Low Back Pain and Hip Muscle Imbalance in Athletes

Low back pain or LBP is commonly reported in youth and adolescent athletes. LBP is pain that occurs in the region under the ribs to under the glutes and, it may or may not involve leg pain. Incidence rates vary considerably from sport to sport. A sport requiring athletes to do repetitive bending backward, forward, and twisting, have higher incident rates. The causes of pain are wide-ranging. Causes may include an acute injury, overtraining, improper training, or a more serious structural problem. Youth and adolescent athletes are much less likely to have simple sprains and strains than adults are. This rarity is why back pain should never be ignored and should always be thoroughly evaluated by a medical provider. Early diagnosis and treatment of LBP can also reduce lifelong problems. In some cases, it is just a matter of rebalancing and properly training some muscles in the growing athlete.

Let's focus on two main muscle groups- the hip flexors and extensors. Hip flexors are located on the front of the spine, travel inside the pelvis, and run below the knee cap. These muscles can tighten protectively when our other hip or core muscles are weak. This reaction creates a sensation of tightness, but this type of tightness will not resolve with only stretching exercises. The glutes are a group of muscles on the back of the hip. The gluteus maximus is the most well-known of these, and it is also the largest muscle of the body. The glutes help keep us standing upright and move our hips backward. When we do not have adequate strength of the glutes, our pelvis is less functionally stable, and we tend to lean forward more, increasing strain on the low back, tightening the hip flexors, and causing pain. When these two muscle groups are out of balance- weak in one and tight in the other, we often experience back pain. In developing athletes, these imbalances can be significant. However, properly identifying these issues and adjusting exercise and training should relieve the pain.

One way to check your glute strength is to stand on one leg—if your hip drops down on the leg you are standing on, or if you have to lean forward, you may lack glute strength.

Another way to test your glutes is to check your squat. Stand facing a chair, so your knees touch the front of the seat and your feet are slightly under the chair. Hold your arms out in front of you and squat. If you lean forward onto the chair, push it forward, or if you lose your balance, then your glutes may need work.

Never ignore back pain—it is not normal! Here at Carle McLean County Orthopedics, we have providers that can appropriately evaluate the problem, address the issues, and help you return to pain-free play.

Please call 309.663.6461.