Many of us think of lower back pain as a condition that affects us as we age. As a result, when our child is experiencing back pain, it can be a real cause of worry and concern. In fact, pediatric back pain is common, with estimates showing that anywhere from 30-70% of young people aged 10-17 will experience back pain. While back pain can be common in more sedentary children, studies show that participation in sport, particularly those with high levels of training volume and intensity, is also associated with an increased incidence of paediatric back pain. The overwhelming majority of these cases are not caused by serious conditions, but rather relate to overuse and inappropriate training load. This is what is referred to as mechanical low back pain.

Physiotherapy for adolescent back pain

Physiotherapy is a mainstay of treatment for mechanical low back pain. In a Physiotherapy Assessment, the physio will:

Take a detailed history of the child’s presentation including nature and onset of pain, medical and family history, etc.
Establish the child’s training load via questions about their typical schedule of activities and overall lifestyle.
Screen for any underlying conditions that may be affecting the child’s spine itself, such as scoliosis or vertebral fracture.
Perform a movement screening and assess the child’s posture, as well as the flexibility and strength of their back and legs.

This allows the physiotherapist to identify all of the many factors that may be contributing to the child’s symptoms and develop a personalised treatment plan for them. Treatment may include activity and/or lifestyle modification (absolute rest is almost never the answer!), a programme of stretches and strength/mobility exercises, advice and education on managing symptoms, manual therapy, and more!

So, you may be wondering - how can my athletic child lower their risk of developing back pain?

Ensure they are engaging in proper warmups and cooldowns. Warmups should include dynamic, sport-specific movements which prepare their bodies for the demands of the activity. Cooldowns should include static stretches of all of the involved joins and muscles to ensure they are finishing the session in a lengthened position. This is important as young people are particularly prone to muscular tightness due to the mechanics of growth their bodies are experiencing.
Encourage variety in their physical activity - early specialisation in one sport increases the risk of overuse injuries. Not only does engaging in a variety of activities lower injury risk, it can also improve performance by encouraging development of a wider range of athletic skills.
Cross-training with strength work. The demand our young athletes are placing on their bodies with, for example, 5 football sessions a week, requires their muscles and joints to have immense capacity to tolerate this load. If they are not engaging in targeted work to strengthen their muscles and joints, they will be more prone to injury and poor performance.
Monitor and manage training load (volume, frequency, and intensity of exercise) and recovery. Alongside all the considerations above, remember that rest and recovery are crucial when it comes to athletic performance and injury prevention. There is no hard and fast rule when it comes to how much is too much, and this will vary from child to child, but it is important to keep this in mind. Alongside their training load, sleep, hydration, nutrition, and stress management all play an essential role in recovery and injury prevention.

If your child is struggling with back pain, consider booking them in for an assessment with a physiotherapist. Appointments can be made with one of our Physiotherapists in Aberdeen, here.

Finally, if your child is experiencing back pain alongside any of the following symptoms, this is an indication that there may be something more serious underlying: pain that wakens them up at night, numbness or pain radiating down their legs, changes in their bladder or bowel habits, pain and swelling in other joints, and/or signs of more systemic unwell such as fever, weight loss, or night sweats. If your child is experiencing these symptoms, seek advice from your GP.

This article was written by Physiotherapist Tamara Ranspot, ReformPhysio & Pilates, Albyn Terrace, Aberdeen.