SPORT: A Novel Biopsychosocial Framework for Chronic Low Back Pain in a Young Athlete - A Case Report.
The 45 lb squat with pain became a 335 lb pain-free squat over 17 weeks of progressive training, goal setting, pain education, and coach support in one 18-year-old athlete.
This is one person, not a pattern, and the treating coach was also his friend.
Key findings
1The subject's squat went from 45 lb with discomfort to 335 lb for 5 reps pain-free at week 17, and his deadlift went from 45 lb with discomfort to 385 lb for 5 reps pain-free. After a further 7 weeks, he performed a 435 lb squat and a 465 lb deadlift with no discomfort, which the paper notes surpassed his pre-injury lifts of 345 lb and 445 lb.
2Six clinicians (physical therapist, orthopedic surgeon, orthopedic specialist, athletic trainer, spine surgeon, chiropractor) provided passive and mixed interventions over five months, including electrical stimulation, heat, ice, stretching, spinal adjustments, over-the-counter medications, cupping, massage, myofascial release, and posture corrections, with little to no improvement in pain or disability.
3The 17-week program combined progressive lower-body resistance training (squats, deadlifts, accessory work), daily bodyweight exercises, goal setting, pain education, graded exposure to feared movements, sleep and hydration guidance, and weekly coach check-ins, structured in three phases guided by the subject's symptoms.
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What it does not show
This is one person. The authors state the positive response cannot be considered an effect of the treatment and cannot be generalised to athletes with varying sports, abilities, injury types, or ages. The subject was a disciplined athlete with extensive experience in three sports, which may make him an unusually motivated and compliant participant. It is unclear whether this approach applies to acute low back pain, other chronic conditions, or non-athletes seeking to resume daily activities. No standardised patient-reported outcome measure was used; pain and function were tracked through self-report. The author was the subject's strength and rehabilitation coach and a friend, which is a significant conflict of interest that could influence both the treatment delivered and the reporting of outcomes.
Declared interests
The author served as the subject's strength and rehabilitation coach and is also a friend of the subject. No financial conflicts of interest are declared.
The easy way to misread this
Do not read this as evidence that the SPORT framework treats chronic low back pain. It is one person, the treating coach was also his friend, and there is no comparison group. The imaging showed only mild degenerative changes, and the improvement could reflect the supportive coaching relationship, the progressive loading, the psychological support, or any combination of these rather than a specific framework.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →