SPORT: A Novel Biopsychosocial Framework for Chronic Low Back Pain in a Young Athlete – A Case Report

Background and Purpose: Chronic low back pain (CLBP) is a disabling injury for athletes with an unclear pathway to return to sport (RTS). Biopsychosocial (BPS) treatment can address the complex needs of athletes recovering from injury by considering the interplay between body and mind. Current BPS models lack specific guidelines for clinicians. This case report presents and applies a novel BPS framework, SPORT (Systematic Progressive Overload Rehabilitation Training) to a young athlete with CLBP. Description: An accomplished 18-year-old male athlete who engaged in soccer, football, and powerlifting presented with CLBP. The symptoms originated with kicking and worsened for 13 months. Despite five months of treatment from clinicians, there was no RTS or improvement in pain and disability. The SPORT framework consisting of 18 evidence-based principles was implemented. The outcomes tracked were strength, sport participation, and reported pain and function. Outcomes: A 17-week intervention resulted in strength gains as measured by performances on the squat and deadlift. Squat improved from 45 lb to 335 lb. Deadlift improved from 45 lb to 385 lb. The subject's recreational sport participation increased from inactivity to 45 minutes of play for five consecutive days. He improved from daily pain and disability to near pain-free living and function. Seven weeks post treatment, post-case outcomes included a 435 lb squat, 465 lb deadlift, participation in recreational sports, sustained improvements in pain and function, and successful flare-up management. Discussion: The subject presented with unique challenges which required a holistic approach to RTS. SPORT provided tools for managing his CLBP. Future studies could compare SPORT to other treatments for CLBP in young athletes, ideally on a larger scale and with diverse populations. Conclusion: The case presents the creation and application of an original BPS framework, resulting in reductions in pain and a RTS in a young athlete suffering from CLBP. Level Of Evidence: 4.