Low back pain in young athletes is much more common than you think. Disc herniation is rare before the 18-30 group, so this is not typically on our short list of possible issues. However, when the student is tumbling, dancing or cheer-leading these are the main possibilities:

1. Facet Syndrome: Basically, too much pressure between the face to face contact inside a joint. After adjustment, an air gap protects these two faces for 24 hours so they can calm down. After multiple adjustments, the effect is compounded. Return to activity is almost immediate, even if treatment continues to completion afterwards. Can be pinching, tight, or just achy.

2. Trapped tissue: We have lots of soft tissue. When you are as flexible as the young, you can stretch outside of your comfortable range. When the bones come back together, they can pinch down on tissues, not unlike trapping a finger in a door. Then, each time they move in the wrong plane, it is not unlike someone leaning on that door with the finger still trapped - it hurts! These are usually sharp and very tender. Massage can even make them worse. Once the adjustment releases the tissue, it can take 24-48 hours for relief as the inflammation goes down. Then the rest resolves within a week or two. There is a critical window of continued care on these. While the tissue is inflammed, it is easily "caught" again because it is swollen. Imagine this is like when you've bitten your cheek on the inside and because it sticks out more, you keep irritating it.

3. Worst case scenario: A Pars fracture: Two "bridges" of bone connect the vertebra round body to the back part of the spine. There is one bridge on each side and the spinal cord is between. Hyper extension, such as with gymnastics can cause these to fracture. Treatment is not chiropractic and requires a thin, but plastic brace be worn around the torso for many months to brace for the healing. These are rare, but not uncommon. If the athlete fell hard on the butt, which happens in snowboarding a lot, axial pressure straight up through the spine can cause vertebral body crush fractures. These are usually not dangerous, but do cause a lot of pain. These also usually cause scar tissue that starts to be annoying 1-2 years after the injury. Chiropractic during the early phase may prevent this, but it can also be very helpful later after healing has completed.