Background Low back pain (LBP) in young athletes is increasing. Understanding spinal pathology related to sports may enhance design of prevention programs.

Objective To test the hypothesis that rowing athletes with LBP have a higher likelihood of degenerative disc disease than athletes from other sports.

Design Retrospective case series of 199 athletes (14–25 years.) with LBP.

Setting Clinical assessment of interscholastic, intercollegiate and elite athletes presenting to a sports medicine physician complaining of LBP.

Patients The medical records of athletes (14–25 years) seen from 2003 to 2008 with the complaint of LBP were reviewed and included. 23 sports were represented and 32% of the athletes were rowers.

Interventions Athletes had a thorough history and physical examination, MRI and/or bone scan. Results in the rowing athletes were compared to other athletes.

Main outcome measurements Results of the history, physical examination and radiographic studies were evaluated and the data analyzed by t-test or chi square.

Results Demographically, the rowers and non-rowers were similar. The incidence of disc injury, involved disc levels, and physical findings were similar between the male and female rowers. Female rowers had a higher likelihood of disc herniation and a higher incidence of multiple disc level involvement than other female athletes (p<0.05). Male rowers and American football players had a higher incidence of disc herniation and multiple disc level involvement (p<0.05). Male rowers were more likely to present with positive physical findings compared to other male athletes (p<05). Overall, 89.5% of the males and 76.9% of the females had positive MRI findings affecting up to three lumbar levels.

Conclusion Complaints of LBP in young athletes are highly correlated with lumbar spinal abnormalities. This is especially true for the young rowing athlete. Rowing techniques and training methods must be re-evaluated to decrease stresses on the lumbar spine and allow development of injury prevention programs.