Spinal Stress Fractures in Athletes. Who’s to blame?

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There is a growing concern happening now to our young athletes. Lumbar Spine stress fractures are on the rise. Who is to blame?

Stress fractures occur because of overuse and repeated tensions, usually a torque, on the bone. It can happen as a change of activity or too much of the same activity. In the case of spinal stress fractures, in the lower back, it is commonly found in athletes who use a high amount of rotation (baseball pitchers and hitters) or in those that have to quickly change direction of movement (soccer, tennis).

“In the confrontation between the stream and the rock, the stream always wins–not through strength but by perseverance.” – H. Jackson Brown

Repeated stress on a bone no matter how strong it is will eventually wear down and break. In the cases I have been seeing lately there seems to be an alarming number involving the lower Lumbar vertebrae. The parts of these bones that are breaking are a result of repeated torque or rotation of the spine caused by overuse. Normal body mechanics of the spine show that on rotation and extension (bending backwards) the vertebrae get closer together and in some cases can even touch together. In a controlled and slow manner this wouldn’t be any big deal. In the case of a gymnast who does obvious extreme back bends and tumbling repeatedly compressing these joints you might easily understand how their bones could break under the pressure. But what about the less obvious sports such as soccer and baseball/softball/cricket? What are these athletes doing to cause such compression? They are not bending backward? What can be causing their spine to over-rotate or extend? What part of their body is not working and causing the back to take up the slack?

It’s really very simple. Our bodies move in the path of least resistance. As we are growing and developing as young athletes we tend to overuse the muscles of our hips. We run and play hard and sometimes there is no “off season”. This accumulation of tension around the hips might go unnoticed in younger ages because of how quickly they grow but as we develop into our teenage years our growth slows and hormones shift and we begin to feel the tightness develop. If you are over the age of 35 now are you as flexible as you were when you were 10? Can YOU touch your toes??

As we age our tissues naturally tighten. This means we need to work a bit harder to keep or gain that flexibility. It’s NOT easy especially if you never had to do it when you were younger. If we had learned how to MAINTAIN our childhood flexibility by creating a ‘muscle memory’ for the movement stretch then it would be alot easier to feel loose today.

SO who is to blame???

I blame the HIP! Not a slacker by nature but quite the opposite, a truly hard worker. Tight hips means less motion. Less motion at the hip means less rotation. If we can’t rotate through the powerful muscles of the hip then the next closest area to help out is the lower back. Take the case of an athlete swinging a bat. It takes ALOT of rotation through the spine especially if they miss the ball! Proper body mechanics would allow the HIP to decelerate the power behind that swing and not let you fall off balance if you miss the ball. Ever hit yourself in the back with the bat as you finish the swing?? Not Good! It means your hips are not doing their job.

Look at the full body movement of Soccer players as they accelerate down the field and have to suddenly decelerate and change directions. If you watch them you’ll see upper body and lower body going in opposite directions leaving the pivot point to be the lower back! If there is any loss of rotation through the hips you get excessive load and torque across the spine. Over time the path of least resistance becomes an overstressed bone in the spine that can eventually break under pressure.

WHAT CAN YOU DO??

This tension is NOT just muscle tightness. It is IMPORTANT to know that the real problem here is JOINT tightness. That is very different. If we can get the back side of the hip moving better it will allow a deeper motion for the muscles like the hamstring and adductors (inner thigh) to get a better stretch. If you don’t loosen up the back hip joint then the muscles can’t lengthen and your motion is altered. This is a reason that you can go through all the right stretches but never really feel loose.

HOW TO LOOSEN THE BACK HIP!?

I’ve put together a short video of one exercise we do with every one of our tight hip athletes. The more you do it, the more you’ll remember it and the easier your regular muscle stretches will be.

Please reference our earlier blog titled: 3D Warm up and Flexibility: Lower body for more ideas to further loosen the hips.

If you are experiencing spine pain please get a full evaluation by your movement specialist for a proper diagnosis. Please reference our previous post titled: University Athlete Away from home and Injured…

QUESTIONS to ponder…….

Are we overtraining our youth?

Should there be an OFF season for athletes under the age of 18?

Are the coaches and trainers spending the time for proper warm up and flexibility training?

Dr. Donna Copertino,DC, DACRB, FAFS

http://www.drbackinaction.com

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