Should Youth Athletes Play With Low Back Pain?

By Angela Jackson

In many sports such as cricket, gymnastics and tennis, the presence of low back pain is often considered normal by coaches and therefore athletes. In adolescent tennis players, 60% are estimated to have symptomatic lumbar bone stress injury (LBSI), many continuing to play without understanding the cause of their symptoms.

What is the most common cause of low back pain in youth athletes?

The most common cause is lumbar bone stress injury (LBSI). LBSIs occur when bone capacity is exceeded due to increased load or decreased capacity from a myriad of complex interactions including inadequate sleep, nutrition, growth spurts, illness, injury, or stress. They occur along a spectrum from an asymptomatic bone stress response through to a complete stress fracture in the posterior neural arch of L4 and L5 (1).

Bone adapts to stress through osteogenesis, laying down new bone where needed. Adequate time and nutrition allow bones to become stronger through increases in bone mineral density (BMD). Without this, bones may develop stress reactions or fractures.