Postural Back Pain — Conservative Management (Youth Athlete) — Non-Operative

Massachusetts General Hospital · MGH Brigham Pediatric Sports Medicine

Weight-Bearing

N/A

Key Restrictions

Athletic activity cessation may be recommended; lumbar extension NOT restricted (distinguishes from spondylolysis protocol); discharge criteria: 0% Micheli Functional Scale, full pain-free ROM, pre-injury performance level

Timeline & Phases

Phase I (0-2 wks, 2-4 visits): active rest, heat/ice, soft tissue mob (paraspinals/QL/glut/piriformis), hip/thoracic mobs, local core control (TA/MF isometrics), hip strengthening, aerobic (treadmill/bike); Phase II (4-6 wks, 4-6 visits): scapular strengthening (I/T/Y, push-up plus), neutral trunk stabilization (plank, dead bug, bird dog), closed chain hip/LE; Phase III (6-8 wks, 4-6 visits): anti-rotation exercises, squat/deadlift progression, plyometrics, return-to-run program; Phase IV (8+ wks): sport-specific, full return to play

Notes

06/2024; distinct from spondylolysis protocol — no lumbar extension restriction; Micheli Functional Scale outcome measure; criteria include prone MT lift, TA biofeedback test; 4 phases; patient/family/coach education component.

Surgeon / Author

MGH Brigham Pediatric Sports Medicine

Published

2024-06