Love Your Spine: Common Causes of Back Sprain and Prevention Tips

Top 3 injuries seen on and off the tennis court and prevention tips from Andrew Hecht, MD

With the US Open now in full “swing,” tennis buffs, are wondering how top-seeds Serena Williams and Novak Djokovic will fare in Forest Hills. Williams is recovering from a sore shoulder while Djokovic’s left wrist is causing problems. While shoulder, wrist, knee and other injuries—including the infamous tennis elbow—hog attention, it turns out that lower back pain is very common among tennis players according to the International Tennis Federation.1
Back of chair showing "US OPEN" with symbol lower back pain is very common among tennis players according to the International Tennis Federation.1 Photo
“Common patterns of lumbar injury in athletes are not that different from what we see in everyday people. The only difference is in elite athletes we tend to see more acute injuries that happen suddenly rather than injuries that progress over time,” says Andrew Hecht, MD, Associate Professor, Orthopaedics, Neurosurgery, Icahn School of Medicine at Mount Sinai, Chief of Spine Surgery for the Mount Sinai Health System and Director of The Spine Hospital at Mount Sinai. Dr. Hecht is also a consultant to the United States Tennis Association (USTA) and performs spine surgery for the NY Jets and Islanders.

According to Dr. Hecht, the top three injuries seen on and off the tennis court are

Number 1

Simple muscle strain is due to overuse or sudden exertion that leads to an injury or “pull” of the muscle. “It’s something we’ve all experienced at one time or another,” says Dr. Hecht, “And it usually means that you didn’t warm up the muscles, stretch or get loose before you started exercising or exerting yourself,” he adds.

  • Duration: Typically, this type of injury resolves in 1-4 weeks.
  • Treatment: Anti-inflammatory medication (ibuprofen) and physical therapy if needed.
  • The good news: Simple muscle strain is “usually a self-limiting thing that gets better by itself,” says Dr. Hecht.

Number 2

Disc herniation occurs when a lumbar disc ruptures. The discs sit in-between the vertebrae and serve as shock-absorbing cushions. “When a disc herniates or tears, the shock-absorbing cushion extrudes through the outer covering. “It’s kind of like jelly coming out of a donut,” says Dr. Hecht. This herniation can happen suddenly or the tear can happen slowly over time.  The tear leads to pressure or pinching of a nerve and that’s what causes back pain, pain in the buttock or down the leg. This type of injury can cause numbness, tingling and even some muscle weakness says Dr. Hecht.

  • Duration: Between 4 and 10 weeks.
  • Treatment: Anti-inflammatory medication, epidural cortisone injections and/or oral cortisone medication. “Every once in a while if the situation doesn’t improve, a minimally invasive surgery technique called a discectomy allows us to remove the bone fragment of the disc that is pushing or pressing on a nerve.
  • The good news: Even if surgery is needed, about 90% of elite athletes go back to their preinjury function says Dr. Hecht. Dallas Cowboy quarterback, Tony Romo, missed the 2013 season finale after undergoing a discectomy but came back in fighting form. The take-home message for everyone is if you sustain this kind of injury and require surgery, you’ll do very well,” he says.


Number 3

Spondylolysis, a stress fracture of one of the bones that make up the spinal column, “is most commonly seen in young players and athletes,” says Dr. Hecht. According to the American Academy of Orthopedic Surgeons,2 this injury is caused by repetitive hyperextension of the back, during a tennis serve, for example, but also in weight lifting or gymnastics. This hyperextension can cause disc compression, stress on the small joints of the spine and the muscles, ligament and tendons surrounding the spine.
Spondylolysis Illustrated

  • Duration: Depends on the severity of the problem.
  • Treatment: Suspend the sports activities and specific workouts that may have caused the problem. Anti-inflammatory medications, such as ibuprofen, may help reduce back pain. Physical therapy may be recommended.
  • The good news: In the vast majority of cases, especially among younger athletes, the injury resolves on its own with few complications.

Prevention techniques

Maintaining your overall health is the first step. So is preparing yourself to be active. Before you exercise or engage in any physical activity, be sure to stretch and limber up your muscles. And while you’re exercising, remember to focus on spine and core strength. Core strength is essential to maximizing good spine health and minimizing episodes of back pain, stresses Dr. Hecht.

And if an injury occurs, don’t take to your bed. “We don’t recommend that anymore,” says Dr. Hecht. “We encourage you to get out of bed and get going without overdoing.”

However, if your back pain lasts more than 6-8 weeks, or if you have lower back pain along with pain down the leg, numbness or tingling, or you have trouble going to the bathroom, see your physician right away.

Updated on: 03/19/19
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