Back pain in athletes can interfere with performance and might even bring any athletic career to an abrupt and possibly permanent halt. Athletes are known for pushing their bodies to extremes and all this physical stress can certainly help facilitate purely structurally-motivated back pain problems. However, athletes are also people who put tremendous pressure on themselves psychologically, especially if they rely on their bodies to provide for their basic needs in life. Both of these factors predispose athletic individuals to the ideal circumstances that foster back pain.
This vital topical essay delves into the existence of back pain in athletes of all types and abilities. We will examine the physical and psychoemotional reasons why athletes might develop pain and then provide guidance on the best ways of eliminating dorsopathy and moving forward in any athletic endeavor.
Structural Back Pain in Athletes
Athletic individuals place themselves at risk for many types of back injury, including general sports trauma and repetitive strain disorders. Some types of athletes are known to suffer back pain more commonly than others. In fact, virtually all athletic pastimes seem to create dispositions towards certain types of pain syndromes, especially in novice or serious competitors.
Impact athletes, such as martial artists, boxers, judo players, American football players, gymnasts, rugby players and others tend to suffer recurrent and severe types of anatomical injury on a regular basis. Meanwhile, nonimpact athletes, such as basketball players, soccer players, weight lifters, bowlers, golfers, tennis players, baseball players, hockey players, equestrians, skiers, surfers, climbers, cyclists, swimmers, lacrosse players and cricket players tend to develop repetitive strain disorders, joint problems, limb pain conditions and activity-specific pain syndromes. All types of athletes are susceptible to a wide range of muscular pain syndromes based on injury or overuse.
Athletes might suffer muscular, tendon or ligamentous injury in or around the spine. All of these conditions can create severe pain and might require time off and even professional treatment or rehabilitation. Athletes might also suffer spinal injury, such as a vertebral fracture, vertebra subluxation, vertebral displacement or herniated discs. All of these factors can once again be responsible for creating acute or chronic presentations of purely structural back pain.
The body is well designed to heal and repair itself in virtually every instance. For finely-tuned athletes, it seems almost illogical to theorize that any type of injury, barring the most catastrophic, would produce pain over the extended timelines often seen clinically. Although structural irregularity might be present and appear to be evidence of an anatomically-motivated pain syndrome, patients and doctors alike are cautioned that atypical structure rarely accurately predicts pain. This is a lesson well-learned by modern medical science. In essence, the demonstration of atypical structure might be incidental to pain that exists. This fact helps to explain why so many structural “defects” are targeted to for treatment using a wide range of conservative, moderate and drastic surgical interventions, yet pain remains despite active care. In many of these instances, an alternative source of pain exists and this mindbody source might be primary, as a direct cause of the discomfort or secondary as an exacerbating factor or perpetuator of symptoms after organic healing occurs.
Mindbody Athletic Back Pain
Physical injury and degeneration are not the only causes of back pain in athletes. In fact, a great many recurrent pain syndromes are mindbody-enacted and are therefore the result of psychological and not anatomical issues. Athletes are human and have the same disposition towards suffering physical pain that is created as a distraction mechanism as the rest of the general population does. However, many athletes possess certain personality traits that make them even more prone to developing these psychogenic and psychosomatic syndromes, including perfectionism, competitiveness, extreme drive to succeed and being highly critical of oneself.
The underlying emotional reasons for pain might have nothing at all to do with athleticism. Instead, the issues might be created from any life circumstance or experience and might trace all the way back to the formative years of childhood. However, athletes might also suffer mindbody variations of pain due to the direct stresses of their physical exertions and chosen pastimes. This is far more common in competitive athletes and especially those who depend on their abilities to earn a living, put themselves through school or otherwise compete for their perceived survival.
Psychogenic pain is virtually always mishandled by doctors, since it is rarely correctly diagnosed. Therefore, it rarely responds positively to any form of treatment, including and especially the most dramatic, such as spinal surgery. This truth really helps to clarify why so many people seek treatment for athletic back pain and so few find permanent relief.
Dr. John E. Sarno writes about how the ego of many athletic patients prevents them from seeking care for any mindbody disorder. These people can not accept that their pain might be due to mindbody factors, since they view this as a sign of weakness and dysfunction. In reality, psychogenic manifestations in health are universal in humans, which is a proven scientific fact clearly demonstrated daily in any form of clinical medicine. All athletes would be best served by embracing their humanity and reaching out for help if they suspect that there may be a mindbody component to their pain.
Treating Back Pain in Athletes
Successful treatment relies completely on accurate diagnosis. This is one of my most often used quotes and nothing could ever be more true. Therefore, I always recommend that athletes who have pain problems cautiously seek objective evaluation from a variety of indicated caregivers. Patients should never seek premature treatment if there is any doubt to the accuracy of the diagnostic theory in place.
Some rest and the application of ice or heat might be sufficient for minor injuries or repetitive minor pain complaints. Conservative methods of care, such as physical therapy, massage and chiropractic might prove useful in rehabilitating injuries and preventing recurrent flare-ups of pain. Athletes should be wary of using pharmacological therapy, since these substances are literal poisons to the anatomical temple and undermine all the good that athletic activity provides to the mind, body and spirit. Patients should also be wary of injection-based and surgical treatments, unless these are absolutely necessary and completely indicated for the specific problem suffered.
My final advice to athletes of all types and abilities is to learn your body and understand why it demonstrates pain. Remember that the anatomy is not an island. It exists in the world of the human being, which also contains psychological factors that can be causative and/or contributory to pain and injury. All athletes can benefit from coaching, and to this end, I always recommend consulting with not only an athletic coach, but also a health or pain coach to help manage the known and unknown physical, mental and psychoemotional stresses inherent to athleticism and life, in general. With proper care and a proactive attitude, back pain in athletes can become a thing of the past.