Sore and tight backs in children may have many causes, but this is the number one reason.
On any given day I may see 4 or 5 young athletes whose back is tight, sore, or painful, for one reason or another. Often times, these athletes have been to their pediatrician, an orthopedist, their general practitioner, and have even been through a program at a local physical therapist. All to no avail. My office is the quintessential practice where all tough cases end up. I wish many of these kids would just come to me first and avoid spending time and money chasing down symptoms and never addressing problems. In today’s blog I am going to address what the most common reason is for lower back pain and tightness in young athletes. I think it is important to note, that although I see the same issue with most of the kids that come through my office, back pain can be a sign of something more serious. It should never be ignored and if it has persisted more than a week, it is time to seek professional advice. Most back pain in children however, is not something that is terribly serious and can be rectified easily when problems are addressed directly and focus is taken off of symptoms.
The biggest reason for lower back pain in children is poor movement.
This may sound overly simple, and in many ways it is, but believe me, this can get very complex. In order to understand why poor movement can cause back pain, you have to understand how the body develops, how the brain learns, and how important movement is to the brain. All of us start in roughly the same spot. As babies, some of the first things we learn are back extension and flexion. Even before we learn to raise our heads, we must learn spinal control in extension and flexion (curling forward and arching backwards). Twisting is also very important as our spine is designed to move in many different directions. We have 24 spinal vertebrae not counting our sacral and coccygeal regions and surprise surprise, all those joint are designed to move. This is where things can get complex quickly. During development, maps are drawn in the brain locating specific joints. The brain then learns how they move, what muscles control them, and what direction(s) or planes they move within. In a perfect world, we would learn complete and efficient movement in all of our joints. Unfortunately, the quality and efficiency of movement is only as good as the learning that takes place. Our bodies are highly complex systems that that can adapt to environmental and behavioral changes. We learn to survive in the environment in which we have been placed. This is why lower back pain can quickly go from a simple movement dysfunction to a more complicated issue that requires some out of the box thinking.
Why poor movement typically causes back pain or tightness.
Poor movement causes back pain because one joint is being used more than any other.
Our bodies function within the laws of Newtonian physics. The three major structural systems, the skeletal system, muscular system, and ligamentous system (connective tissue), work together to resist gravity. If any one of those systems were missing, we would fall into a heap on the floor. In other words, through compression and tension we are able to resist gravity. This means the brain is walking a tight rope of mobility and stability to create movement and to stand upright. With this incredibly complex system of constant tension, compression, and mobility, we also add complex sequential movement and the brain and body’s ability to adapt to environmental changes. What all this means in simple terms, is the brain will play with all these systems to allow us to live and move. And even though some movements may not be terribly efficient, if they work, the brain will choose to use them. Until of course the movement in question hurts, then the brain adapts movement to stay away from pain. Poor movement causes back pain because one joint is being used more than any other. This is very common with children, they sit in desks all day long, hunched over and adapting to their environment. They practice lower back movement all day long as this is where most of the mobility comes from and they never get control over movement from their upper back. Their thoracic region is locked up and won’t share the workload. If we add poor latissimus recruitment (muscles in the back that control arm movement and stability during walking) then walking will irritate the lower back even more. Poor latissimus use drives most of the force dispersion and ground effect of walking into just a few joints in the lower back. In other words, the one part of your child’s back that is hurting is typically the one thing working correctly. If you have experienced lower back pain and the treatment for it, you may be wondering why some therapy doesn’t work or worse, makes the problem more pronounced. This is why. Imagine a car; if three of the 4 brakes are non-functional, mechanics don’t focus on the one brake working, they repair the other 3! Amazingly, the one functional brake stops overheating! Within this analogy, one or two lumbar vertebrae are absorbing most of the ground forces while the other spinal vertebrae are doing virtually nothing. This causes a high frictional load in a very limited amount of space and excessive tightness via stability dysfunction. I will address how and why kids get into this scenario in another blog post. For the intent of this post, if your child is suffering from lower back pain and tightness, look where the pain isn’t. Observe the way they walk, look at how they sit, where and how they do homework. Are they athletes? If so, all those ground forces are just multiplied. It is not the fact they are working hard, if means they are working hard and earning pain and injury because of poor movement patterns. Make their system more efficient, increase their movement literacy, address the problem, and watch their pain disappear.
All the practitioners at Performance Pediatrics and Human Performance and Rehabilitation are willing to help in any way. If you have questions, or would like to speak with a professional please feel free to call, we do the best we can to make time for parents and aim to educate whenever we can. We can be reached at:
402 West Garden of the God’s Road
Colorado Springs, CO 80907