When back pain strikes an aspiring athlete, it may signal something more serious than just a tough practice. In this article, we’ll explore how repetitive hyperextension of the lumbar spine can lead to serious conditions like stress fractures and spondylolysis, especially in adolescent athletes. You’ll learn to recognize early signs, understand conservative treatment options, and know when to seek advanced care.
At OrthoNeuro, we specialize in diagnosing and treating spine injuries in athletes of all ages. With multiple locations throughout Columbus, OH, our team of orthopedic specialists and physical therapists is ready to guide your recovery journey. Contact us today to start your path toward healing.
What do Olympic gymnasts, world champion rowers, and NFL linemen all have in common? Without a doubt, they are all elite athletes working extremely hard to master their craft, but they are also all individuals who are at an increased risk for a lumbar hyperextension injury due to repetitive hyperextension of the spine.
Whether someone is a young competitor at the highest level or just starting out their first season, it is vital to acknowledge the risk of a lumbar hyperextension injury, especially in particular sports. Lumbar hyperextension injuries occur when the lower level of the spine is bent backwards, or arched, past the normal anatomical position repeatedly. Such stress can lead to a stress reaction in the bone or escalate into a stress fracture if not addressed early.
Specific complications related to lumbar hyperextension injuries include:
Spondylolysis occurs when one of the vertebrae in the spine develops a break or fracture due to the stress of lumbar hyperextension. Figures 1A and 1B point out the common location for this fracture in the vertebra: the pars interarticularis.
A further complication of lumbar hyperextension injury and spondylolysis is spondylolisthesis. If the fractured area of the pars interarticularis becomes too weak, there is a risk of it breaking off completely. The vertebral body can no longer remain in the correct alignment, and it will naturally slip forward as seen in Figure 1C.
This can lead to both damage to the surrounding nerves and damage to the discs that provide cushion between each vertebra. Further and even more serious complications, such as cauda equina syndrome, may develop if treatment is not sought out.
To find further video animation on both spondylolysis and spondylolisthesis, please visit: Spondylolysis and Spondylolisthesis
Although any individual involved in strenuous back extension may be at risk, adolescent athletes are at a particular increased risk for lumbar hyperextension injuries, including both spondylolysis and spondylolisthesis complications. Growing adolescents are at risk due to the tightening of their back and hamstring muscles, which can occur as a result of rapid bone growth.
Young athletes participating in gymnastics, rowing, football, and weightlifting are at an even higher risk due to the increased hyperextension required by these activities.
Signs of Lumbar Hyperextension Injury
When looking for signs of lumbar hyperextension injuries, the first noticeable symptom is severe and persistent lower back pain that lasts at least a few days or becomes more intense over time. However, this may be vague and hard to distinguish from other injuries, such as strain to the surrounding muscles, disc herniation, and stenosis.
Lower back pain that worsens on extension, or arching the back, in addition to muscle spasms, stiffness, radiating buttock and thigh pain, tight hamstrings, and difficulty standing or walking, may also be indicators of a lumbar hyperextension injury.
Signs in adolescents and young children may include complaints of persistent low back pain that lasts for more than 2-3 weeks and worsens with extension or twisting.
Conservative Management of Lumbar Extension Injuries
The majority of cases respond well to conservative treatment, which includes rest, activity modification, and physical therapy focused on improving muscle strength, flexibility, and cardiovascular fitness without placing stress on the spine.
Patients may be fitted with a back brace to ensure the spine remains in a proper position for bony healing, especially when significant pars fractures are present. If symptoms persist despite conservative methods, spine surgery may be considered.
Your physical therapist will play a crucial role in guiding recovery by tailoring rehabilitation exercises that improve strength and prevent recurrence.
In a perfect world, prevention of lumbar hyperextension injury involves avoiding any strenuous arching of the lumbar spine. However, this is unrealistic for almost all athletes of any age.
As parents of children who are at risk, consistently promote active stretching of the hamstrings before and after all activities. Adequate warm-up and cool-down periods are also beneficial. Never encourage movement of the spine during athletic activity that initiates pain in the athlete. When in doubt, seek care and guidance from a physician who specializes in the spine.
As an athlete, pay special mind to the form of every skill performed that involves lumbar hyperextension. Ensure that the movement remains as controlled as possible and strive to master the form before adding 100% speed and force to the movement.
Lastly, listen to your body, and if problems ever arise, seek medical treatment promptly from a spine specialist to aid in preventing the problem from worsening. Awareness and proactivity can be the key to avoiding a devastating lumbar hyperextension injury and all its complications.
If you or your child is experiencing ongoing back pain or symptoms consistent with a lumbar hyperextension injury, early diagnosis and proper care can make all the difference. At OrthoNeuro, our team of expert spine specialists and physical therapists works together to develop personalized treatment plans, whether you need conservative treatment or evaluation for surgical treatment.
With multiple convenient locations across Columbus, OH, we’re here to support you every step of the way—helping you heal, restore strength, and prevent future injuries. Schedule your appointment today at OrthoNeuro and take the first step toward recovery and long-term performance.
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