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Core Knowledge


How to Reduce Back Pain


Whether you are an elite athlete, a weekend warrior, or a regular exerciser, you can be almost certain of three things regarding back pain: 1) Sooner or later, you will have it. 2) Most of the time, the pain will be in the lower back. 3) With or without treatment, it will get better.

Apart from those three near-truths, things get a lot more complicated. The muscles, bones, joints, ligaments, tendons, and disks of the back all have to work together in perfect harmony to avoid injuries. Even when all the parts work well, some back injuries are simply unavoidable. Athletes accept the risk of back injuries when they decide to play a sport or exercise regularly, vigorously or over a long period of time.

Among a variety of possible back injuries and back conditions, the University of Maryland Spine Program has identified the four most common injuries and conditions likely to affect athletes:

  1. Back strain
  2. Spondylolysis
  3. Spondylolisthesis
  4. Herniated disk

The causes, symptoms, and treatment may be slightly different, so it would be a mistake to consider all low back problems as a single condition with exactly the same cause, treatment or prevention strategy.

Nevertheless, there are some common denominators when it comes to lower back pain caused by strains, and those factors will be discussed in this report. 

How It Happens

Because of the complexity of the structures in the back, there is no single mechanism that accounts for lower back injuries and pain. But back strains—tears in tendons or ligaments—are among the most common sports injuries. They occur after sudden or awkward movements, when lifting or moving a heavy object (like an opposing lineman) or when absorbing a blow from another athlete. Sometimes back strains are triggered by seemingly harmless movements, such as bending over to tie a shoe, picking up a child or reaching up to get something out of a cabinet.

Structural problems may also cause lower back pain and may accompany strains. A bulging disk (the soft material between vertebrae) may press against a nerve. If it presses against the nerve that extends downward through the leg, it can cause a shooting pain called sciatica that affects the buttocks and the back of the leg. Skeletal irregularities such as scoliosis—a side-to-side deviation of the spinal column—can cause pain in the upper, mid or lower back. And the lower back is one of the most frequent areas affected by osteoarthritis. 

By the Numbers

Back pain is the number two reason (behind colds and the flu) that Americans seek medical attention.

Estimated percentage of all sports injuries related to the lower (lumbar) spine.

Percentage of the population that will have lower back pain at some point in their lives.

Percentage of lower back pain that will improve with or without medical attention. 

Who’s At Risk

Any athlete who places stress on the spine is vulnerable to a back strain. Weight lifters and field event athletes such as discus, javelin and shot throwers/putters are the most obvious examples, but lower back strains are often reported in skiers, runners, golfers, skaters and lacrosse, basketball, football and tennis players. 


  • Pain in the lower back
  • Lower back muscle spasms

See a doctor immediately if the pain is intense, spreads down one or both legs, causes weakness or numbness, or follows a fall or a blow to your back.

Initial Treatment

  • Rest your back for 24-48 hours, but do not stay completely immobile; limited, mild movement is better than bed rest.
  • Apply ice packs for 15-20 minutes, 3-4 times a day for the first 48-72 hours.
  • Apply moist heat after the first 48-72 hours if it makes you more comfortable.
  • Aspirin, ibuprofen and naproxen may relieve pain and reduce inflammation.
  • If you sleep on your side, place a pillow between your knees.
  • If you sleep on your back, place a pillow under your knees.

Comeback Strategy

  • Avoid sitting in one position for long periods of time. Get up and stretch every 20-25 minutes.
  • Execute each movement required in your sport, gradually increasing the speed of movement, before returning to normal training and competition.
  • Use a lower back support to keep the pressure distributed evenly on the muscles of the lower back.


Incorporate these prehab exercises into your comeback routine:

  1. Front Pillar Bridge
  2. Lateral Pillar Bridge
  3. Glute Bridge
  4. Hand Walking
  5. Half-Kneeling Chop
  6. Half-Kneeling Lift

Movement Prep

Incorporate these movement prep exercises into your warm-up routine:

  1. Quadruped Posterior Rocking
  2. Foam Roll (but not directly on the area of a strained muscle)
  3. Quadruped Opposites

How to Avoid It

  • When lifting heavy objects, keep your back as straight as possible and use your legs. Do not bend at the waist.
  • Avoid slouching when sitting.
  • Use a lower back support to keep the pressure distributed evenly on the muscles of the lower back.
  • Do not increase exercise intensity, frequency or duration more than 10 percent a week.

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.

Tags: Back Pain, Injury Prevention, Hockey, Injury, Prehab, Rehabilitation, Lower Back, Back


  1. Steve Smith, PT, DPT, SCS, CSCS, Manager, Performance Physical Therapy Services Athletes’ Performance, Florida
  2. American Academy of Orthopaedic Surgeons
  3. MayoClinic.com
  4. University of Maryland Medical Center


External Links