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Returning to sport

2008 Author: Rosy Hyman

Exercise is known to be beneficial in the rehabilitation and management of back pain. However, deciding which type of exercise is best for you can be confusing.

If you are aiming to get back to a particular sport, it is important to first prepare your body. This is much easier if you have a general understanding of your injury and the type of movements that may aggravate it.

Acute back pain can be the result of damage or injury to one or more of several different structures. Establishing which structures are involved, and their position and function in the back, will provide vital information when designing a rehabilitative exercise programme.

Example 1:
A disc bulge/prolapse (‘slipped disc’) will be aggravated by exercises involving bending forward of the trunk.
   
Example 2:
If the joints between the vertebrae are involved then arching backwards or side-bending movements may cause pain.


Before you start exercising, it is strongly advised that you seek professional medical advice from an osteopath, physiotherapist or chiropractor.

Ask them to explain your condition and to advise you which exercises or actions you should avoid. They will usually recommend specific exercises to aid your recovery. These will be designed to get you to the point where you can safely return to your pre-injury exercise routine.

In the early stages of recovery from back pain, you may be advised to only do exercises involving small, gentle movements. This may be all you can manage initially, but these can have a dramatic effect on your recovery.

Gentle movements will help to squeeze out the waste products that build up around the site of the injury and encourage fresh blood to enter the site in order to continue the repair process. In addition, they aim to improve the range of movement of the joints and gently stretch the muscles. Returning to sport

Whilst you are recovering from your back injury it is often possible to continue with gentle cardiovascular exercises, such as walking. Again, you are advised to check which exercises are suitable for your condition and stage of recovery.

Once you understand what you are able to do, you can now try to work out what you will be required to do during your sport.

Take a close look at your sport and try to break it down into the different movements and skills required.

There are some requirements that are common to all sports.

As with any form of exercise, before participating in any sport it is essential to warm up sufficiently to prepare the muscles for activity. It is just as important to cool down and stretch afterwards to prevent future injury.

All sports demand a good level of general cardiovascular fitness.

Depending on the severity and type of back injury you sustained, you may have managed to maintain some level of cardiovascular fitness. Otherwise this must be improved gradually and safely.

Each sport will require varying levels of balance skills, flexibility and muscle strength. This will be specific to each sport and can be trained by selecting ‘functional’ exercises that mimic the movements you will need to perform. The functional exercises should be designed to prepare you for your particular sport.

You may need to seek professional advice to help you select suitable exercises and check you are performing them correctly. The advantage of working with a professional is that they will first evaluate your ability before prescribing an exercise programme. They will also monitor your improvement and increase the intensity of your exercises as your rehabilitation progresses.

Lastly, it is important to remember that acute pain can be a warning sign. Unless you have been advised by a medical professional that a particular exercise may cause some discomfort, stop if you experience any pain whilst exercising and seek professional advice.

 

Things to consider before returning to sport.  

  • How long were you unable to participate in your sport?  

  • Have you managed to maintain your cardiovascular fitness level during this time?  

  • Did your back injury occur whilst (or as a result of) playing your sport? If so,

  • Do you need to modify your technique?
  • Were you overdoing it?
  • Were you participating in your sport too often or for too long at a time?
  • Were you getting adequate rest periods? 

  • Does your diet provide you with sufficient nutrients for your level of activity?  
  • Does your sport require mobility and/or repetitive spinal motion in any particular plane? For example: A golf swing requires repetitive spinal rotation in one direction. Cycling may involve bending forward for long periods. If so,

  • Were you able to perform this movement comfortably preinjury?
  • Can you perform it comfortably now, post-injury?
  • Were you warming up before participating in your sport? Did you include ‘rehearsal’ movements to prepare your body for the movements to come?
  • Were you cooling down and stretching you muscles afterwards? Did you include stretches in the opposite direction of any repetitive movement in order re-balance your body?  

  • Have you set yourself a realistic time period to recover from your injury?

 

If you are unsure of the impact of your answers to the above questions, seek professional advice from your osteopath, physiotherapist or chiropractor.

 Rosy Hyman, osteopath and BackCare Helpline Volunteer