Lower Back Injuries in the Top Three for Young Athletes

Lower back injuries were common in athletes under age 18 and can lead to long term problems

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Young athletes deal with their fair share of aches and pains. Along with knee and ankle troubles, lower back injuries top the list of most common injuries among young athletes.

A new study found that lower back injuries ranked as the third most common injuries among athletes younger than 18. More than a third of these injuries were serious, and involved stress fractures and related complications.

"Take a break from sports if experiencing persistent pain."

Teenage and younger athletes put their backs through a lot of stress and strain, often through excessive twisting, lifting, hyperextending, as well as by a lack of development in the abdominal and back muscles.

Neeru Jayanthi, MD, a sports medicine physician with Loyola University Medical Center in Maywood, outside of Chicago, led research looking at 1,200 athletes who had a total of 843 injuries.

Some of the injuries kept young athletes out of action for one to six months.

Participants were between ages 8 and 18 and had come in for sports physicals or treatment for injuries at Loyola and Lurie Children’s Hospital of Chicago between 2010 and 2013.

About 15 percent of all injuries were related to lower back pain, while knee injuries topped the list at 31 percent of all incidents, and ankle episodes came in second, comprising 16 percent of all episodes.

While 61 percent were considered less serious (including injuries in the lumbar facet and sacroiliac joints), 39 percent were serious. These serious injuries included stress fractures and complications of stress fractures such as spondylolysis and spondylolisthesis (a condition in which one of the bones of the spine slips out of place onto the vertebra below it).

Lumbar facet joints are small joints at each segment of the spine in the lower back. The sacroiliac is the joint in the lower back where the spine meets the pelvis.

According to Dr. Jayanthi, some damage to the back can linger with an athlete into adulthood, according to Dr. Jayanthi.

“Long-term back problems include spondylolysis — stress fracture that does not heal in the low back, and then its subsequent complication, spondylolisthesis. These are typically not reversible. Surgery is uncommon, but if there is progression of slippage or neurologic symptoms, you must consider repair or fusion,” he told dailyRx News.

This research highlighted that back injuries were more likely to happen to kids who played more sports.

Laura Dugas, PhD, in the Department of Public Health Science at Loyola and co-author of this study, said that young people with back injuries spent an average of 12.7 hours per week playing sports, while all kids who were injured devoted an average of 11.3 hours per week to sports.

Those who focused on a single sport fared worse than others. The authors noted that children specializing in one sport raised their risk of overall injury. "We should be cautious about intense specialization in one sport before and during adolescence,” Dr. Jayanthi said in a press release.

To reduce the risk of injuries in young athletes, Dr. Jayanthi made the following recommendations:

  • Take a day off from sports if experiencing pain in a high-risk area such as the lower back, elbow or shoulder.
  • If symptoms last longer than two weeks, the young athlete should visit a sports medicine doctor for evaluation.

  • Take care with body position in racket sports. These athletes should assess their form and strokes to limit overextending their backs.

  • Consider taking injury-prevention programs taught by qualified professionals.
  • Young athletes should not spend more hours per week than their age playing sports. In other words, a 10-year-old should not spend more than 10 hours per week playing sports.
  • Young athletes should not spend more than twice as much time playing organized sports as they spend in gym and unorganized play.

  • Young athletes should not specialize in one sport before their late teens.

  • Young athletes should not play sports competitively all year. They should take a break from competition for one to three months a year — not necessarily in a row.

  • Young athletes should take at least a day off per week from training in sports.

Dr. Jayanthi told dailyRx News that these same recommendations apply to knee and ankle injuries as well.

Satish Sharma, MD, pain management physician at the Advanced Pain Management Center in Las Vegas, Nevada, told dailyRx News, "To help young athletes prevent overuse and trauma injuries: have a pre-season sports physical; stay hydrated before, during and after practice and competition; always warm-up and cool-down; make sure to stretch; stop the activity if there is pain or injury is suspected; and contact your doctor with any questions or concerns."

This study was presented on October 28 at the American Academy of Pediatrics National Conference and Exhibition in Orlando. The research was funded by two research grants from the American Medical Society for Sports Medicine (AMSSM). Dr. Jayanthi is a member of an AMSSM committee that is writing guidelines on preventing and treating overuse injuries in young athletes.

Review Date: 
October 28, 2013
Last Updated:
December 30, 2013