By Dr. Rob LaPrade
http://drrobertlaprademd.com

Question:  I play forward on a high school team. I have a question about my back. Sometimes when I get checked, my low back gets painful and it goes into spasm. What causes this? Is there anything I can do to prevent this?

Answer: The problem that you are describing may have many different sources which can cause pain. Low back pain can be from either the back itself (a bony or soft tissue problem), or from a problem in some of the deep organs in the lower part of the torso (especially the kidneys).

In young athletes like you, one of the most common causes of low back pain is a condition where one of the supporting structures in the bones of the lumbar spine (low down in the spine) has either a stress fracture or a congenital lack of bone healing. This is called spondylolysis. Patients who have spondylolysis often have stiffness and cannot bend and touch their toes and tend to have quite tight hamstrings. Athletes with this condition often have pain with extending their backs and may notice low back pain when they attempt to lie on their stomachs and read with their upper torso propped up.

Another source of your back pain could be a bulging or herniated disc. There are discs, which act as spacers, between the vertebral bodies of the spine. The purpose of the disc is to allow motion between the different vertebral bodies, and to provide a cushioning effect with pounding activities. While it is very rare for a disc to rupture out of its casing and pinch a nerve at your age, a disc that can bulge out and push against a nerve root can cause significant searing pain. Patients who have a bulging or herniated disc usually have pain when bending forward, such as when they tie their skates. The usual treatment for patients who do have a bulging or herniated disc is to give it some time to quiet down and to do appropriate back related exercises. Approximately 90% of patients who do have a herniated disc are able to do well without surgery.

Overall, the best way for hockey players to prevent low back injuries is to participate in proper training techniques. The most common causes that we see for low back pain, in high school, collegiate, and professional players, are due to lack of proper technique when lifting in the weight room. It is important to make sure your knees are bent, and not your back, while performing weightlifting exercises. This will minimize the chance of injuring one’s low back and losing time from competition and potentially leading to further long term problems down the line.

Robert F. LaPrade, M.D., Ph.D. is a complex knee surgeon at The Steadman Clinic in Vail, Colorado.  He is very active in research for the prevention and treatment of ice hockey injuries. Dr. LaPrade is also the Chief Medical Research Officer at the Steadman Philippon Research Institute. Formerly, he was the team physician for the University of Minnesota men’s hockey team and a professor in the Department of Orthopaedic Surgery at the U of M. If you have a question for the Hockey Doc, e-mail it to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .