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      • Straight Leg Raise Test
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      • External Rotation Lag Sign
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      • Internal Rotation Lag Sign
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Low Back Pain and the Athlete

10/22/2018

2 Comments

 
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 Low back pain is one of the most prevalent “dx” physical therapists see across the board.  So how does low back pain management change with athletes?  In some ways it’s exactly the same and others completely different.  The important thing is to pay attention to the big picture stuff so you don’t miss a major injury. 

Let’s talk about some of the major things we want to look out for and consider with the low back pain athlete.  First of all, low back pain is not a normal finding.  There is a reason the athlete is experiencing low back pain.  For example, when I have a football lineman or gymnast come to me with low back pain my PT senses are automatically heightened. Why? Because these particular sports and positions are more predisposed to having a potential spondylolysis or spondylolisthesis.  The reason being is the repetitive hyperextension and vertical loading required in these sports/positions.  Therefore, part of my screening process is determining if I need to get these athletes imaging.  From there, the management of these athletes with pars defects depend on the degree of slippage.  For example, if an athlete has a lower grade slippage than often there is some period of activity restriction until pain subsides and then most importantly a gradual reloading with activity.  
 
Another diagnosis often seen is disc issues.  These are more common than one would think and can be another injury that takes an athlete out for some time depending on the severity.  Athletes that undergo more axial loading, flexion and rotation in addition to collision sports are often in the higher rate of athletes with lumbar disc herniations.  One clinical pearl to offer is that sometimes when there is nerve involvement, the motor function is more affected than the sensory function.  Therefore, just because an athlete doesn’t complain of the “common” tingling or numbness in the leg, doesn’t mean you should skip a myotomal exam.  
 
Return to sport following a low back injury in the athlete can be another challenge.  While there is no “gold standard” return to sport testing for low back pain, plenty of data exists that athletes can return at a very high level following a low back injury (ex: Tiger Woods, Rob Gronkowski). Instead of the common algorithm like the knee has with hop tests (etc), the lower back is a little more multifactorial. However, similar principles apply. Return the athlete to his/her baseline function, clean up movement abnormalities, re-establish strength levels, and have a gradual return to sport with controlled to uncontrolled practices in the respective sport.  There is no one way and we should not make it one way.  Instead, understanding the needs analysis of the sport, position, and the athlete’s previous level of function should be our goal.  
 
Low back pain in athletes can be a challenging case to manage.  While it starts with a very solid assessment, understanding the biomechanics and positional demands of the respective sport will guide your interventions and eventual return to sport.  Make sure you understand each sport and position carefully.  For more information on return to sport considerations in the athlete and specific progressions and regressions, check out our Insider Access. 

Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
Board Certified Sports Physical Therapist
​

Frustrated with tough patient cases? Can't afford a sports or orthopedic residency? Want more skills to advance your career? Check out our TSPT official courses! 
​
Residency Level Education by Board Certified Sports & Orthopedic Physical Therapists!

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2 Comments
dumpduncan.org link
7/9/2023 11:40:43 am

The privatization of public schools is a pressing concern that demands strong opposition. Privatizing education jeopardizes its quality and accessibility, denying a fundamental right to all, regardless of socioeconomics. When profit takes precedence over student needs, inequality grows, limiting opportunities for marginalized communities. Moreover, privatization erodes democratic control and accountability. We must recognize the significance of public education, advocating for policies that uphold and improve our schools, benefiting students and society. Let's unite against privatization and prioritize the well-being of our public education system.

Reply
reviews on wegovy link
5/23/2024 10:08:43 pm

Low back pain is a common issue among athletes, often stemming from overuse, improper technique, or muscle imbalances. Effective management includes proper conditioning, stretching, and sometimes medical interventions. Recently, some athletes have considered weight management options like Wegovy to alleviate stress on their lower back. Reviews on Wegovy suggest it can aid in weight loss, potentially reducing the burden on the spine and improving overall performance and recovery for athletes suffering from low back pain.

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  • Home
  • About Us
  • TSPT Academy
  • Resources
    • Newsletter
    • Orthopedic Blog
    • Featured Articles
    • Research Articles
    • Residency Corner
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test