Keeping Your Back in the Game: Expert Advice from Dr. Brandon Rebholz

As an Orthopedic Spine Surgeon, I work very closely with athletes at all levels who unfortunately develop injuries to their backs that prevent them from playing the games they love. Although I am able to provide the treatments necessary to get them back to action, they obviously would wish to have avoided those injuries in the first place. I am often asked about the best ways athletes can protect their backs. As with many things in athletics, performance and injury prevention are often tied to training.

Athletic training and sports performance can often be highly sport- and even position-specific. Determining the amount of focus to place on strength, speed, or endurance can be highly variable based on the goals of each individual athlete. Multisport athletes will even train differently at different times of the years based on the differing demands of the season or sport. Despite these variations, there is one aspect of training that every athlete should commit to regardless of sport, season, or even age: the development of a strong core.

The core is comprised of the muscles that surround your torso and pelvis. These include the muscles of the back, abdominal muscles, hip muscles, and glutes. These groups of muscles are critical in the development of explosive power and help protect athletes from injuries to their backs. Committing early to creating a strong core will allow young athletes to develop great long-term habits and limit injuries that can keep them from play.

Young athletes have a tendency to begin their training with a focus on the areas that can show rapid growth. This usually includes working the extremities—arms and chest one day and legs and glutes the other. You can see definition of these body parts directly and easily see progression in the weight amounts that you are able to lift. But by equally focusing on the core, you can develop more meaningful power in your arms and legs, improve your lifting form, and subsequently protect yourself from injury. Core exercises do not need to be intense, but they should be done consistently. Athletic trainers and physical therapists are a great resource for learning these excises and developing a program that maximizes your time and performance.

In addition to keeping a strong core, it is critical that young athletes in particular focus on stretching their hamstrings. Tightness in the hamstrings can alter the dynamic muscular pull on the pelvis and contribute to low back pain and spine problems.

Sometimes despite even the best of efforts maintaining a strong core and loose hamstrings, injuries can still occur to the back. These are typically minor muscle strains or pulls that will respond to things like physical therapy, anti-inflammatories (i.e. ibuprofen or naproxen), heat, over-the-counter medicated patches, and possibly muscle relaxers. These usually resolve after a few days to weeks.

Rarely significant structural problems can occur to the spine that warrant a more extensive evaluation with x-rays, CT scans, or MRIs. These studies are ordered by physicians when an athlete has severe back pain, back pain that is worse with extension activities, pain that is not relieved with rest, or pain that starts in the back, but then travels down the legs. It is important to see a spine-specific provider if these symptoms develop and persist.

So, get into the gym and on the exercise mat to work your core and stretch those hamstrings in order to maximize your athletic performance and time on the field, while keeping your back out of trouble.

Dr. Brandon J. Rebholz, MD, FAAOS, is a board-certified, fellowship-trained orthopedic spine surgeon who specializes in treating the full spectrum of spine conditions, from complex deformities and trauma to degenerative disorders. Dr. Rebholz serves as a Spine Surgery consultant to both the Milwaukee Brewers and Milwaukee Bucks and athletes of all ages. Recognized as one of America’s Best Spine Surgeons by Newsweek, Dr. Rebholz is dedicated to providing high-quality surgical care using innovative techniques to restore function and improve patients’ quality of life.