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Squash And Lower Back Pain

Published: 16 May 2006 - 22:35 by jnorth51

Updated: 05 Mar 2011 - 14:38

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Hi All -

As you can probably tell, i am fairly new to the board. 

I recently (3 months ago), had a small slip and hurt my hurt back. I didn't think it was anything serious, however, the pain progressively got worse.  I finally sought physio treatment and to date, haven't found a lot of results.  I have decided to take some time off the court to recoup and hope that it works (even though it breaks my heart to do so).  Thats why I am catching up on as much as my squash reading as I can since I can not play.

Just wondering - has anyone hear had lower back pain/injury and came back to the squash court?  I need some hope and encouragement!

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From dehamtona - 23 Oct 2006 - 03:03

I had a bad back several years ago - that kept me away from the court (and most other things) for 4 months.
My suggestion for overcoming the pain is two fold - (1) walk as much as possible. and (2) stretch your hamstrings

After about 12 weeks of Physio focused entirely on my lower back - i started stretching my hamstrings very thoroughly and it made a huge improvement for my back.

It may be useful to consult with a physio about the best way for your body to stretch the hamstrings.

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From jnorth51 - 19 May 2006 - 21:54

Yeah, it did get worse but at the time that it was getting worse, I hadn't stopped playing squash.  I was still playing 4-5 times per week.  I imagine that might of had something to do with it. 

I don't know what else to do.  My GP is useless.  He didn't even look at me.  He said "rest it".  I was the one who suggested physio. 

All i think i will do is rest it for a few more weeks (from squash I mean) and do some light physio and cardio to keep moving, all the while going to my physio and getting in my stabilty/strengthening exercises. 

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From rippa rit - 19 May 2006 - 07:40

Viper - you are such a speed reader sometimes.....slow down.....this is what I said and I do not even see the word physio in the sentences

"Yep, the medical system in this country precludes you from going to a Specialist without referral from a GP...so that fixes that for Queensland/Australian residents."

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From aprice1985 - 18 May 2006 - 22:57

Yes it can take a long time, it just would worry me that the pain seems to be getting worse even with physio from what you are saying, no pain no gain is one thing but i do still think a medical check up is needed from a GP to see if it is more serious or maybe referred from another part of the body.  It does sound mechanical but a sponylolis or similar is possible, as is pain referred from a hip injury.  I hate to say it but i think viper's advice is wrong, yes see a specialist physio if you can but they have a limited remit wheras medics should be able to diagnose a wider range of the possibilities and referrals are to prevent everyone and anyone getting to specialists and clogging up the system.  Although physio will help many conditions the major indicator for medical/surgical intervention is persistance of symptoms.  And apologies for my poor proof reading, as indicated by rita spondylolisthesis is the slippage, spondylosis is the fracture, i put latter where i should have put former, i typed too fast and read too slow!  The important thing is to rule out more serious causes of back pain and if it is mechanical keep with the physio, just make sure they are properly qualified. 

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From jnorth51 - 18 May 2006 - 22:30

Wow - thanks for all of the great info guys. 

 

Firstly, just to give you some background.  I was playing squash over the Xmas break.  I slipped on a dusty floor and landed on my butt.  It wasn't a serious fall at all.  I mean, i have fallen MUCH worse over the years playing various sports.  Initially my right wrist (which is my racquet hand) took much of the force, as I tried to catch myself before impact.  My wrist was immediately sore, but i knew that my butt would be sore the next day.  I continued to play squash over the next week or so, and the biggest problem I had was with my wrist.  I was really worried about my wrist and it bothered me when i was playing.  My back would be 'stiff' for a while, but once I got to the courts and started playing, it was fine.  The biggest issue with my back around this time was if i was sitting for an extended period of time, when i went to stand up, getting fully straight hurt a LOT.  It was almost like I could get up to a 45 degree angle, but getting completely straight hurt.  But once I was standing straight, i was ok. 

 

After 4weeks of this, i was more worried about my wrist, and i talked to my GP about it. He suggested rest and said to take it easy.   I rested everything for a couple of weeks and didn't really get any relief.  So i went back to my GP and he suggested physio for some exercises.  So after that, i began to seek physio treatment (and still am).  The physio didn't think anything was wrong with the discs, etc, but sent me to have x-rays just in case.  They came back fine.

 

So here I am - its months later - back pain has gotten progressively worse (gone from only hurting when i stand, to a low dull pain most of the time).  I am working on my exercises daily and we are going to try acupuncture this week to see if that gives me some relief. 

 

Don't get me wrong, I am not in a lot of pain (nothing like that).  Just a massive inconvenience.  And as I like in Canada, an MRI is out of the question.  The wait list for where I live is about a year and a half. 

 

Hopefully, aprice 1985, that answers some of your questions.  There is some stiffness and soreness, but it doesn't keep me up at night.  It is certainly the worse when I wake up in the morning though and it hurts the most when i am standing and bend forward and come back up.  Sitting at my desk all day at work doesn't help either.  But no, when I slipped first the pain wasn't bad at all.  I didn't even notice my back pain until the days following (and even then it wasn't that bad), but it got worse after that. 

 

I chatted with a friend of mine recently.  His wife is also a physio.  She said its not uncommon for a lower back pain issue to take months to recover.

 

Who knows?  For now, I am trying to keep a positive attitude and do my strengthening exercises daily and hope it will get better so i can get back to the squash court eventually. 

 

In the meantime, I am trying to keep up some cardio activity to try and keep fit - walking on the treadmill and riding the exercise bike.  I guess that’s ok.....

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From Viper - 18 May 2006 - 22:19

ooohhhh don't start me on the scam of referals   absolute money spinner for the GP's

Quote:

"Physio is great for many back pains but if we say it is a spondylolisthesis then physio could make it worse, same for herniated discs, most cases of misalignment cannot be treated by them nor can osteophytes/spurs."

Um....... I do not think so.

Why would you go to general mechanic to fix a specialist suspension/brake, etc  problem in your car ?

No you would go direct to a brake suspension specialist who works in this area day in day out.

Same with medical problems like back pain, IMO

Thankfully the ridiculous referal system to see a  physio is long gone in my experience.

 

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From rippa rit - 18 May 2006 - 21:36

Yep, the medical system in this country precludes you from going to a Specialist without referral from a GP...so that fixes that for Queensland/Australian residents.
The GP can order X-rays to take to the Specialist, but often those x-rays are insufficient for thorough evaluation purposes.

If I have a persistent problem, and recurring, it is better to have all the evidence at hand otherwise the pros would be "flying by the seat of their pants".

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From aprice1985 - 18 May 2006 - 19:55

I make it clear that a medically qualified person should be seen, not all back pain can be diagnosed/treated by a physio, it appears that a physio has been seen, no benefit has come, see someone who can deal with the whole range of back problems not just the mechanical in case it is severe.  Physio is great for many back pains but if we say it is a spondylolisthesis then physio could make it worse, same for herniated discs, most cases of misalignment cannot be treated by them nor can osteophytes/spurs.  Their diagnostic remit is more limited and although they may be a good start point if they don't give some relief quickly you need to make sure, the back cannot be easily repaired once damaged. 

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From Viper - 18 May 2006 - 17:19

Mostly good advice aprice. Except I must disagree with this :

"in conclusion, see a doctor "

Waste of time going near a GP, always go to the source/specialist, ie in this case an experienced back related physio.

All a GP will do is charge you to tell you the same thing.

 

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From aprice1985 - 18 May 2006 - 07:47

As a medical student i have to put my nose in and comment.

1) If you can tell me what makes the pain worse and relieves it, does it keep you awake at night, is there stiffness, does it limit specific movements then i might be able to think through some of the possibilities.

2) When you initially slipped was the pain immediate and severe or slower and not so bad?

3) If physio is not working after a few months then it may not be a simple mechanical problem and so may need more medical intervention.  Have you seen a doctor about it yet as this is long term however three weeks of rest unfortuantly isn't.  Even basic strains and sprains can take weeks to months to recover and if pushed just flare up again so make sure it is rested from all exercise for a while

4) chiropraxis can be very useful but make sure they are qualified and assess you fully before pumping your spine sorry "manipulating"!  Lots of people do have minor irregularities in the spine but as shown the chiropractor didn't heal it and you will probably see them long term and there are isues with what they are doing and wether it may mask more serious problems by providing short term relief so get a medical check before seeing them if possible and ask a GP for advice on good ones.

5) As rita says the scans can sometimes be definative about more serious causes of back pain but if you are in the UK the set she recommends will set you back up to £2000 privately or 6 months wait for and MRI.  Rita has listed many causes of back pain and only doctors can be definative on what you have (if you are lucky not all have a clear cause)  Herniated dics are common and most don't need surgery just a long period of rest and spondylolis or spondylolisthesis (there is a difference the latter includes a fracture of the vertebral process) sound like possibilities and can be treated if you get medical help

6) Dont rely on a book to diagnose and cure all, every condition has a reem of ways it can present and you dont want to mis-diagnose yourself and cause harm through the wrong treatment.  Get a diagnosis, treat the problem then see about stabilising exercises.

7) L4/L5 is a very common site of disc problems as the bulk of the weight goes through it, if all scans are clear then it may well be muscular or ligamentous, if so rest until pain is going down then a gradual build of of strengthening exercises will help, don't push it too far but don't rest it totally for too long

8) i don't know of any proof for hanging from bars and be careful of straining other joints but it shouldn't be harmful and glucosamine has very good reports for helping joints but if it is muscular or disc then this will not be helpful but may be useful to try it.

In conclusion, see a doctor, rest it well, don't try the hitting the ball until it starts to clear up as for a good swing you need core involvement and therefore put pressure on the back, try the glucosamine as it will be good for you in general

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From BizarreCo - 18 May 2006 - 02:39

I can't say that I use the stuff myself, but apparently Glucosamine Sulphate is an excellent suppliment for helping with the joints. As for the back pain, seeking professional advice is definitely the best route to go down. I've been given a series of stretches by my chiropractor which I'd be happy to scan in and email to anyone who wants them!

ADZ

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From missing_record1 - 18 May 2006 - 00:10

One thing I do for my bad lower back is to hang from a chin up bar several times a day for a few minutes. I have one at my office so it is easy for me to do. Since the back is under compression most of the time, the tension of hanging seems to offer some relief for me. It doesn't strengthen your back at all, though. I find it is good for all my joints in general.

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From jnorth51 - 17 May 2006 - 21:49

Wow - thanks for the response people!

I didn't know that about Stewart Boswell.  Good to hear.  Also, didn't I hear once that Lee Beachill was in a car accident and had some serious back issues? 

Great comments ADZ - any suggestions as to how I should 'look after my knees/ankles/arm and back'??

Thanks Rita - I have been going to weekly physio appointments since March.  Minor improvements since then.  I have had the full x-rays done and everything came back fine.  The physio is convinced that there is nothing wrong with discs or anything like that.  She said my pain is from the L4 L5 region (lower back - right around where my belt is) and it hurts the most when i have to stand after sitting.  She is convinced that its an issue with the joints and muscles around that area and that my lower back and core muscles are weak.  Therefore we are doing a lot of strength exercises that I do every night when I get home. 

She is convinced that things will get better soon and I will be back to normal.  Me, being the pessimist (and never having a sports injury that lasted this long) is doubtful.   But I am hoping she is right.  This is my 3rd week of not stepping onto the court and its making me depressed.  I wonder if its ok if i was to step onto the court myself and lightly hit balls up and down the wall myself, just to practise my swing and keep myself mentally into squash mode.  I can't see that doing any more damange as I won't be doing any twisting, etc. 

I will check out that Sarah Keys book!  Thanks for the recommendation.  I ran out and bought "The Back Doctor" by Hamiliton Hall.  Haven't read it yet, but I am hoping it will do some good.

Signed,

Scared of not being able to play squash again....

 

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From Viper - 17 May 2006 - 18:06

If you are willing to put in the effort, buy this book and do the movements, you will improve, and more importantly you will understand what the problem is :

http://www.sarahkey.com/catalogue.cfm?pageID=9&productcategoryID=2&productID=7

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From rippa rit - 17 May 2006 - 15:55

jnorth51 - I really only think the way to know what is going on with your back, and to put your mind at ease, is to take this action
  •  an X-ray, and if not satisfactory, a Cat Scan, followed by an MRI. 
There are of course all sorts of possibilities for recurring lower back pain, eg muscular imbalance, wear and tear, genetic factors, eg leg length, scolioscis (curvature, as Biz mentioned, which is not uncommon right at the base of the spine), spondylolisthesis (slipped vertebrae), herniated disc and spurs (in which case it could interfere with the nerves) so the problem needs to be isolated before a course of action can be decided. 

I, personally, sought the opinion of a GP, Orthopaedic Surgeon, and Neuro Surgeon before electing to have surgery. 

I know of a few people who have had surgery (laminectomy) as well as herniated disc and are back on the court.  This will also depend on the severity and extend of the wear and tear as well as knowing if there is any osteo-arthritis.

If all is clear, and it is muscular, I would definitely recommend a gym program as follow up.
The longer the lay off the longer the rehabilitation.

Hope this helps.

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From BizarreCo - 16 May 2006 - 23:13

Jnorth,

After 18 years of squash at varying levels I began to feel a pinching pain in the middle of my hips and just to the right of the base of my spine. A trip to my local chiropractor came as a bit of a shock to me when I was diagnosed with a rather nasty curvature of the spine. It was enough to cause an extra 18lbs of weight to be travelling down my right hand side!!

 

30 "manipulations" and 3 months later and the weight had balanced and I was feeling great. I still get the occasional twinge (after which I immediately go straight back for another treatment - about £25 per session). The difficulty with my injury is that is was in such a place that couldn't be stretched out - so lots of ice and heat sessions at home!!

 

Rule 1: Look after your knees/ankles

Rule 2: Look after your playing arm

Rule 3: Look after your back

 

All three of those areas are really tough to come back from once you have a stress injury. Take your time, stretch well and best of luck!

ADZ

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From missing_record1 - 16 May 2006 - 23:05

Stewart Boswell had a career threatening back injury and is now back playing in the top 20.

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