Management of lumbar injuries in athletes

Lumbar spine pain is a common and disabling condition affecting an athlete's ability to train and compete. The athletic management team must take a cooperative approach to diagnosis and treatment. The presentation pattern and injury history may provide an early cue to diagnosis; information gained by the trainer or therapist at the time of injury is particularly important. The unique anatomy and biomechanics of the lumbar segments leads to certain injury patterns. Knowledge of the potential motion, muscle effectors of motion and mechanisms of injury allows for a highly specific diagnosis. A meticulous physical examination with particular attention to neurological findings should be used to confirm suspicions from the athlete's symptom pattern. Early conservative treatment should be initiated for all patients except those who are mechanically unstable or neurologically impaired. Aerobic and nonpainful sports-specific training may be continued under the care of the trainer or physical therapist. This will limit the loss of skill and endurance when normal activity is resumed. Diagnosis-specific medical and physical therapy should supplement this training activity. A care team that carefully analyses the pain presentation, injury history and symptoms, and directs a diagnosis-specific treatment programme, should manage lumbar spine conditions in the athlete.