As with ACL injuries, female athletes are more prone than their male counterparts to small, hairline fractures of the lower (lumbar) spine, usually from overtraining (e.g. overuse injuries) or improper loading of the spine. Because such injuries can be misdiagnosed, it is important for coaches and parents to recognize the symptoms and seek appropriate medical treatment.
The types of spinal fractures suffered by female athletes are most often found in sports involving a lot of bending of the back and therefore the potential for lumbar hyperextension. Females generally have more ligamentous laxity than males, therefore, they can extend their backs into areas of greater risk. While this bony contact is not harmful with day-to-day tasks, overloading the structures of the back consistently can cause breakdown.
Here are a few examples of where back hyperextension is common:
The motions in these sports are very common, but when combined with the following predisposing factors, injury can occur:
When the spine is extended too much and too frequently, the pressure on weight-bearing structures results in microtrauma. Females athletes often will hyperextend to generate more velocity on a tennis or volleyball serve, kick a ball farther, or generate more speed while completing a series of back flips. While harmless when done infrequently, relying on this motion excessively can lead to problems.
There are many signs and symptoms of small spinal fractures, but they are not the focal point for parents and coaches. The one thing parents and coaches can do to is to follow this one injury concept: chronic back pain is not normal, nor should be accepted among young female athletes.
If a young athlete is having chronic back pain (more than a week), she should see a doctor if she has signs of any of the following:
The aches and pains adults have with sedentary jobs, out of shape muscles, and aging spines are not common to young athletes. Young female athletes have very healthy, strong, and resilient spines that can easily handle the pressures of day-to- day activity, as well as competitive sports. Chronic back pain is a red flag for coaches and parents to seek medical attention. Allowing a medical professional to determine if there is any underlying problem is critical to prevent further damage.
The most important thing an athlete can do in the rehabilitation process is GET TO THE DOCTOR AS SOON AS POSSIBLE.
Rehabilitation will involve:
None of these are as important, however, as seeing a doctor or sports medicine specialist. Physical therapists cannot perform magic on an athlete that has been hurting for a year. It may takes months to get back to pain-free competition if conditions are allowed to linger for so long. A qualified physical therapist can educate any young athlete how to prevent the problem from happening again, but it is far easier to have that talk when the healing time frame is a couple weeks as opposed to "wait till next season."
Finally, if your young athlete gets a sore back from running 5 miles, don't jump on the Internet to try to diagnose them yourself as having a vertebral fracture and throw a back brace on them. If your young gymnast, soccer player, or volleyball player complains of an aching back week after week and is not sleeping, a small co-pay and a trip to the doctor is your best move.
Created October 15, 2010, updated January 4, 2012
Links:
[1] https://www.momsteam.com/health-safety/muscles-joints-bones/knee/acl-injuries-in-female-athletes