Back Pain - Talking Rehab with SST

DID YOU HURT YOUR BACK ...OR... DOES YOUR BACK HURT?

The answers to these two questions have distinctly different meanings and outcomes. The International Center of Hockey Excellence provides an Injury Reporting System (I.R.S.) and the NCAA’s Injury Surveillance System (I.S.S.) define an injury as any condition for which the athlete seeks the help of a qualified medical person and if the athlete misses at least one game or practice. This tells us that back pain is not an injury until it is enough to limit the player from participation. Back pain is part of the game, but must it end the hockey player’s career? Remember Mike Bossy of the N.Y. Islanders whose career stopped because of back pain? Every NHL season players miss games due to back pain. Many different diagnoses are given inducing muscle spasm, buldging or herniated discs, pinched nerves or muscle imbalances and now most recently the “soft tissue injury”. All of these injuries are categorized as mechanical low back pain, which is commonly experienced in the lower back, pelvis and groin.

The mechanical movements of the hockey player represent repetitive or cumulative forces on the body. Mechanical low back pain may be caused by a single hit, twist, sprain or strain. Added to the repetitious movement of the nature of the game, low back pain often results as a Cumulative Trauma Disorder (CTD) or Repetitive Strain Injury (RSI). This would define that mechanical low back pain should be treated as a CTD or RSI before it becomes an injury. Cumulative Trauma Disorder is a group of neuro-musculoskeletal syndromes resulting form the Cumulative Injury Cycle. The one common factor for all CTD injuries is the cumulative injury cycle and it is the cycle itself that must be treated by myofascial therapies such as Active Release Techniques® (ART®) and stretching.

These muscles must be free to move without the limitations of fibrous adhesions or scar tissue. Active Release Techniques® would best be considered to remove these adhesions and allow the proper functioning of muscles. Mechanical low back pain caused by hip flexor (psoas) muscle weakness, imbalance, or tightness can be treated. Treatment of mechanical low back pain should also include spinal manipulation to increase the flexibility or range of motion of the lumbar facet joints, which is often the source of pain. The hip flexor muscle (psoas) will be ultimately involved and treatment to it must be considered. Science has proven and reported through research the success and effectiveness of spinal manipulation as a treatment for mechanical low back pain.

But, without the athlete performing regular stretching to the psoas and groin, the repetitive posture of hockey can cause the recurrence of tightness, weakness and possible adhesion formation.

So remember, Active Release Techniques® can treat soft tissue injuries and Target Loading strength training is the best way to strengthen hockey muscles and prevent injury. Dr Joe Pelino and Dr Lawrence Micheli from the Soft Tissue Institute are Instructors of Active Release Techniques® and utilize protocols of Variable Resistance Exercise to strengthen hockey players.

Larry Jusdanis, SST Director