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Lower Back

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Low back strain is an abnormal stretching or tearing of the muscles in the lower back that help support the spine and the weight of the upper body.

It most often occurs as a result of a sudden extension contraction usually in combination with a twisting motion, or faulty posture such as excessive lumbar curvature (lordosis), flat back or scoliosis.

Low back strains are often characterized by pain around the low back and upper buttocks and/or muscle spasms that are generally relieved with rest.


A low back sprain is an abnormal stretching or tearing of any of the many ligaments that connect the bones of the lower spine (lumbar vertebrae).

The most common type of sprain involves the lumbar facet joints and typically occurs when an athlete is bent forward and twisting while attempting to lift or move an object.

Low back sprains are characterized by pain around the low back and upper buttocks and/or low back muscle spasms that are generally relieved with rest.


Spondylolysis is a degeneration of the bones of the spine (vertebrae) - often congenital - that manifests as a stress fracture.

Spondylolsis, by itself, rarely produces symptoms unless there is a forceful hyperextension of the spine or a disc herniation occurs.

In these cases, athletes with spondylolsis typically report pain and stiffness in the low back that increases after physical activity rather than during it.

Sports movements such as gymnastics, weight lifting, blocking in football, serving in tennis, spiking in volleyball, or swimming the butterfly stroke hyperextend the spine and typically cause this condition.


Spondylolisthesis is a forward slipping or displacement of a bone of the spine (vertebrae) in relation to the one below it (typically the L5 vertebrae slipping on S1).

Often caused by a direct blow, sudden twist or chronic low back strain, spondylolisthesis is more common among girls and those athletes with excessive lumbar curvature (hyperlordosis).

Athletes with spondylolisthesis typically report pain and stiffness in the low back that increases after physical activity rather than during it.

They may feel the need to change positions or self-manipulate the low back frequently in an attempt to reduce the pain.

If great enough, the displacement of the vertebrae may also trigger some neurological deficits.


Sacroiliac dysfunction is an abnormal movement or misalignment (either anterior or posterior rotation), where the sides of the pelvis (ilium) join the base of the spine (sacrum).

Most often resulting in pain, swelling and point tenderness over the rear of the pelvis, low back, or upper buttocks, rotation of the ilium can be caused by any number of improper movements including:

  • Stumbling forward
  • Falling backward
  • Twisting with both feet on the ground
  • Stepping too far down and landing heavily on one leg
  • Forward bending with the knees locked during lifting