Low Back Pain in an Adolescent with Core Weakness, Hamstring Tightness, and Increased Body Mass Index

We present a case of a young teenager with multiple risk factors for his mechanical low back pain, including increased body mass index, physical inactivity, core instability, and hamstring tightness. There is a known association between both obesity/overweight and sedentary lifestyles and low back pain. Fortunately, exercise can be effective for improvements in low back pain in these populations. The core itself is comprised of abdominal, spinal, pelvic floor, and diaphragm musculature. Core stability is dependent on the interaction of three interdependent systems: the osseoligamentous, the musculature, and the neural control systems. These control the motion of the spine both at end-range and within a “neutral zone” of motion. Specific examination maneuvers and clinical observations of a patient’s posture and mobility can determine the patient’s core stability or instability. Core stabilization exercises may improve core stability and low back pain symptoms. Finally, hamstring tightness has been shown in some studies to be associated with low back pain; therefore, hamstring tightness is important to evaluate and treat.