Expert Interview - Back pain in football

Premiership physiotherapist Neal Reynolds talks about back pain in football and preventing back pain.

Preventing back pain

The main issue in preventing back pain is posture. The first hour or two in the morning is when you really need to look after your back. Just be aware of your posture and avoid flexion (bending forwards) positions. Sitting postures are really important, as are lifting postures. It's no different for someone whether they are involved in sports or not.

When it comes to sport, it has become fasionable to do a lot of core stability for preventing back pain. This focuses on the pelvis and lower abdomen area where the muscles are attached to the back and help stabilise and support it.

Neal isn't a fan of lots of sit-ups etc for the reason that they can make a back injury flare up. However, lower level core exercises can be really effective.

Back pain in football

There are so many different structures that can be injured and different diagnoses so it's a really big topic. The main things you see in football are players in their mid to late 20's which are starting to display signs or early arthritis in their lower spine. Symptoms tend to flare up with this. Usually within the season they are fine. It causes more problems in the off and pre-season as their bodies are used to a change in activity.

Treatment for this kind of injury is based around the condition of the muscles, as there is nothing you can do for the spine or discs. Ice is used to help it calm down, then switching to heat quite early on as it isn't an injury as such and there isn't any bleeding. Then lots and lots of massage and muscle energy techniques to get the muscles to settle down. Teaching postural education on how to bend and lift etc.

The other main problem tends to be in the younger play who is constantly arching the back which can cause a stress reaction in the bones in the back which can result in a small fracture. They don't tend to be unstable, although can cause pain on repeateded movements. This should be referred to a back specialist who will decide if surgery is necessary. Often it won't be and rest is enough, although this can mean the player is out for 3-4 months. There are injections which can be used to try to stimulate bone growth, as well as some other options, but the main thing really is resting.