Back Injuries in the Young Athlete

d’Hemecourt, Pierre A.; Gerbino, Peter G.; Micheli, Lyle J.

doi:10.1016/s0278-5919(05)70231-3

Cited by 135 publications

(151 citation statements)

References 61 publications

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“…An increased incidence of spondylolysis is seen in adolescent athletes who practice sports with repetitive and excessive hyperextension such as gymnastics, diving, ballet, and soccer. 38,39 In the general population, spondylolysis is more frequent in males, though young female athletes are also at risk for spondylolysis. 39 Other risk factors include spina bifida occulta, sacral anatomy, and family history.…”

Section: Spondylolysis and Spondylolisthesismentioning

confidence: 99%

Imaging of Back Pain in Children

Rodriguez¹,

Poussaint²

2009

AJNR Am J Neuroradiol

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SUMMARY:While back pain presents less frequently in children than in adults, it still poses a significant clinical challenge with respect to making a firm diagnosis and developing an effective treatment plan. When children have back pain and medical attention is sought, an underlying pathology is usually suspected. Pediatric patients are evaluated, first, with a complete clinical history and examination and, second, by an imaging work-up that is based on initial findings, including the child's age and size, signs and symptoms, and suspected etiology. This article describes 1) the epidemiology of back pain in children, 2) the imaging work-up used, and 3) the correlation of imaging findings with disease entities that may cause back pain in the pediatric patient. The list of diseases giving rise to back pain is not meant to be exhaustive but rather reflective of the most commonly identified pathologies and disorders among young children and adolescents, from athletic injuries to lethal cancers.ABBREVIATIONS: ALARA ϭ as low as reasonably achievable; ESR ϭ erythrocyte sedimentation rate; FSE ϭ fast spin-echo; 18 F ϭ fluorine 18; LCH ϭ Langerhans cell histiocytosis; LDH ϭ lactate dehydrogenase; MBP ϭ mechanical back pain; PET ϭ positron-emission tomography; RFA ϭ radio-frequency ablation, SPECT ϭ single-photon emission computed tomography; STIR ϭ short tau inversion recovery; 99m Tc-MDP ϭ technetium 99m methylene diphosphonate; WHO ϭ World Health Organization B ack pain in children presents less frequently than in adults. The incidence of back pain in adults has been estimated to be as high as 60%-80% 1 ; the actual incidence of back pain in children, however, is unknown. Back pain in children presenting to the emergency department was originally thought to be an uncommon complaint, 2 reflecting significant underlying pathology compared with adults. Although recent studies have shown an increased prevalence of back pain in children, [3][4][5][6][7] relatively few patients receive medical attention.

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Section: Spondylolysis and Spondylolisthesismentioning

confidence: 99%

Imaging of Back Pain in Children

Rodriguez¹,

Poussaint²

2009

AJNR Am J Neuroradiol

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“…Studies have also established the Minimal Clinical Important Difference (MCID) to be six points [3]. However, the OSW has yet to be validated in young athletes [7]. The patient's initial score was 18 out of 50.…”

Section: Patient Historymentioning

confidence: 99%

The Effectiveness of a Home Exercise Program for a Young Athlete with Schmorl's Nodes: A Case Report

Swain¹,

Evans²

2014

Glob J Medical Clin Case Rep

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Background and Purpose: Adolescent soccer players are often prone to low back pain and one source of low back pain incurred by adolescents is Schmorl's nodes, or endplate disc herniations. Patients with low back pain due to Schmorl's nodes are often given home exercise programs to manage their symptoms and increase their core stability. The purpose of this case report is to describe the treatment and outcome for a young athlete with Schmorl's nodes causing low back pain and lower extremity weakness.Case Description: A 12 year-old female soccer player with a history of low back pain was referred to physical therapy with a diagnosis of Schmorl's nodes. Following 8 weeks of physical therapy, the patient was then discharged to a home exercise program. The patient underwent a 7-week home exercise program involving core strengthening exercises designed to decrease her low back pain and help her return to playing soccer with one-hundred percent effort. Outcomes:The patient completed her 7-week home exercise program. Following intervention, the patient demonstrated improvements in lower extremity and core strength as well as improvements in athletic performance. The intervention did not result in significant changes in the patient's low back pain.Discussion: Home exercise programs are effective in the management of low back pain in young athletes. However, the effectiveness of a home exercise program for adolescent athletes with Schmorl's nodes is not well established. The home exercise program in this case was effective in increasing the patient's strength, but not at decreasing the patient's pain. More research is needed to determine the best physical therapy treatment and optimal home exercise program for adolescents with Schmorl's nodes.unable to keep pace with the rate of bone growth, causing muscle imbalances and decreased spinal stability [2]. Articular cartilage and secondary ossification centers in the skeleton are particularly vulnerable to injury in young athletes because they have a decreased ability to transfer and absorb imposed forces [2]. Additional risk factors for LBP among young athletes include abdominal weakness, hamstring tightness, increased femoral anteversion, genu recurvatum, and increased thoracic kypohsis, which all increase lumbar lordosis and place increased stress on the lumbar spine [2]. LBP can affect participation among adolescents and has been shown to decrease quality of life, increase use of medications, and contribute to absence from school [3].Approximately 10% of chronic lumbar spine injuries are of discogenic origin [4]. During the development of the spine, the nucleus pulposus is relatively more hydrophilic than that of an adult and distributes forces more centrally [5]. In periods of rapid growth, the vertebral body grows at its ossification site in the vertebral end plate. This end plate is composed of hyaline cartilage, lies just adjacent to the nucleus pulposus, and is often very weak. Thus, the combination of a centrally distributed force of the nucleus pulposus wit...

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“…During growth spurts, muscles and ligaments cannot keep pace with bone growth, causing decreased flexibility and muscle imbalances (5,6).…”

Section: Risk Factorsmentioning

confidence: 99%

“…Structural differences in the paediatric spine include growth cartilage and secondary ossification centres, which are susceptible to compression, distraction and torsion injury (5,7). Cartilaginous end plates and ring apophyses overlying the epiphyseal growth plates at either end of the vertebral bodies may be damaged by repeated flexion of the spine.…”

Section: Risk Factorsmentioning

confidence: 99%