Low Back Pain in Crossfit Athletes
While lower back pain is not specific to Crossift athletes, it is a common experienced in the Crossfit community. There are many different causes of low back pain. This section will focus on mechanical low back pain, including facet syndrome, sprain/strains, and SI joint dysfunctions. Discogenic related low back pain (disc bulges & disc herniations) and sciatica are discussed in depth here.
Mechanical Low Back in Crossfit
There are several potential sources for mechanical low back pain. Since Crossfit involves heavy and dynamic movements, there is a potential for injury of the muscles, ligaments, and tendons in the lower back. Injury can occur due to poor form and technique or loading too heavy for the tissues. These can go hand in hand, especially when fatigue starts to kick in and form begins to suffer too.
The facet joints on the back of the spine as well as the sacroiliac joint (SI) can become irritated with increased loading. These injuries typically occur when performing a squat, deadlift, snatch, or row and quickly extend the low back leading to localized pain in the low back.
While tissue injury can certainly be a cause of mechanical low back pain, chronic low back pain is a different beast. As time after an injury increases (or if the pain begins without a clear reason), the association between tissue damage and pain decreases. In chronic pain, pain is being overprotective of the low back even though the tissues have healed. For more information, check out our post on chronic pain.
Imaging for Low Back Pain
Imaging, such as an X-ray or MRI, for mechanical low back pain is generally not recommended in the initial stages of treatment. However if there was trauma and a fracture was suspected or another sinister pathology was suspected, then referral for imaging would be indicated. A thorough history and examination can determine whether imaging is appropriate.
Treatment of mechanical low back pain
All of the current guidelines for the treatment of low back pain recommend beginning with a conservative approach. Spinal manipulation, massage, and exercise are among the therapies recommended for the treatment of low back pain.
For Crossfit athletes, it is important to build the stability of the core and hip muscles after a low back pain. While planks and glute bridges are excellent exercises to start with, the rehab programs needs to progress to more challenging exercises with higher loads to reduce the risk of re-injury.
As stated above, a common mechanism for mechanical low back pain in Crossfit is a quick hyperextension of the lower back during a row, kip, squat, etc... Focusing on strengthening the anti-extension core muscles, like the abdominals and obliques, can help to reduce future low back flare ups.