Nearly 60% of athletes experience low back pain over the course of a year, but continue to play, limiting performance and increasing risk of a time-loss injury. In this course, Dr. Kyle Kiesel and Dr. Todd Arnold team up to present the best knowledge and application of treatment for the athlete with spinal pain. As experts in the field of sports medicine, Doctors Kiesel and Arnold specialize in the clinical examination and treatment of the lumbosacral spine. The goal of this course is to sharpen the decision-making and examination skills of the sports physical therapist in a clinical setting in order to streamline treatment of the athletes with neck and back pain that is limiting their participation. Upon completion of this course, the sports physical therapist will also be able to appropriately guide the athlete through a movement-based exercise progression and utilize guidelines for improved return to play decision-making. Live case examples of lumbar spine injuries will assist the sports PT in the development of critical thinking, problem solving, and patient/parent education.
Dr. Kiesel is an Professor and Chair of Physical Therapy at University of Evansville. His areas of research include motor control of the core and functional movement testing and training. Because of his long-standing interest in athletic performance, injury prediction and recovery, his research has also led to significant work related to functional movement screening, testing and assessment for athletes. He has authored over 20 peer-reviewed publications and regularly presents his work nationally and internationally as well as reviewing manuscripts for a variety of journals. He serves as a consultant for professional and college sports teams as well as the military where he assists with injury prevention and implementation of the functional movement systems model. He has extensive experience teaching lecture and lab courses emphasizing core training and functional movement assessment and intervention including both the FMS and the SFMA. He contributed his expertise related to the SFMA, FMS research, and the adverse affects of pain on motor control to the book, “Movement”. Dr. Kiesel is engaged in patient care in orthopedics and sports at ProRehab PC in Evansville, Indiana.
Dr. Todd Arnold is a primary care/sports performance physician with over a decade of experience caring for athletes of all levels from scholastic to professional. He serves as a sports performance scientist for USA Track and Field, and has worked extensively with over 50 athletes in preparation for the 2012 Olympic Games, where the team won 29 medals. He has served as head team physician at both Division I and Division II colleges. Todd has extensive training through the Titleist Performance Institute in the biomechanics of the golf swing, golf fitness and health care related to the golfer, and is the co-creator of Prescription Golf & Fitness™. He sees patients daily and is committed to increasing the public’s awareness of concussions. Dr. Todd Arnold is a board certified sports medicine specialist. He is currently licensed to practice medicine in Indiana. He received training at the Indiana University School of Medicine, Poudre Valley Hospital, and the University of Colorado Denver School of Medicine.
Dr. Kyle Kiesel discusses a modified treatment based classification model for the athlete. He discusses the differences in low back pain in athletes, as compared to the general population. In this chapter, the participant will be able to accurately classify athletes into one of three treatment categories. Based on these categories, the user will be able to conduct tests, provide treatment programs, and conduct appropriate discharge testing for their athlete.
Dr. Todd Arnold discusses the medical diagnosis for athletes with back pain. He explains the importance of taking a detailed patient history, being sure not to skip over the signs and symptoms that may be red flags for a young athlete. Dr. Arnold also explains the importance of referred pain and diagnostic tests. He covers the specificity and sensitivity of various tests for flexion, extension and mobility patients, as well as treatment and prognosis options. At the end of the chapter, Dr. Arnold provides imaging examples for the spine.
In this chapter, Drs. Arnold and Kiesel walk through a case study of a soccer player using a live patient. The two team up to discuss both the medical and rehab considerations for a soccer player with low back pain. The patient presents with motor control dysfunction for spinal flexion and positive Thomas and FABER tests and is classified in the mobility treatment category. Dr. Kiesel discusses and demonstrates the treatment and outcomes of the patient.
Drs. Arnold and Kiesel discuss the case of an athlete that presents with low back pain and B pars stress injury without slippage, confirmed by an MRI scan. The patient’s pain is greater on the left side than the right side, and is painful in extension. In addition, there is breathing dysfunction and a negative straight leg raise test. Dr. Arnold discusses the medical treatment plan, and how it relates to the physical therapy treatment program. Once referred to physical therapy, Dr. Kiesel discusses his treatment approach, including diagnostic testing, discharge testing, and expected outcomes.
For more information on the lumbar spine and athletic low back pain, we recommend you look through the following study materials. These materials will help you manage low back pain and see the answers to the advanced case questions.