Sports medicine has become an important part of the American way of life. The duration, intensity, and frequency of athletic participation have increased the number of back complaints. Overuse can result in different types of spine problems in a young athlete versus those in the more mature participant. Increased mechanical stress to the lumbar spine can result in spondylolysis, a stress fracture to the posterior elements of the spine. Gymnastics, football, and weightlifting cause repetitive hyperextension activities of the spine. These activities increase the risk of stress fractures. Treatment consists of a temporary decrease in activity, which usually decreases the pain enough to begin a rehabilitation program. Short-term use of a back brace may also be helpful. Surgical repair of the fracture is seldom needed.

The fracture of spondylolysis can allow the affected vertebra to gradually slip forward. This slippage, called spondylolisthesis, may worsen in childhood and adolescence but tends to stabilize in adulthood. The management of spondylolisthesis, depending on the severity, is best handled by a pediatric orthopaedic spine specialist or spine specialist skilled in dealing with the adolescent spine.

Over the past ten years, I have witnessed an increase in the number of pre-teen and teenaged athletes complaining of back pain. The most important thing about back pain in a young athlete is not to ignore it but to address the situation promptly.