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Localized pain in the lower back                                  

por Francisco García

Low back pain or Lumbago.

“Sorry, I can’t play today… I have lower back pain!”

Who hasn’t read or written this sentence in their WhatsApp group dedicated to padel. Lumbago is defined as pain located in the lower back, in the lumbar spine, which is made up of 5 very robust vertebrae together with the corresponding intervertebral discs capable of supporting all the weight of the axis of our body.

Severe low back pain can affect about 85% of people at some point in their lives and causes a limitation in the game, that ” snap or whiplash ” causes us to immediately abandon the game and generates a feeling of gravity for a few days. This event may be resolved and never occur again, but there is a small proportion that evolves into chronic or recurrent low back pain, which takes away a lot of functionality in the player in the long term and can appear before or even after playing, sometimes leading to more serious injuries.

Padel involves a large number of movements of our back, such as flexion, extension, lateralisation and rotation. If we review each type of stroke we make in a match, we can see that the back plays a fundamental role in the technique of the following:

  • Defensive low balls: these are forced movements that require a technique that needs to distribute the weight to the knees and gluteus instead of the back. The amateur player abuses abrupt turns overloading the lumbar and paravertebral musculature; which can be contracted or overloaded to avoid more serious injuries (warning sign).
  • Smash: involves a forced extension of the back, with a bending of the knees and extension of the ankles. The aim is to distribute all this force towards the stroke. Amateur players with poor technique and/or disproportionate strength can cause whiplash in the lower back.

As for the PREDISPONSIVE FACTORS, we should point out that they are usually multifactorial, usually involving many of them. There are two main groups:

  • Organic: Structural alteration at muscle, ligament and/or vertebra level (disc protrusion, disc herniation, scoliosis, ankylosing spondylitis…) or visceral alteration at the level of a nearby organ, for example, renal colic or gynaecological pathology.
  • Non-Organic: Professional activity of the amateur player involving manual handling of loads, forced postures and/or repetitive movements; aggravating psychological factors, too hard court surface, unsuitable footwear and/or muscular decompensation due to lack of adaptation/tolerance.

The SYMPTOM is localised pain in the lower back, both on palpation and on movement, and can sometimes be accompanied by pain radiating to one or both lower limbs. In this case it would be called lumbosciatic pain as it affects the sciatic nerve.

The DIAGNOSTIC by excellence is usually imaging tests. We will start with conventional X-ray, which will provide us with a great deal of information. In the case of scoliosis, a complete Teleradiography of the spine will be necessary for the study of curvatures. In the case of lumbar discopathies, we need MRI or even a CT scan.

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