Keene J S, Drummond D S
Compr Ther. 1985 Jan;11(1):7-14.
Effective management of mechanical back pain in the athlete requires an understanding of the significance of the nature and the location of the pain and which injuries are related to the age or sport of the athlete. Muscle strains and interspinous ligament sprains occur at any age and in all sports. However, the adolescent may have an iliac crest apophysitis rather than a muscle strain, and the gymnast or diver may have interspinous process bursitis or a stress fracture of the pars interarticularis rather than a ligament sprain. Similarly, the swimmer with upper thoracic pain, training in the butterfly stroke, may have Scheuermann's kyphosis, while the weight lifter with upper lumbar pain may have Scheuermann's changes in the lumbar spine. Athletes of all ages with persistent midline lumbar pain may have a disk injury or chronic instability because of a fracture of the vertebral body or posterior elements. If the physician performs the pertinent physical tests described and obtains the appropriate radiographic studies listed, correct diagnosis of the most common causes of mechanical back pain in the athlete will be assured.
对运动员机械性背痛进行有效管理，需要了解疼痛的性质和部位的重要性，以及哪些损伤与运动员的年龄或运动项目相关。肌肉拉伤和棘间韧带扭伤在任何年龄和所有运动项目中都可能发生。然而，青少年可能患有髂嵴骨骺炎而非肌肉拉伤，体操运动员或跳水运动员可能患有棘突间滑囊炎或关节突部应力性骨折而非韧带扭伤。同样，进行蝶泳训练且有上胸部疼痛的游泳运动员可能患有休曼氏脊柱后凸，而有上腰部疼痛的举重运动员可能在腰椎有休曼氏改变。各个年龄段持续存在腰部中线疼痛的运动员，可能因椎体或后部结构骨折而出现椎间盘损伤或慢性不稳定。如果医生进行所述的相关体格检查并进行列出的适当影像学检查，就能确保正确诊断运动员机械性背痛的最常见原因。
