I am a 16-year-old athlete who trains for the 200/400 metres. I also run at the national level.
During pre-season training, I suffered from severe back pain on the left side, just above the gluteal muscle.
I was advised to take an X-ray (digital lumbar spine AP and Lat). The radiologists concluded that I had narrowing of the L5-S1 disc space. I also had an X-ray done of the pelvis and both hip joints. No abnormality was detected. Post this finding, I was advised complete bed rest for two weeks and then to start walking short distances. It has been about four weeks since, and I can walk briskly without pain. Can I start my pre-season training and resume running? I do not want to jeopardise my health in any way and want to ensure that I do not suffer any such injuries in the future.
From the information you have given me, it seems like you may have suffered a back spasm.
It is common for track athletes to have this problem in their left leg as they only run anti-clockwise around the track. This causes an imbalance between the left and right hip. This imbalance affects your hamstrings, glutes and lower back muscles and often results in a hamstring tear or lower back muscle strain.
Here are a few tips on how to prevent this:
1. When warming up, jog clockwise around the track. This uses the muscles in the opposite manner to which you usually use them and helps strengthen the weaker side.
2. Do a full abdominal muscle workout three times a week. Include at least 120 repetitions and aim to build that up to 500 per session. As a sprinter, you have to push your body to its limits of physical ability. Your abdomen (stomach and back) is the foundation from which the rest of your body draws stability and strength. We call this the ‘core’ in physiotherapy. If one half of your core is weak, you will overload the other. So make sure both sides are strong enough to withstand the strain that you put on them.
3. Stretch after training. Your muscles become tight after a training session. If you don’t stretch regularly, that stiffness will compound and eventually you will start to lose flexibility. That affects performance and increases the risk of injury. So stretch after each training session, within 30 minutes of its completion. This is when your body is warm and will stretch easier.
In your case, I would suggest returning to the track. Start at 50 per cent of your usual training load. Do the warm up as I explained and then stick to straight run-throughs at 50 per cent. Just do enough in the first week to break a sweat and then stretch.
After a week of building it up slowly, warming up clockwise and completing your ab routine, you should be able to get back to training. Don’t overdo it in the second week either.
The nationals are in November so you can build it up slowly, so that your abdominal strength is much better by the beginning of October and you have not taken any risks. From October you will have six weeks to get back up to full speed. If you aim to increase your load by 15 per cent each week, you should be at full capacity by mid-October. That leaves three to four weeks for your speed work and then it’s on to the nationals to show them what you’re made of. Good luck.
Matthews is a physiotherapist with the Mittal Champions Trust