Exercise by young athletes –
especially by those who train in one sport – can cause fractures of the back,
tiny cracks in spinal bones, may account for almost half of low back pain cases,
among active teenagers who seek medical attention for their pain, according to a
report in the January issue of the medical journal The Physician and Sports
Spondylolysis is more common
than doctors visits indicate, the article said teens “often cope with the
condition by hoping it will just go away,” the journal reported.
In many cases, it does go away,
or teens play despite the pain. But treatment can reduce the pain and possibly
head off a recurrence.
Spondylolysis typically happens
to young athletes who specialize early in a sport such as gymnastics which can
require the athletes to bend repeatedly far backward, putting pressure on bones
in the lower spine, said Dr. James Moeller, chairman of sports medicine at
William Beaumont Hospital in Troy, Mich., Moeller was co-author of the journal
Risk of injury rises with the
level of competition and time spent in a sport, Moeller said. The risk is
greater in college or pro activity than in middle or high schools, he said, but
young athletes who specialize early in one sport face similar dangers.
It would be better if kids
varied their sports while they were young and didn’t decide on a favorite
until they were in their early teens, Moeller said. This would reduce the risk
of overuse injury, he said.
Young athletes also can reduce
their risk by strengthening muscles in the abdomen, as well as hip flexors and
other muscles that support the back, Moeller said. Typically, however, coaches
prefer to focus their limited training time on muscles needed for the sport
instead of on prevention of injury, he said.
“I think if they work in this
prior to any problems, they might be able to avoid the problems altogether,”
Doctors look for the condition
by having the patient bend backward. If it hurts, that’s a sign of
spondylolysis. The tiny cracks also can show up on x-rays, but more
sophisticated imaging may be needed to make a diagnosis, the journal article
The cracks can heal in two ways
– the bone fuses back together or a softer material called collagen fills in
the crack. Collagen self-repair is
less stable, however and increases the possibility of a recurrence of
spondylolysis, said Dr. John Sarwark, a professor of orthopedic surgery at
Children’s Memorial Hospital in Chicago.