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Lower back injuries
mvpboxing |  May 04, 2017, 12:05PM
Lower back strain
  1. Definition and Occurrence
    1. The way the vertebral joints are aligned in the low back make it one of the most mobile areas of the entire spine. Combining this with weakened core musculature can often lead to injury in this region. The low back strain is one of the most common injuries in both the athletic and non-athletic population. Lower back strains involve the ligaments that provide stability to this area. Strains and sprains are often grouped because their treatment approach is similar.
  2. Signs and Symptoms
    1. Pain in the area
      1. Pain is worse with activity and lessens or subsides with rest
    2. Muscle spasm
    3. Pain with bending over
    4. Pain is isolated to the low back
  3. Treatment
    1. Rest, Ice, NSAID’s
    2. Massage to control spasming muscles
    3. Once pain has subsided, muscle strengthening can be initiated
      1. Focus is on muscles that control and stabilize the spine
    4. Important to not rest too much, 2 days of bed rest maximum
  4. Prevention (prehab)
    1. Stabilizing exercises for the spine
    2. Proper lifting technique
Herniated Disc
  1. Definition and Occurrence
    1. Between each vertebrae are fluid filled discs that help with distributing the load placed on the spine. With increased load placed on the spine over time, combined with improper lifting technique and the effects of aging, the fluid in the disc can begin to become displaced posteriorly. As the ring of tissue holding the fluid back begins to weaken due to aging and other factors, the fluid can rupture leading to a herniated disc.
    2. As the fluid is moved back, it can place pressure on structures such as the nerves that provide sensation to the lower legs. This is what accounts for the numbness/tingling that can so often accompany this injury.
    3. Herniated discs often are noticed on MRI, but do not cause symptoms
  2. Signs and Symptoms
    1. Depending on which nerves, if any, are affected, the symptoms in the leg will be different
    2. Most often, the L4-L5 or L5-S1 discs are affected. If the nerves are compressed, numbness and tingling down back of the leg and into the foot can result.
    3. If it is a traumatic disc rupture, pain could be noticed immediately in the back and down the leg.
  3. Treatment
    1. Usually, conservative management will be attempted for a period of time to try and calm the inflammation in the area, allowing pressure to be relieved from the nerve root.
    2. There are many different conservative approaches to disc herniation, all having merits. Consultation with a physical therapist and initiation of an individualized treatment plan is usually the first step towards healing.
  4. Prehab (prevention)
    1. Proper lifting technique and sitting posture
    2. Strengthening of the stabilizers of the spine
    3. General overall fitness, including maintaining a healthy weight
Spondylolisthesis
  1. Definition and Occurrence
    1. Spondylolisthesis is an injury to the part of the vertebrae that connects two adjacent vertebrae and results in the slipping of one vertebrae on the one below it.
    2. This injury is more common in athletes that participate in sports that require forceful extension of the lumbar spine including high jumpers and gymnasts
  2. Signs and Symptoms
    1. Generalized pain in the low back. Occasionally, tingling and painful symptoms can move in the legs
    2. Usually, leaning forward provides the most relief for someone who has spondylolisthesis. Leaning back usually increases symptoms.
    3. Tight hamstrings
    4. Hunched over walking pattern to try and avoid extension of lumbar spine
  3. Treatment
    1. Conservative treatment consists of:
      1. Stabilization exercises of the muscles surrounding the lumbar spine to try and increase stability around the affected area
      2. Stretching of tight hamstrings
      3. Proper lifting technique

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