Much like the ankles and knees of NBA players, the low back takes its fair share of pounding on a regular basis. It’s not so much the proverbial “straw that breaks” a basketball player’s back, but the routine grind and rigors of a season that takes its toll.

There are many factors associated with low back injuries in athletes. At times it a sharp move or direct hit can inflame the area, while at other times, a spasm gradually creeps up on the player and renders him in a significant amount of pain.

In analyzing these injuries, it is imperative to look beyond the obvious. The forces of running and jumping are transferred from the floor through the legs to the hips and back. Therefore, if there is a minor biomechanical problem at the hips, the low back takes more than its share of this force. In evaluating a player’s low back, typically a team’s medical staff will consider some of the following:

Back problems sidelined David Robinson for the Spurs' first seven playoff games.
Harry How/Getty Images
Problems with the spine: There can be limitations in the range of motion from dysfunctions of the “facet” joints or disc herniation. They could limit the ability to bend forward and backward or sideways.

Uneven Pelvis on leg length differences: This is a common biomechanical problem associated with low back injuries. Muscle spasms in the area can affect the hips.

Foot Problems: Bad foot mechanics can cause an uneven weight distribution while running.

Muscle Imbalances: This could include weak abdominal muscles or tight hip flexor muscles or hamstrings.

In many cases, rest is an important element in the management of low back pain. It’s important to eliminate the stress and sometimes rest is mandatory. Therapeutic modalities such as electrical stimulation along with ice, heat, and massage all have a vital role in managing pain also; spinal mobilization can be beneficial when it is appropriate. Restoring proper lumbar flexibility is an important first step on the road to recovery. Eventually the hips would need to be stabilized and strengthened.

Medical clearance for the player’s return to play can be based on flexibility, strength, and discomfort. Our collective goal is to prevent that difficult rebound or hard drive to the basket from being like a “piece of straw” to injure their back.