By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopaedic Surgery, Stanford University
The Master’s Golf Tournament has a bit of a hollow feeling this year. As I write this post it’s Saturday morning and the third round has yet to get underway, with no Tiger, no Phil, no Dustin… and about 20 other “big name” golfers also out of the picture. For several of those golfers a balky back has led to decreases in performance, and in Tiger’s case it’s required surgery. For the young athletes we focus on, when is back pain something to really pay attention to, and could a serious injury requiring surgery happen in a young athlete? Is it a “sore back” or is it “back pain”?
Many young athletes will have an occasional sore back as part of the normal process with a sport. This is especially common in sports requiring twisting or torsion on the back such as gymnastics, golf, tennis, and lacrosse. In general, a sore back will involve mild to moderate discomfort and will tend to be located along the large strap muscles in the low or midback. Soreness will generally resolve with simple treatment such as ice/heat, rest for a few days, and perhaps some anti-inflammatory medication such as Advil.
Red Flags that signal a possible serious injury
There are a few things to be on the lookout for that could signal that the problem is something more significant than simple muscle soreness. Watch for these things and seek evaluation and treatment from a sports medicine physician soon:
• Did the pain start with an injury associated with a “pop” or sudden sharp pain? This could be a sign of a stress fracture, or rarely a disc injury.
• Is it “pain” or “soreness”? This is a tough call, as each of us will have a slightly different personal definition of “pain”. But in my experience a young athlete definitely knows when something is “painful” vs. “sore”. If the complaint is about “pain”, seek evaluation urgently.
• Any numbness or tingling going down the legs or buttock? This could be an injury to a disc or to the bone causing nerve irritation. Proper early evaluation and treatment is important.
• And if it’s soreness that’s lasted more than about 2 weeks, you’d be wise to seek proper evaluation. In my medical practice this is a common reason for young athletes to seek care. Back soreness that lasts more than about 2 weeks is uncommon and often means there’s an underlying cause. I have seen a big jump in the number of young athletes with this scenario, and oftentimes we find that they have a condition called a “stress reaction” or even a “stress fracture” in one of the lower back vertebrae. This condition can lead to a lifetime of low back problems if not treated, but can usually be fully rehabilitated without long-term consequences if treated properly.
With some sports it’s impossible to completely eliminate the stresses placed on the spine. If you have any of the “red flag” conditions I’ve outlined above then you should get some help from a sports medicine physician. Any golfer would love to play like Tiger or Phil at their prime, but I don’t think any of us want their backs.