. This condition is called spondylolisthesis.
• Herniated and Ruptured Disks – Discogenic injuries—or injuries to or related to the spinal disks—of all sorts are common in athletes, affecting pros and amateurs alike (Tony Romo, Dwight Howard, and Peyton Manning have all been sidelined by a herniated disk). Some of the most common in this group are slipped (herniated) and ruptured disks. These injuries refer to damage to the cushioned disk tissue between the vertebrae, which tend to occur due to repetitive motion or trauma. Degenerative disk disease, common in older athletes, is a similar problem that occurs when the disk becomes more rigid and dry with age.
• Sciatica – Sciatica is defined by a radiating pain that runs down the sciatic nerve (from the lower back down one or both legs). It may be triggered by a herniated disk, bone spur, or some other injury that places pressure on the nerve. Some of the most high-risk athletes for developing sciatica are those who practice repeated swinging or trunk rotation, including golfers and tennis players.

Given the high number of back pain sufferers across all sports and physical activities, preventing injury and pain is of utmost importance for all athletes, coaches, and parents. While there’s no way to completely safeguard the back from impact, there are certainly some things you should do to prevent back pain while playing sports.

• Stretch before you begin training. Routine stretching helps improve your balance and mobility, which can, in turn, prevent injury. Develop a full-body stretching regimen that supports and strengthens the back.
• Warm up and cool down. You need to prepare your body for all exercise with a warmup in order to increase blood flow to your muscles and prepare them for a strenuous workout. Cooling down gradually decreases your heart rate and blood pressure so that your body doesn’t experience any sudden drops.
• Strengthen your core and legs. The back muscles are supported by the surrounding bones, muscles, tendons, and joints throughout the entire body. Building strength in the core and legs will prevent your body from putting too much pressure on the spine or allowing it to become misaligned.
• Exercise on the right surface. As much as you may enjoy running on the road or sidewalk, keep your workouts to padded tracks or soft trails. Running on hard surfaces can irritate the muscles in your lower back and compress the spine.
• Consider wearing a weightlifting belt. Those who spend their time lifting for sport and are serious about pushing themselves to the next level might consider wearing a weightlifting belt for an extra layer of support.
• Use guided weightlifting machines rather than free weights. These machines are specifically designed to help you exercise in slow, safe motions with the proper support throughout the body, which can help reduce injury in the back.

• Wear the right shoes. Of course, the right shoes will depend on your feet and the activity at hand. Just remember that the feet have an effect on the whole body, including the back, so a supportive pair is important to a pain-free back.
• Think about posture. Whether you’re a golfer, a runner, or a baseball player, you know your stance matters. Bad posture during swinging and other repetitive movements can trigger and reinforce poor alignment, leading to pain.
• Get plenty of rest. One of the most likely reasons why athletes experience muscle strains is because their muscles are fatigued. Be sure to incorporate rest days and regularly get massages or use relaxing pain relief therapies.
• Don’t overdo it. It doesn’t matter the sport or the injury that’s most likely to occur when you play it, the ethos should be the same— know when to stop. Your body can be pushed too far, and overextending and overusing your muscles are common ways to get injured while practicing or competing.
• Drink lots of water. Like every part of your body, the back—including its muscles, bones, and ligaments—needs water to function properly. Make sure you’re properly hydrated before and during any physical activity.
• Wear the right pads and equipment. This is imperative if you’re playing any contact sports, such as hockey or football. Pads provide a layer of protection against impact on your back, ribs, and shoulders, so don’t skip them.
• Check in with yourself. Try to get into the routine of stopping to check in with yourself throughout the day as you work out or train. The occasional full-body scan will help you find any muscles that are weak, tired, or pained, helping to indicate that it may be time to stop or move on to a different activity.
• Get proper sleep. Rest is vital to good health and a lower likelihood of developing injuries due to fatigue or mental fogginess. Practice good sleep habits, such as putting your phone away an hour before bedtime and having a cutoff time for consuming caffeine, alcohol, tobacco, or any other stimulant.

Prevention is essential when you’re not yet suffering from back issues, but what if you already have a back injury? There are a few things you can do to mitigate pain, stiffness, and spasms as you allow your back to heal. For athletes, a well-devised pain management treatment plan is crucial to success. Without one, it would be impossible to train or properly heal before a big competition. With one, athletes can enjoy freedom from pain plus added benefits like stress relief and improved mobility.

• Low-Level Laser Therapy – Low-level laser therapy for back pain is a painless, non-invasive option for temporarily providing relief of minor muscle and joint aches, pain and stiffness, and muscle spasms. Wearing a low-level laser therapy belt around the affected area for a short period each day can increase local blood circulation and aid in the relaxation of muscles, which can help you get better, more productive rest before you head out to train. We recommend incorporating laser therapy into your post-train recuperation plan each night and on rest days.

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• Ice and Heat Therapy – Depending on the kind of injury you have, ice and heat therapy can be of great value in providing relief and getting you back on the path to healing. This is especially important in the hours and days following the initial injury. Be sure to talk to your doctor about when to use which therapy, as it’s often best to alternate heat with cold when healing from back injuries.
• Massage Therapy – Serious athletes must consider incorporating routine massage therapy into their training and health regimens, given that it’s one of the best ways to loosen up tight muscles and knots after vigorous exercise. It’s also a good way to mitigate stress and anxiety, which can lead to back pain and muscle tension. Massage therapy may include going to a professional massage therapist or using self-massage devices, such as massage balls and foam rollers.

• Hydrotherapy – Hydrotherapy may involve everything from performing strength- and flexibility-boosting movements in the pool to sitting and relaxing in the hot tub with jets providing a gentle back massage. The temperature and light pressure of the water can help relax tense muscles and increase blood flow, which may result in a reduction in pain and swelling. Research indicates that hydrotherapy can lead to a reduction in back pain and that it may also improve mobility in the lumbar.

Remember, the back is a complex structure made up of many bones, muscles, tendons, and ligaments. We rely on it for just about all activities, from sitting while working at the computer to competing in the Olympics. Keeping it in all-around good shape is important to persevering in sports and life. But don’t obsess over it or sit out on activities you love out of worry! A little bit of prevention and the proper treatment options will keep the back healthy and the pain at bay for the long run.