Low Back Pain in Overhead Sports, Mike Golemba, Physical Therapy Assistant, Total Heath Systems of Macomb County

Overhead sports 2
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Sports such as volleyball, baseball, tennis, swimming and basketball are considered overhead sports. Sometimes those who participate in these sports suffer from low back pain and Overuse Injuries - Tight & Sorestiffness due to over extension and or overuse in the low back.
This pain may be caused due to the in-ability of the shoulder or shoulders to properly flex and externally rotate overhead because of a decrease in range of motion. This decrease may be caused from an increase of tightness or pain caused from either injury, overuse or both. With the decrease in the ability to flex and externally rotate the shoulder back far enough the participant may start to compensate by arching and or rotating the low back to be able to make up for the lack of shoulder flexion and external rotation.
With the increase of overuse and strain in the low back this may cause an imbalance of strength and a decrease of range of motion which may cause pain. Below in Figures A and B we can see a volleyball player serving. In figure-A the volleyball player is flexing and externally rotating her right arm and has minimal low back arc and rotation when serving. In figure-B the server has minimal external rotation and flexion in the shoulder. Because of this the server is forcing the back to arc and rotate to the right to get the serving arm further back.
The types of injury or overuse problems can come from participating in their own sport due to repeated movements. Some types of injuries or overuse problems that can restrict the range of motion in the shoulder could be tendinitis (inflammation of the tendon), tendinosis (a degeneration of the tendons collagen due to overuse), muscle pain due to overuse or injury from contact and shoulder joint pain due to overuse or injury.
Shoulder dislocation or subluxation (temporary partial dislocation of the shoulder joint) can also lead to other injuries such as labrum tears, tendon tears and muscle tears which can leave the shoulder with pain during movement, instability and weakness. Also, tightness in the chest muscles,biceps and rotator cuff muscles can impair the shoulders mechanics.All of which can lead to a shoulder that has an in-ability to move in its full range of motion.
When the participant goes to the Doctor with low back pain the first line of treatment is generally muscle relaxers and pain medication.This is good for early acute treatment of pain and inflammation. The problem of how and why the low back ended up this way may not be treated properly unless the patient is recommended for further treatment.
Utilizing Physical Therapy for an evaluation and treatment will help diagnose the patient’s ailment by seeking what type of sport the patient plays, what makes the pain increase and when the patient feels the most pain.  Also looking at a patient’s range of motion, patients muscle strengths and weakness.
Once the cause is found the treatment can begin by utilizing manual therapy, ice and or heat treatment, kineso taping, electrical stimulation, ultra sound and stretching and strengthening. Each patient is different and should be treated as such.
The important thing is getting diagnosed and treated soon after the injury or when the pain starts to inhibit performance. The longer the participant lets it go the worse it will get and will take longer to treat and longer to get back to the sport the play.

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