Sports Medicine: Dealing With Lower Back Pain on and off the Court

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Lower back pain is one of the more common complaints to a doctor. Almost everyone will experience lower back pain at least once in their lifetime. Inactivity, lack of proper exercise, being overweight, smoking, family history, jobs or tasks that require heavy lifting, or frequent repetitive activities are just some of the risk factors that can lead to lower back pain. Weekend warriors or competitive athletes may also develop lower back symptoms.

There are many sources of pain generators in the back, including discs, nerves, bones, joints and soft tissue, such as muscles, tendons and ligaments. If someone is experiencing back pain that is also associated with shooting, tingling, numbing, burning pain down the legs, there may be a herniated disc, and/or a pinched nerve. If there is a direct trauma, a fracture should always be ruled out. Medical attention should be sought in those situations.

Diagnostic testing, such as X-rays, MRIs and nerve tests, may need to be performed. Once a diagnosis is established, a specialist will be able to prescribe and perform treatments, such as proper physical therapy and injections. Injections can include trigger point injections, joint injections, and at times epidural injections and nerve blocks. In rare instances, surgery is also considered when conservative measures fail, or if there is the presence of significant neurologic deficits, such as a foot drop, bowel and bladder disturbances.

The good news is that a majority of the time, lower back pain is due to soft tissue injuries, pressure and inflammation of the joints. Due to the nature of the sport of tennis, which includes overhead motion, repetitive rotation, flexion, extension, and occasional falls, lower back pain is a high risk. Muscle imbalance is very common amongst tennis players due to overuse of one side of the body.

In episodes of acute lower back pain, especially within the first 48 hours, the best advice is to place ice on the affected area for 20 minute intervals, relative rest and anti-inflammatory medications. If pain does not improve, a doctor should be seen.

For pain to diminish, physical therapy modalities, such as ultrasound and electrical stimulation are used. Physical therapists and trainers will also begin manual techniques, such as myofascial release and massage. The most important step on the road to recovery is stretching exercises. To further your recovery, strengthening of core posture (abdominal and back) muscles and aerobic exercise is a must.

The next step is prevention. When returning to play, it is important to properly warm up, including stretching, foot movement, and gradual increase of swing velocity. At the end of play, a set of stretching exercises is also recommended. Proper footwear should be used, and a clay court is easier on the back than a hard court.

In summary, back injuries should be treated seriously. Specialists like orthopedic surgeons and physical medicine and rehabilitation doctors will establish a diagnosis, and prescribe proper treatments, which should lead to recovery and prevention of future injuries.