Lumbar Spine

12 Lessons

Lumbar spine (L-Spine) injuries in football are quite rare with an incidence of 6%. While the rate of injury is relatively low, 36% of players complain about low back pain. This makes back pain almost as common as thigh problems (40%) and even more common than hip and groin pain (24%).1 Spine injuries and chronic low back pain are responsible for between 15% and 22% of premature career ending in professional football players.2

The lifetime prevalence of back pain in youth players already exceeds 40%.3 While back pain seems to be common in this group, recent data suggest that this rate is lower than the prevalence in school children with low levels of physical activity.4 As a result, football might rather have a beneficial effect on back pain in childhood.

In this module you will learn about the general role of the lumbar spine in football players from a biomechanical viewpoint. You will review the available clinical assessment and diagnostic tools. You will also learn about the three most frequent pathologies – soft tissue injuries, spondylolysis and problems arising from the intervertebral disc.

Presented by

Learning outcomes

  • the functional role of the L-Spine in football;
  • how to take a history and clinically examine an athlete presenting with back pain;
  • how to develop a diagnostic algorithm for the most frequent spine problems;
  • the different treatment options and outcomes – including when to refer for a specialist opinion.


  • Watch/listen to the 11 slide talk and review the provided text.
  • Read the required reading.
  • Review any associated media content.
  • Complete the case-based assessment task.

Required reading

F-MARC Football Medicine Manual 2nd Edition

Chapter 3.7 (pages 206-213)


  1. Peterson, L., Junge, A., Chomiak, J., Graf-Baumann, T. & Dvořák, J. (2000). Incidence of football injuries and complaints in different age groups and skill-level groups. Am J Sport Med, 28 (5 Suppl), S51-7.
  1. Drawer, S. & Fuller, C.W. (2001). Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. B J Sports Med, 35 (6), 402–408.
  1. Aoki H., Kohno T., Kato H., Yatabe K., Morikawa T., Seki J. (2010). Incidence of injury among adolescent soccer players: a comparison of artificial and natural turf. Clin J Sport Med 20; 1-7.
  1. Skoffer B, Foldspang A:(2008): Physical activity and low back pain in schoolchildren Eur Spine J. 17; 373-379.
  1. F-MARC Football Medicine Manual, 2nd Edition, Dvořák J, Junge A, Grimm K (eds.) FIFA, Zurich, Switzerland, 2009.
  1. Krayenbuehl H (1965): Treatment of herniated disk. Dtsch Med Wochenschr. 90:1215-6.
  1. Gatt CJ Jr, Hosea TM, Palumbo RC, Zawadsky JP (1997): Impact loading of the lumbar spine during football blocking. Am J Sports Med. 25(3):317-21.
  1. Fenton DS, Czervionke LE (Eds.): (2010): Image-guided Spine Interventions. Saunders Philadelphia – London – New York.
  1. Ladenhauf HN, Fabricant PD, Grossman E, Widmann RF, Green DW (2013): Athletic participation in children with symptomatic spondylolysis in the New York area. Med Sci Sports Exerc 45: 1971-1974.
  1. Gregory, P.L., Batt, M.E. & Kerslake, R.W. (2004). Comparing spondylolysis in cricketers and soccer players. British Journal Sports Med, 38 (6), 737–742.
  1. Morita, T., Ikata, T., Katoh, S. & Miyake, R. (1995). Lumbar spondylolysis in children and adolescents. J Bone Joint Surg Br, 77(4), 620–625.
  1. Reilly, T., Bangsbo, J. & Franks, A. (2000). Anthropometric and physiological predispositions for elite soccer. J Sport Sci, 18(9), 669–683.
  1. Sairyo K, Sakai T, Yasui n, Dezawa A: Conservative treatment for pediatric lumbar spondylolysis to achieve bone healing using a hard brace: what type and how long? J Neurosurg Spine. 2012 Jun;16(6):610-4.
  1. El Rassi, G., Takemitsu, M., Woratanarat, P. & Shah, S.A. (2005). Lumbar spondylolysis in pediatric and adolescent soccer players. The American journal of sports medicine, 33 (11), 1688–1693. unter doi:10.1177/0363546505275645.
  1. Adams MA, Roughley PJ: What is Intervertebral Disc Degeneration, and what causes it? Spine 2006;31: 2151-2161
  1. Postacchini F, Giannicola G, Cinotti G. (2002): Recovery of motor deficits after microdiscectomy for lumbar disc herniation. J Bone Joint Surg Br. 2002 Sep;84(7):1040-5.
  1. Mayer HM, Brock M. (1993): Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy. J Neurosurg. 78(2):216-25.
  1. Ruetten S, Komp M, Merk H, Godolias G. (2008): Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976) 33(9):931-9. doi: 10.1097/BRS.0b013e31816c8af7.
  1. Jancuska, J, Spivak, J, Bendo, J. (2015): A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti’s Syndrome. Int J Spine Surg. 9(42).