Epidemiology: Any age gymnast may have mechanical or functional back pain. This is a diagnosis of exclusion (meaning all other causes were ruled out via physical exam and imaging).
Mechanism of Injury/Description: This diagnosis typically occurs due to repetitive hyperextension (arching), poor posture (rounded shoulders), decreased shoulder forward flexion, and tight hip flexors all lead to increased pressure and loading of the spine causing this overuse injury.
Signs/Symptoms: Gymnasts may have pain with extension (arching), and sometimes pain with flexion (bending forward). Pain is typically non-specific and not in a “pinpoint area” but typically in the low back region. This pain typically has been ongoing for a few weeks or months.
Diagnosis: This is a diagnosis of exclusion-meaning your Medical Provider has ruled out all other causes/diagnoses. Your Medical Provider may diagnose you based on physical exam and imaging (ex: x-rays, MRI, CT scan, etc…).
Treatment: Your Medical Provider may recommend a brace, activity modification in the gym, and physical therapy.
Prevention: You can prevent mechanical back pain by working on core strength/stability, posture, improving shoulder and hip flexibility, and by using proper technique with arching skills.
Gymnastics Medical Provider PEARLS: Consider ordering a 3T Lumbar Spine MRI to obtain more detail. Sometimes on MRI facet inflammation may be seen. Also consider Baastrup’s syndrome if spinous processes are inflamed on MRI or tender on exam.
Gymnast, Parent, and Coach PEARLS: Do not ignore back pain. Back pain treated early is easier to get rid of than back pain which has been there for months or years.