5 Common Causes Of Low Back Pain in Cross Fit Athletes

3D render of a male figure leaning over with spine highlighted



In this video I talk about the five common causes of low back pain experienced by CrossFit athletes, weightlifters and cyclist. I also give some advice on how to treat and manage the pain.

Let first get a quick overview of the anatomy of the lumbar spine.

The lumbar spine is made out of 5 vertebra, each vertebra has a spinous process and a facet joint on each side. In between the vertebra their is a disk. Their are also ligaments and muscles that surrounds the joints and the disks.

The 5 Common Causes of Low back pain:

First cause : Muscle strains or ligament sprains

Muscle strains and ligament sprains normally happens suddenly due to an injury or due to repetitive movements. Muscle strains occur when a muscle is stretched to far and a tear occurs. A ligament sprain is also due to over stretching of the ligament and a tear occurs.

Movements like

  • Lifting a heavy object like a bar, or twisting the spine while, lifting can cause a tear.
  • Sudden movements or a fall can place too much stress on the lower back.
  • Poor posture or bad technique over time can cause an injury in the ligament or muscle.

When and injury occurs suddenly, it is normally associated with severe pain. My advice will be to rest for the first 48 hours. Apply some ice to the area and brace the area by using either strapping or a soft back brace. After 48 hours you can start taking anti-inflammatory medication and book an appointment with your physiotherapist.

How does physiotherapy help?

Physiotherapy will assist in promoting the healing of the torn ligament or muscle, by using techniques like soft tissue mobilisation, dry needling, strapping and spinal mobilisation.

Second cause : The Disk

Intervertebral discs are tough, fibrous structures that act as ligaments between vertebrae, absorbing pressure and providing cushioning for the spinal column. Discs are flexible yet sturdy enough to facilitate movement such as bending forward, backward, and sideways.

3D render of a close up of a spine with the discs highlighted

Disks show signs of wear and tear with age. Over time, disks dehydrate and their cartilage stiffens. These changes can cause the outer layer of the disk to bulge out fairly evenly all the way around its circumference — so it looks a little like a hamburger that’s too big for its bun. The disk can bulge to the one side and compress on the nearby nerve. This can then lead to radiculopathy or otherwise known as referred by down the buttock or leg. Movements like bending forward, sitting and sideway movements, put more mechanical strain on the disk. That is why those movements feel worse when you have a disk bulge.

When crossfit athletes or weightlifters do movements like a dead lift, it put a lot of strain on the disk. Injuries normally occur when the athlete is tired and looses a bit of concentration with their technique. Cyclists tend to be in a forward bending position for extended periods of time, which also put a lot of extra pressure on your disk.

A herniated or slipped disk is when the jelly-like center of a lumbar disc can break through the tough outer layer. The fluid that oozes out is full of proteins that cause inflammation when they reach the nerve and irritate a nearby nerve root. The disc wall is also richly supplied by nerve fibres, and a tear through the wall can cause severe pain.

How does physiotherapy help?

Physiotherapy can help immensely for the disk patient; especially when the disk only bulges out to the side. Your physio will focus on exercises and spinal mobilization to try and push the disk back to the middle.

A Herniated disk is trickier to treat. Studies have shown that conservative treatment can help, but it can take up to a year to get better. If there is weakness in the leg or when your sensation is affected, we recommend that you go to an orthopaedic surgeon for a possible operation.

Third cause : The facet joints

There are two facet joints behind each disc, at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is richly innervated by nerves. These joints can be painful by themselves, or in conjunction with disc pain. Facet joint are synovial joints and consist of the same properties like your knee or shoulder joint. Just like your knee or shoulder joint can become arthritic and degenerates, so can your facet joint. It can also become stiff.

Movements like standing, walking and running put more pressure on the joint and cause a sharp pain. Sitting normally relieve pain.

How does physiotherapy help?

Physiotherapy can help to mobilise the stiff joint and surrounding muscles

Fourth cause : SIJ dysfunction/ lumbo pelvic dysfunction

The sacroiliac joint connects the sacrum at the bottom of the spine to each side of the pelvis. It is a strong, low-motion joint that primarily absorbs shock and tension between the upper body and the lower body. Pain in the SIJ is normally in the buttock, groin or on the outside of the hip. The sacroiliac joint can become painful if it becomes inflamed (sacroiliitis) or if there is too much or too little motion of the joint.

Lumbo pelvic dysfunction and pain can be quite complex and can happen with cross fit athletes, cyclist and weightlifters. Your physiotherapist will do an in-depth examination to see if there is too much, or too little movement at the SIJ. She will also look at your muscle control in your hip and core. The treatment will focus on loosening of the stiff muscles, strengthening the weak muscles and correcting poor posture.

Fifth cause : Nerve root pain

Nerve root pain is caused when something is compressing on the nerve. It can either be at the disk or somewhere along the nerve root. Pain normally refers down the leg and can either be dull or give you numbness and pins and needles.

Cyclists can struggle with nerve root pain due to the prolonged forward bending position on the bike. This position put the neural structures under more stress.

How does physiotherapy help?

Your physiotherapist will evaluate your symptoms to determine where the compression occurs. Once a proper diagnosis is made they will focus on releasing the nerve with various soft tissue techniques, spinal mobilisation or exercises.

Do you need help with your low back pain?

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Written by: Adrien Dannhauser (BPhyst, SPT1)