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Drs. Abbott (Bo) Kagan and Todd Atkinson are fellowship trained orthopedic orthopedic surgeons who practice general orthopedic surgery with a concentration in their area of expertise.

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Back Basics

By Abbott Kagan II, MD
And Jim Marshall, ATC/L

Back injuries are a frequent problem experienced by today�s athletes. Most of the lower back problems involve the lumbar and sacral regions of the spine. There are five lumbar vertebrae that are moveable and five sacral vertebrae that are fused, or do not move. The most common places for injury to occur are at the fourth lumbar, fifth lumbar and first sacral vertebrae. Injuries of the lower back include lumbar stains, lumbar fractures, sciatica and herniated lumbar discs. The good news is that back injuries can be prevented through good posture, abdominal strengthening, increased flexibility and proper stretching prior to exercise.

Good posture is something athletes can practice every day with standing and sitting. In a standing position, the athlete should: shift positions from one foot to the other, avoid arching the back and stand tall, flatten the lower back and relax the knees. In a sitting position: sit forward on the chair with the back arched, sit on a firm straight-backed chair. The feet should be flat on the floor with the knees above the level of the hips. When at work, the chair should be set at the proper height so both feet are flat on the ground. The desk should be at the proper height, and the computer should be at eye level.

Abdominal strengthening is very important to prevent lower back injuries, because it counterbalances the abdominal muscles and the lower back muscles. Exercises good for increasing abdominal strength are curl-ups, trunk rotation, crunches and sitting tucks. When performing these exercises, be sure you use good posture so as not to cause injury.

Good flexibility will also help prevent lower back injuries. Often with injuries to the back, an athlete will have very tight hamstrings. The lumbar region of the back is affected by all the muscles in the legs. So it is important to increase flexibility of the hamstrings, quadriceps (front thigh), gastrocnemius (calf) muscles and low back muscles.

The final thing an athlete needs to concentrate on is stretching prior to exercise. Athletes should warm up, then perform each stretch five times, holding for 45 seconds each time. That allows the muscles to stretch and retain the stretch. Many injuries of the lower back occur when playing golf. Realize that golf is a unilateral sport in the fact that a golfer will take anywhere from 65 to 110 strokes all from the same side. Golfers need to stretch both sides of the lower back as well as stretch every few holes.

By practicing proper posture, strengthening the abdominal muscles, increasing flexibility to leg muscles and lower back muscles and stretching proper to athletic activity, one can dramatically reduce lower back problems.