Dolor lumbar

Lower back pain and its management in high-performance athletes

My experience treating high-performance athletes in their recovery process when they have lower back pain, especially football players, has helped me deeply understand the demands and challenges you face as a high-performance athlete.

Lower back pain can not only affect your performance on the field but also your quality of life off it. Here I offer you a guide tailored to your specific needs, based on key points about lower back pain, to help you overcome this hurdle and reach your full potential.

Understanding Lower Back Pain

As an athlete, your back is under constant stress, whether from weightlifting, repetitive movements, or impacts during training and competition. Recognizing that pain can originate from various structures in your back is the first step to addressing it properly.

Specific and Non-Specific Causes

In the context of high-performance athletes, especially those who play football, it’s crucial to determine if lower back pain is the result of a specific injury, such as a herniated disc or a fracture, or if it’s non-specific pain, possibly due to muscle strains. This distinction is fundamental as it will guide the appropriate recovery and prevention approach.

The causes of lower back pain in football players can be varied and of different origins. Anatomically, it may come from the bone and ligament structures of the spine, such as wear and tear on the posterior joints or intervertebral discs, or from the viscera surrounding the lumbar spine, like the kidneys and pancreas. Other, less common causes include traumatic (vertebral fractures, spondylolysis), metabolic (vertebral fractures due to osteoporosis), tumoral, infectious, and the acceleration of the evolutionary process of disc degeneration after surgical intervention for a herniated disc.

The most common cause of chronic lower back pain in football players is the degeneration of the intervertebral discs and posterior joints. This degeneration process is part of the normal aging of the spine, which begins from the age of 20, similar to other parts of the body. In the context of football, this process can be exacerbated by poor abdominal and lumbar musculature, overweight, and the physical demands of the sport, such as standing for long periods and adopting continuous forced postures in lumbar flexion.

Recognizing and addressing these specific and non-specific causes of chronic lower back pain is essential for effective management and prevention in high-performance football players, allowing them to maintain their performance on the field and minimize the risk of long-term injuries.

Risk Factors in Athletes

Lifting incorrectly, inactivity during recovery phases, and the mental and physical stress of competition can increase your risk of lower back pain. Recognizing these factors is essential for prevention.

Symptoms and When to Seek Help

Don’t ignore pain that interferes with your performance or that persists beyond a few weeks. Sciatica, for example, may require specialized attention to avoid long-term impacts on your career.

If you have any special condition or want to define a high-level recovery strategy, don’t hesitate to make your reservation through our WhatsApp or by booking on our reservation page, we’ll be happy to advise you.

Diagnosis and Self-Help

Staying active and adopting a positive attitude are crucial. As an athlete, you know the importance of movement; don’t let pain stop you. Use pain management techniques, such as anti-inflammatory medications and heat or cold treatments, to aid your recovery.

Specific Treatment for Athletes

Explore treatment options that align with your sports goals, including physiotherapy to strengthen back muscles and improve flexibility. Cognitive-behavioral therapy can also be helpful in addressing the mental aspect of recovery.

Focusing on the treatment of lower back pain for high-performance athletes, it’s crucial to adopt a stepped and personalized approach to maximize recovery and minimize time away from competition. Here’s how to integrate these treatments into your recovery plan according to the level you’re at, broken down into three phases:

1. First Step of Treatment

  • Lumbar Spine Stabilization: The use of belts or corsets can offer immediate support during the acute phase of pain, but it is essential to complement this with toning the abdominal and spinal muscles through isometric exercises. These exercises strengthen the core and provide greater stability to your spine, which is crucial for preventing future injuries.
  • Postural Hygiene Measures: Adopting ergonomic practices in your daily life and during training is key. This includes using ergonomic furniture and adopting proper lifting and movement techniques to protect your back.
  • Achieving a Suitable Weight: Maintaining a healthy weight reduces the pressure on your lumbar spine, decreasing the risk of injuries.
  • Pain Management: The use of anti-inflammatory drugs, both nonsteroidal and corticosteroids, painkillers, and muscle relaxants, can be crucial during periods of pain flare-ups. The application of physical therapies such as electrical currents, massages, traction, and heat can temporarily alleviate symptoms.

2. Next Step

Periarticular infiltrations with local anesthetic and corticosteroids can offer significant relief. If lower back pain reoccurs, percutaneous denervation of the posterior branch or rhizolysis may be an effective option, potentially alleviating symptoms for an extended period in up to 70% of cases.

3. Final Step

For cases of chronic lower back pain that do not respond to other treatments, surgery may be necessary. This involves stabilizing the lumbar spine by fixing the affected vertebrae, using a bone graft from the patient and facilitated by metal implants such as pedicle screws.

For young athletes, disc replacement can be a promising option, offering the possibility to retain more mobility and reduce recovery time.


Incorporate specific strengthening and flexibility exercises for your back into your training regimen. Learn and apply proper lifting techniques and make sure to modify your training and competition to protect your back.

Here’s a simple but very useful video with exercises you can do from the comfort of your home to reinforce your recovery process.

Other complementary exercises to prevent lower back pain

For high-performance athletes, it’s crucial to maintain a healthy spine and strong abdominal muscles to prevent injuries and improve sports performance. The following exercises are focused on these goals, with a brief description of each:

1. Pelvic Tilt for Lumbar Stability

Lower back pain

Objective: Core strengthening and prevention of lower back pain.
Description: Lying on your back, knees bent, heels on the ground. Press your back against the floor, contract glutes and abs, lifting the hips slightly. Hold for 10 seconds, 20 repetitions.
Relevance: Improves core stability and pelvic alignment, essential for efficiency in sports movements and prevention of lower back injuries.

2. Crunches for Core Strengthening

Lower back pain

Objective: Strengthening of the abdominal muscles.
Description: Lying on your back, knees bent, hands crossed over the chest. Contract abdominals, lift shoulders without straining the neck. 3 sets of 10 repetitions.
Relevance: A strong core is vital for energy transfer in sports activities, improves balance, stability, and prevents injuries.

3. Knee to Chest Stretches for Lumbar Flexibility

Lower back pain

Objective: Improvement of lumbar flexibility and tension relief.
Description: Lying on your back, bring knee to chest with the help of your hands. Hold for 10 seconds, 10 repetitions per leg.
Relevance: Increases mobility of the lower spine, essential for a wide range of sports movements and reduces the risk of injuries due to stiffness.

Frequently asked questions that come up in my office about lower back pain

Since the goal is to give you good advice and make it as comprehensive as possible, here I share some of the most frequent questions I get from high-performance athletes who consult me about this condition, and who knows, maybe you have the same question and can find the answer in this list:

1. When is lower back pain serious?

Lower back pain is considered serious and requires immediate medical attention in the following cases:

  • Loss of bowel or bladder control: Inability to control the bladder or bowels.
  • Extreme weakness in the legs: Inability to bear body weight or difficulty moving the legs.
  • Pain that doesn’t improve: Intense pain that doesn’t lessen with rest or worsens over time.
  • High fever: In combination with back pain, it may indicate an infection.
  • History of cancer, osteoporosis, steroid use: These conditions may indicate more serious complications related to lower back pain.

Is lower back pain from the kidneys?

Lower back pain can be related to kidney problems if it occurs along with other symptoms, such as:

  • Pain in the sides or pain that radiates to the lower abdomen area.
  • Changes in urine, such as blood in the urine or changes in urinary frequency.
  • Fever and chills, especially if a kidney infection is suspected.

It’s important to differentiate between muscular/skeletal pain and pain that comes from the kidneys, as the treatment and management will be different.

2. Can lower back pain cause leg pain?

Yes, lower back pain can cause leg pain. This often happens due to sciatica, where the sciatic nerve is compressed or irritated. Athletes may experience pain, tingling, or weakness that radiates from the lower back down to one or both legs. It’s common in cases of herniated disc or spinal stenosis.

3. Can lower back pain cause hip pain?

Yes, lower back pain can also cause hip pain. This can be due to problems in the spine, such as herniated discs or arthritis, which affect the nerves that radiate towards the hips. Additionally, muscular imbalances or injuries in the lower back can alter biomechanics and posture, leading to hip pain.

As a high-performance athlete, your body is your most valuable tool. Treating and preventing lower back pain is essential to ensure that you can give your best, both on and off the field. Remember, the key is in a proactive and personalized approach, considering both your physical and mental health. Together, we can overcome this challenge and help you achieve your sports goals.

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