Football, volleyball, cheer, and strength training can fill a Keller teenager’s week. When lower-back pain keeps showing up during practice, parents face a difficult question: should we give it time, or have it checked?
Recurring low-back pain in a teen athlete deserves an evaluation, especially when it repeatedly returns with the same activity. Muscle strain is one possibility. A bone stress injury is another, and the difference cannot be determined by whether your athlete can finish a game.
Why a teen athlete can develop back pain without a collision
An injury does not always begin with a tackle, fall, or awkward landing. Repeated loading can also stress the developing spine.
One condition clinicians consider is spondylolysis, a stress injury or fracture involving a small bridge of bone at the back of a vertebra. Sports involving repeated backward bending can place stress on this area. Football, gymnastics, and weightlifting are examples described by the American Academy of Orthopaedic Surgeons. [1]
This does not mean those activities are inherently unsafe or that every athlete with back pain has a fracture. It means persistent symptoms should guide a careful examination rather than an automatic assumption that the muscles are tight.
Pain patterns worth discussing with a clinician
Scottish Rite for Children, a North Texas pediatric orthopedic center, describes back pain and stiffness during or after activity as common symptoms of spondylolysis. Repeated back extension can occur during tumbling, football blocking, and volleyball or tennis serves. [2]
Consider arranging an evaluation when:
- Pain returns whenever your athlete resumes a particular drill or workout.
- Backward bending repeatedly brings on the pain.
- Symptoms persist instead of steadily improving.
- Your athlete changes how they run, lift, land, or stand to avoid discomfort.
These observations help tell the story. They do not diagnose the injury. Pain that feels like a muscle strain can also occur with spondylolysis, and feeling better with rest does not rule it out. [1]
What parents can do before the appointment
Pause the sport movements or workouts that reproduce the pain. If a bone stress injury is possible, repeatedly testing the painful movement is not a useful way to determine readiness. Scottish Rite describes avoiding activities that cause or increase pain as part of initial treatment for spondylolysis. [2]
Give the coach or athletic trainer a clear description: “Their lower back hurts when they arch during this drill,” is more useful than “Their back is a little sore.”
Bring a short record of when the pain began, where it occurs, what brings it on, and whether it affects school, walking, or sleep. Include school practices, club sessions, private lessons, and lifting in the weekly schedule. This information helps the clinician understand the demands surrounding the symptoms.
When medical attention should come first
Back pain with fever, unexplained weight loss, trouble walking, pain that disrupts sleep, or leg numbness or weakness needs prompt medical assessment. The AAOS identifies these as concerning symptoms in children. [3]
Seek emergency care for new loss of bladder or bowel control, difficulty urinating with back pain, numbness around the groin, or severe back pain after a serious accident. These symptoms should not wait for a routine office visit. [4]
Why an examination sometimes leads to imaging or referral
A useful evaluation considers the athlete’s history, movement, and relevant neurological findings. It should answer whether the problem is appropriate for conservative care or needs further investigation.
An examination alone cannot reliably exclude a bone stress injury. Scottish Rite notes that imaging may be needed to confirm spondylolysis and that an MRI can identify stress injuries that are not visible on an X-ray. [2]
If a fracture is suspected, medical evaluation and appropriate imaging take priority over treatment aimed only at easing tightness. Confirmed spondylolysis is commonly managed without surgery, using an individualized plan that may involve activity restriction, rehabilitation, and sometimes bracing. [1]
How Firm Foundation approaches an athlete’s back pain
At Firm Foundation Wellness Center in Old Town Keller, care begins with time to listen and examine. Dr. Corey Strunk’s background in Exercise and Sports Science, personal training, and chiropractic informs a movement-focused approach.
The first question is whether care in our office is appropriate. Depending on the findings, the next step may be individualized rehabilitation and hands-on care, or referral for medical evaluation. An adjustment is not automatic.
Parents and athletes should leave understanding the findings, any remaining uncertainty, and the next step. Learn more about our approach to sports injuries and what to expect at the first visit.
If your teen’s back pain keeps returning, schedule an evaluation or call or text (817) 776-1023. Our office is at 140 Pecan St, Keller, TX 76248.
Educational information only. Individual symptoms, treatment, and return-to-sport decisions require an appropriate clinical evaluation.