Do I Need Physical Therapy for Low Back Pain in Petaluma
Introduction
As Petaluma residents begin to shake ourselves out from the winter months, it's common for athletes to begin to notice some low back discomfort. The question that always comes to mind - "Do I need physical therapy for low back pain - or will it go away on its own?"
Whether you're out on trail runs in Helen Putnam or Pt. Reyes, ramping up more time on the mountain bike in Annadel, or your child is ramping up in their club sports around Sonoma County, activity is on the rise with the temps. And if you're noticing your low back talking to you, then this article is going to help you answer that above question.
We help athletes recover from injury, return to sport, and train for their active lives. And with low back pain being the most common condition we treat at BaseCamp Performance Co., we wanted to give some helpful info on the causes of low back pain, on the common mistakes people make, and also help you figure out whether you need more help or not.
Short answer: If your low back pain is limiting activity, lasting longer than 1-2 weeks, or keeps coming back, performance physical therapy is often the best way to resolve it long-term.
Let's dive in.
What is Low Back Pain?
Low back pain is a symptom, not a diagnosis. In other words, pain in the lower back can come from several different sources, including muscles, joints, or discs. Often, these tissues are placed at higher levels of stress due to inefficient movement patterns elsewhere in the body.
Because sports place even higher degrees of stress on the body, and because athletes are even better compensators than the general public, athletes often experience lower back pain more frequently.
While the underlying cause of low back pain can be quite different among different athletes The most common forms of back pain are muscular strains, joint irritation, or disc-related conditions.
The vast majority of cases are non-serious and do not require surgery, injections, or even pain medications. But, these cases do require the right approach to fully resolve.
At our clinic in Petaluma, most of the back pain we see is related to movement dysfunction elsewhere in the body, rather than a specific injury of the spine itself.
Why Does Low Back Pain Happen In Athletes?
Athletes place themselves under significantly higher stress than the average population. For this reason, they are more susceptible to lower back pain. Because certain sports often have repetitive movements, they lend themselves to similar underlying causes for low back injury. Below, we break down the most common causes for low back pain in the most common sports we work with.
Low Back Pain In Runners
The high degree of repetitive movement in running makes it easy to over-stress certain tissues. The most common issue we see with runners is an inability to effectively stabilize their pelvis and hips. As a result, their spine is exposed to a higher workload, leading to irritation of any of the above mentioned tissues (i.e. discs, joints, muscles). This is the purpose of adding in cross-training or strength-training to your running program - without it, it is very difficult to develop the strength of the muscles that stabilize the core and pelvis.
Low Back Pain in Lifters/CrossFitters
Because there are so many different movements involved in group fitness, strength training, or CrossFit, identifying the common theme of back pain in this group might seem difficult. In reality, injuries here often come down to 2 causes - inefficient movement, and excessive stress.
Inefficient movement encompasses form breakdown, improper timing of contraction, and excessive tightness or excessive mobility in any segment of the movement chain.
Excessive stress typically results from inefficient movement.
Let's use a deadlift as an example. When the athlete picks the weight up off of the ground, it's necessary for the stabilizing muscles of the lower back to fire first, followed rapidly by the hamstrings and glutes. If the body doesn't fire these stabilizer muscles at the right time, excessive stress is placed on the spine, causing irritation of the joints or discs.
For this reason, it's imperative that lifters take into account the need to build efficient movement prior to scaling their load on any movement. Failure to do so can be a recipe for recurrent frustration and lack of progress.
Low Back Pain in Rotational Sports
Athletes participating in baseball, softball, tennis, pickleball, swimming, and even ball/field sports such as soccer and football, all fall into this category. These sports require rapid rotational movements, such as throwing a baseball, or changing direction in soccer or basketball.
The hips and shoulders are the primary sources of rotation throughout the body. Athletes from the above sports often struggle to achieve the appropriate hip mobility, or hip strength, to execute these rotational movements. As a result, they ask their spine to be a power generator for rotation - a job it isn't well suited to do.
With the rise of club sports in Petaluma, Santa Rosa, and the rest of Sonoma and Marin county, youth athletes are exposed to a higher volume of sport than previously. Practice for these sports will often focus on technical skill - such as throwing a baseball or kicking a soccer ball - rather than creating effective movement without compensation. As a result of this, compensatory movements show up often, leading to increased stress on the low back. Sadly, we see this every day in athletes seeking physical therapy for low back pain.
To summarize, the common thread amongst low back pain in athletes is that the source is often elsewhere in the body. The location can vary between sports, and is often exacerbated by the specific movements of the sport. Increased frequency of training or competition can accelerate irritation of the tissue by increasing the amount of stress it's exposed to.
Common Mistakes People With Low Back Pain Make
The most common mistakes for athletes with low back pain are:
- Waiting too long to seek help.
- Guessing the root cause instead of identifying it properly
- Relying on rest, heat, ice or medications alone
Let's expand on these more.
The biggest mistake athletes make when treating their lower back pain is to avoid seeking care, thinking that the problem needs to be worse before they try to solve it. This leads to furthering any compensatory strategies the body is taking, making it harder in the future to solve the real issue.
Instead, they focus on strategies such as rest, avoidance of painful movements, or the use of ice/heat or other pain medications. These strategies may improve symptoms, and are used frequently by physicians. However, the relief is often temporary, and low back pain can often return in these cases as the athlete hasn't addressed the actual source of their injury.
Another common mistake is in misidentifying the root cause of their low back pain. These are well-intentioned attempts at solving the 'problem', but sadly have no higher degree of success.
Here's an example:
A runner sees on TikTok that runners often suffer with tight quads, and that the presence of a tight quad can increase stress on the lower back. As a result, this athlete spends considerable time each day stretching their quads.
But, if the real source of this runner's problems are stemming from improper stability of the pelvis, then this athlete will likely grow frustrated. The time they spent pouring effort into solving their problem would be met with minimal positive result.
How Performance Physical Therapy Solves Low Back Pain
Unlike traditional physical therapy that often focuses on symptom relief, performance physical therapy focuses on fixing the root cause and preparing your body for the demands of your sport.
Performance physical therapy takes a much more in-depth approach to solving the athlete's low back pain through examining the entire body in motion to assess where these inefficiencies and breakdowns are occurring.
The next step is the most important though, and distinguishes the best physical therapy providers from average ones.
The performance physical therapist must identify which of these findings is most important. The other findings are simply compensations, or noise that won't move the athlete forward toward solving their lower back pain.
Being able to do this effectively requires experience in working with athletes across different domains, as well as a robust knowledge of the body and the demands of the athlete's sport.
The performance physical therapist will then create an individualized plan for the athlete focusing on the following:
1. Reducing pain
2. Improving the efficiency of the limiting body part's movement
3. Building more strength and resilience to prepare for sport
4. Successful reintegration into sport.
Because of this in-depth approach, the athlete will often return to sport stronger and more resilient than before. At the highest levels, the performance rehabilitation provider will help the athlete unlock new levels of performance.
How BaseCamp Performance Co. Approaches Treatment
At BaseCamp Performance Co., we start every patient with a discovery call. This allows us to determine the best provider on our team, or if there are other providers in the area who would be better suited to help them with their low back pain.
Each patient then moves on to an evaluation. It is in this evaluation that our team of performance physical therapists and rehab sports chiropractors identify the source of the athlete's low back pain. We determine where the athlete's inefficiencies are through an in-depth examination that determines if an athlete possesses enough mobility, strength, and coordination across the major joints of the body.
Once we've identified the source, we construct an individualized plan to help each athlete return to their unique sport demands. Each athlete will require improving strength and resilience for long-term success, but the strength required will be different based on the athletes's unique sport demands.
A program for runners will look very different than a program for a pitcher, because the unique demands of each sport are very different from each other.
Along the rehabilitative journey, our team routinely uses objective testing at the highest levels to determine readiness for returning to sport. The use of force plates and dynamometry allow us to assess if this individual is demonstrating the strength, coordination, and power needed for their level of sport.
This is one of the ways our approach differs. Many providers can assist in helping the athlete reduce their symptoms, but if the body is not adequately trained at the level of demand for sport, then the athlete's symptoms can often return. Returning to sport requires stressing the body at the highest level, and having the ability to objectively determine readiness, then success is less predictable.
Our approach has helped runners get out of pain and complete marathons, moms get back into group fitness and CrossFit classes, and youth athletes crush their sport season without pain.
When Should You Seek Professional Help?
The following are signs that professional help is warranted:
- Pain lasting longer than 1-2 weeks
- The pain shows up during sport or during specific activities
- Modifications are required during exercising to avoid pain
- This is a recurring episode of a pain that has occurred before
Each of these suggests that you have an underlying movement pattern that is placing higher stress on your spine. Without addressing the underlying cause, you risk having future episodes of the same pain. The longer you wait, the more ingrained the compensatory strategies become, and the harder it may be to return to sport.
Remember, one of the biggest mistakes athletes make is to wait until the problem is significantly worse to seek help.
Do You Need Physical Therapy for Low Back Pain?
If your pain is limiting activity, lasting more than 1-2 weeks, or keeps coming back - then yes, performance physical therapy is one of the most effective ways to resolve it long-term.
If you've tried resting without success, have noticed that pain shows up in your sport or during specific movement in the gym, or are having a recurring episode of a previous pain, then it's time to get down to the underlying cause behind your low back pain.
Rest is often not the answer, as it won't help you prepare for the demands of your sport. Seeking out a performance rehab specialist will help you to identify the underlying cause of your lower back pain and get on the path to pain-free performance in your sport and in your daily life.
If you're dealing with low back pain in Petaluma, or surrounding Sonoma County, a discovery call can help you understand whether physical therapy, sports chiropractic, ore another next step makes the most sense for you.
Don't be the athlete who makes the most common mistake. Get started on the road to recovery and performance today.