Returning to sports after a back injury
Back injury - returning to sports; Sciatica - returning to sports; Herniated disc - returning to sports; Herniated disk - returning to sports; Spinal stenosis - returning to sports; Back pain - returning to sports

You might have heard a friend say that they have slipped a disk. Or, you may have slipped a disk yourself during an overly strenuous workout, or by straining while lifting something heavy. A slipped disk can be painful, so painful, in fact, that you can barely move. But what exactly is a slipped disk? And what can you do about it if you have one? This is your spine. In between the bones, which are called vertebrae, are little cushioning disks. These disks not only allow you to bend and move but also prevent your bones from rubbing against each other. Sometimes an injury can push a disk out of place, producing a bulge. This bulge is called a herniated disk. Or, a disk may break open. When a disk moves, it puts pressure on nearby nerves, and that's when you start to feel pain. Most slipped disks are found in the lower back or lumbar region, although you can also have one in your neck, or cervical region. When you have a slipped disk, you'll hurt, but often just on one side of your body. If the disk is in your lower back, you may feel a sharp pain in one part of your leg, hip, or buttocks. Your leg may also feel weaker than usual. If the disk is in your neck, the pain and numbness can stretch all the way from your neck down to your shoulder and arm. You may notice that it hurts even more when you stand for a long period of time, or if you sneeze, cough, or laugh. So, how do you treat a slipped disk? First your doctor will want to make sure that you actually have a slipped disk. To find out, the doctor will check your muscle strength, feeling, and reflexes, and have you move in different ways, for example, by bending, standing, and walking. You may also have a scan to find the exact location of the slipped disk. While bed rest was once the standard therapy for low back pain, studies show that for most people it does not help and may even make the situation worse. Rapid return to healthy normal activity is usually best, being careful not to put too much stress on the back. While you're doing that, you can take medicines like ibuprofen or aspirin to relieve the pain. Muscle relaxants may also help. Acupuncture, massage, and yoga have also been shown to be affective in some studies. Physical therapy may be helpful after the first two or three weeks. It can help strengthen the muscles of your spine, and teach you how to move properly so you don't injure yourself again. If these measures don't help, your doctor may suggest getting steroid injections into the area where you slipped the disk, to reduce pain and relieve swelling. As a last resort when all other treatments have failed, you may have a surgery called a diskectomy to remove the damaged disk. You may be in pain now, but don't despair, with treatment it should ease. Realize that it may take a few months before you're back to your old self. Don't try to overdo it by bending or doing any heavy lifting. You'll just wind up back on your couch, hurting again.

The spinal column is made up of bony vertebrae which are separated from one another by tough elastic disks that allow for movement. These disks are liable to displacement when they're put under strain. Lifting can produce forces that may cause a lumbar disk to move out of place.
Alternative names
Back injury - returning to sports; Sciatica - returning to sports; Herniated disc - returning to sports; Herniated disk - returning to sports; Spinal stenosis - returning to sports; Back pain - returning to sports
Which Type of Sport is Best?
In deciding when and if to return to a sport after having low back pain, the amount of stress that any sport places on your spine is an important factor to consider. If you would like to return to a more intense sport or a contact sport, talk to your provider or physical therapist about whether you can do this safely. Contact sports or more intense sports may not be a good choice for you if you:
- Have had surgery on more than one level of your spine, such as spinal fusion
- Have more severe spine disease in the area where the middle of the spine and the lower spine join
- Have had repeated injury or surgery in the same area of your spine
- Have had back injuries that resulted in muscle weakness or nerve injury
Doing any activity over too long a period can cause injury. Activities that involve contact, heavy or repetitive lifting, or twisting (such as when moving or at high speed) can also cause injury.
When to Return to a Sport
These are some general tips about when to return to sports and conditioning. It may be safe to return to your sport when you have:
- No pain or only mild pain
- Normal or almost normal range of motion without pain
- Regained enough strength in the muscles related to your sport
- Regained the endurance you need for your sport
The type of back injury or problem you are recovering from is a factor in deciding when you can return to your sport. These are general guidelines:
- After a back sprain or strain, you should be able to start to return to your sport within a few days to several weeks if you don't have any more symptoms.
- After a disk herniation (also called a slipped disk) in one area of your spine, with or without having a surgery called diskectomy, most people recover in 1 to 6 months. You must do exercises to strengthen the muscles that surround your spine and hip for a safe return to sports. Many people are able to return to a competitive level of sports.
- After having disk and other problems in your spine. You should be under the care of a provider or physical therapist. You should take even more care after surgeries that involve fusing bones of your spine together.
Making Muscles and Ligaments Stronger and More Flexible
Large muscles of your abdomen, upper legs, and buttocks attach to your spine and pelvic bones. They help stabilize and protect your spine during activity and sports. Weakness in these muscles may be part of the reason you first injured your back. After resting and treating your symptoms after your injury, these muscles will most likely be even weaker and less flexible.
Getting these muscles back to the point where they support your spine well is called core strengthening. Your provider or physical therapist will teach you exercises to strengthen these muscles. It is important to do these exercises correctly to prevent further injury and strengthen your back.
Once you are ready to return to your sport:
- Warm up with an easy movement such as walking. This will help increase blood flow to the muscles and ligaments in your back.
- Stretch the muscles in your upper and lower back and your hamstrings (large muscles in the back of your thighs) and quadriceps (large muscles in the front of your thighs).
When you are ready to begin the movements and actions involved in your sport, start slowly. Before going full force, take part in the sport at a less intense level. See how you feel that night and the next day before you slowly increase the force and intensity of your movements.
References
Ali N, Singla A. Traumatic injuries of the thoracolumbar spine in the athlete. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 129.
El Abd OH, Amadera JED. Low back strain or sprain. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 48.
Hertel J, Onate J, Kaminski T. Injury prevention. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 34.
Version Info
Last reviewed on: 9/4/2024
Reviewed by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
