Low Back Pain in Athletes, Prevention and Rehabilitation Strategies

Although the prevalence of low back pain in the general population is 80-90%, it is reported as 1-30% among athletes. General risk factors of low back pain are occupational activities such as repeated heavy lifting, pulling or rotational movements, as well as smoking, alterations in spinal biomechanics and geometry, obesity, physical inactivity. Potential risk factors in sports are also reported as abnormal lumbar curvature, bone deformities, hypermobility, muscular strength imbalance, excessive fat weight, advanced training years, poor conditioning, improper equipment, poor technique, repetitive activities and training errors. Baseball, golf, gymnastics, football, swimming, weight lifting, ballet, throwing sports and bicycling are most the common sports with a high risk of low back pain. The lifetime prevalence of low back pain in some sports were 54% in wrestlers, 32% in tennis players, 37% in football players, 79% in gymnasts, 33% in golfers, 65% in skiers, and 63% in rowers. Management of low back pain is planned according to acute or chronic phases. Treatment of acute phase includes short term rest, ice, medications, and gradual muscle stretching and strengthening exercises. Chronic phase treatment modalities include high intensity exercise program to restore lumbar and lower extremity range of motion and muscle strength. Prevention strategies include correcting posture, lifting techniques, effective warm-up period and training methods as well as the elimination of negative environmental conditions.