Back and Leg Pain

Find the CAUSE before prescribing the cure.

So many paddle players struggle not only with back pain but also with extremity pain (hamstring, knee,hip, foot, ankle, ). Diagnostic Radiology (MRI’s, CT Scans, X-Rays) is almost always performed and often times recommendations are made on the findings (or lack of findings) on these tests. One of the problems with this approach is that these tests are done in a static (not moving) position. Most athletes however, know that pain and disability occur when actually performing in their sport (motion).

What’s really necessary in evaluating back and leg pain is the functional exam (done in motion and checking all areas related to a particular athletic function). This should always include the following:


  • Is the spine in proper alignment?
  • Are the hips and shoulders level?
  • Does the athlete lean to one side?
  • Are the muscles on one side of the body the same size as those on the other?
  • Are the feel rotated in or out? Are the arches of the feet healthy? Are there bunions or callouses on the feet? Are the shoes wearing out unevenly?
  • Is the posture healthy?
  • Has weight gain produced weak abs?

Palpation (touch)

  • Are the muscles and tendons tender to touch?
  • Are there knots or spasms in the muscles?
  • Are the tendons and joints swollen?
  • Is there any scar tissue or adhesions (stiffness)

Range of Motion

  • Is movement free and full?
  • Is movement better on one side than the other?
  • Is pain increased or decreased with movement?

Once this exam is performed, the real cause of the problem can be addressed. Many times correcting a back problem requires fixing the feet and vice versa. On correcting a knee problem may require strengthening the hip, and so on.

For paddle players to get the best results for back and extremity problems, look at the total picture, be open- minded and develop a plan with your health care team based on examining you, the athlete. You’ll get out of pain faster, have shorter downtime from the game we love and have less chances of the same problems returning in the future.

By Dr. Nicholas S. Bogannam