Low back pain is the second most common reason for doctor visits in the USA , after the common cold . Eighty percent of American adults will experience low back pain at some point in their lives . Disc bulges and disc herniations cause significant pain , time away from work , and of course , time away from the pickleball courts . Pickleball and low back pain are closely related because of the nature of the movements seen in pickleball . Repetitive dinking at the non-volley zone ( kitchen ) means players are often bending forward in order to hit the ball . This , over time , can place a lot of stress on the spine and lead to disc problems ( or exacerbate existing / underlying problems ).
First , let ’ s describe the difference between a bulge and a herniation . Spinal discs are like jelly donuts lodged in between each vertebra . They provide shock absorption , and ensure that the load of the spine is dispersed evenly . A disc bulge is when the disc is pushed ( most commonly posteriorly and laterally , back and to one side ) out of place . This often leads to nerve roots being compressed as they exit the spine , and can create radiating pain , numbness , and tingling in the lower extremities ( known as radicular pain ). A disc herniation occurs not only when the disc is pushed out of place , but when a tear in the disc is also present . This leads to the gel-like substance within the disc being extruded ( think of squeezing the jelly out of a donut ). This , again , can lead to nerve compression and pain felt in the lumbar spine and lower extremities .
The most common mechanism of injury for a lumbar spine disc bulge ( or herniation ) is a combined spinal motion of bending and twisting . This unfortunately is seen all the time in pickleball due to the nature of the dinking game ( not seen in other racquet sports ). It is well-known that the majority of pickleball players are older than 50 , and therefore their quickness , agility , and footwork may not be as good as younger players . This leads to a lot of reaching ( often outside the base of support ) in order to return certain shots , and places these individuals at higher risk for lumbar disc problems . Improving your footwork and agility at the kitchen line can lead to better positioning to hit the ball , and therefore decrease the repetitive stress placed on your spine over time .
How does a lumbar spine disc bulge or herniation present ? Usually , people will report bending over to pick something up or reaching down for something , and then a sharp pain is felt . This is followed by significant stiffness , inability to move , pain in the lower back , and possibly pain in the lower extremities . In addition , a positional shift can often be seen , called a lateral shift ( if you look in a mirror , your shoulders are no longer lined up straight above your hips ). This is a normal response our bodies have in order to avoid compressing nerves and to decrease the pain . Unfortunately , if left untreated , this can lead to longer-term disability and keep you off the court ( or even from returning to work ).
The best thing to do when injuring your lumbar spine is to consult a health care professional ( ideally a physical therapist ) as soon as possible . Research has shown that the quicker acute low back pain is addressed by a physical therapist , the better the outcomes . Physical therapists will be able to perform a full examination and determine the cause of your pain . From there , they can devise an individualized program to correct your problem and return you to the courts as soon as possible . There is a specific sequencing that needs to be followed in order to correct lumbar disc bulges / herniations . Positional shifts need to be corrected , then a progressive exercise sequence is put in place to correct the disc protrusion , followed by a progressive strengthening program in order to get back to all activities .
Lumbar spine disc problems can be painful and debilitating but , with the right approach , can be addressed conservatively and do not always require surgery . Consulting a physical therapist should always be your first approach , and that therapist will refer you if more involved medical attention is needed .
Noe Sariban is a Doctor of Physical Therapy , Certified Pickleball Teaching Professional through the IPTPA , an Engage sponsored athlete , and the Team Engage physical therapist . Visit
www . thepickleballdoctor . com for more information on injury prevention and rehabilitation tips . Noe started his website to provide pickleball players around the world with a reliable and free source of information . Like his Facebook page ,
www . facebook . com / pickleballdoctor , for updates and new information .
SEPTEMBER / OCTOBER 2021 | MAGAZINE 65