Returning to sports after a back injury
You may play sports rarely, on a regular basis, or at a competitive level. No matter how involved you are, consider these questions before returning to any sport after a back injury:
- Do you want to still play the sport, even though it stresses your back?
- If you continue with the sport, will you continue at the same level or play at a less intense level?
- When did your back injury occur? How severe was the injury? Did you need surgery?
- Have you talked about wanting to return to the sport with your doctor, physical therapist, or other health care providers?
- Have you been doing exercises to strengthen and stretch the muscles that support your back?
- Are you still in good shape?
- Are you pain-free when you do the movements your sport requires?
- Have you regained all or most of the range of motion in your spine?
Which type of sport is best?
In deciding when and if to return to a sport after having low back pain, the amount of stress that any sport places on your spine is an important factor to consider. If you would like to return to a more intense sport or a contact sport, talk to your health care provider and physical therapist about whether you can do this safely. Contact sports or more intense sports may not be a good choice for you if you:
- Have had surgery on more than one level of your spine, especially spinal fusion
- Have more severe spine disease in the area where the middle of the spine and the lower spine join
- Have had repeated injury or surgery in the same area of your spine
- Have had back injuries that resulted in muscle weakness or nerve injury
Doing any activity over too long a period can cause injury. Activities that involve contact, heavy or repetitive lifting, or twisting (especially when moving or at high-speed) can also cause injury.
When to return to a sport
These are some general tips about when to return to sports and conditioning. It may be safe to return to your sport when you have:
- No pain or only mild pain
- Normal or almost normal range of motion without pain
- Regained enough strength in the muscles related to your sport
- Regained the endurance you need for your sport
The type of back injury or problem you are recovering from is a factor for deciding when you can return to your sport. These are general guidelines:
- After a back sprain or strain, you should be able to start to return to your sport within a few days to several weeks if you don't have any more symptoms.
- After a slipped disk in one area of your spine, with or without having a surgery called diskectomy, most people recover in 1 to 6 months. You must do exercises to strengthen the muscles that surround your spine and hip for a safe return to sports. Many people are able to return to a competitive level of sports.
- After having disk and other problems in your spine. You should be under the care of a health care provider or physical therapist. You should take even more care after surgeries that involve fusing bones of your spine together.
Making muscles and ligaments stronger and more flexible
Large muscles of your abdomen, upper legs, and buttocks attach to your spine and pelvic bones. They help stabilize and protect your spine during activity and sports. Weakness in these muscles may be part of the reason you first injured your back. After resting and treating your symptoms after your injury, these muscles will most likely be even weaker and less flexible.
Getting these muscles back to the point where they support your spine well is called core strengthening. Your health care provider and physical therapist will teach you exercises to strengthen these muscles. It is important to do these exercises correctly to prevent further injury and strengthen your back.
Once you are ready to return to your sport:
- Warm up with an easy movement such as walking. This will help increase blood flow to the muscles and ligaments in your back.
- Stretch the muscles in your upper and lower back and your hamstrings (large muscles in the back of your thighs) and quadriceps (large muscles in the front of your thighs).
When you are ready to begin the movements and actions involved in your sport, start slowly. Before going full force, take part in the sport at a less intense level. See how you feel that night and the next day before you slowly increase the force and intensity of your movements.
Drezner JA, Harmon KG, O'Kane JW. Sports medicine. Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 29.
Lauerman W, Russo M. Thoracolumbar spine disorders in the adult. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 128.
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.