The Clinical Coach: Back 2 School

, last week we talked about posture in 2025, a little bit about it’s history and its perception in the adult population.

This week I want to bring light to this same topic, but in the younger population.

The reason?

More and more am I seeing young patients (8-16 years old) presenting with “non-specific” low back pain.

The problem?

Posture and Load Displacement.

Youth Posture in 2025

Over the last 10 years, we’ve seen the shift from:

bad posture = pain, to

bad posture ≠ pain

Don’t get me wrong. I am all in favor of this shift.

But does it apply to the youth?

In my clinical experience, I would say no.

As a matter of fact, I’d say posture in younger patients is more important than posture in adults.

Why?

Easy.

1. Their immature musculoskeletal system

2. Underdeveloped motor skills

3. Lack of awareness

Every student with low back pain that I have worked with, who is not an athlete would suggest that there is a link between poor posture and pain in young patients up to 15-16 years old.

The youngest patient I’ve had with low back pain has been 8 years old.

As you might remember from our seasoned professors in school. Pain in general, at least without trauma, in young patients is rare and warrants a much thorough investigation.

When an 8 year old patient presents with insidious low back pain and neither parent or kid can point you in the right direction, tends to kick your brain into overdrive and dig deep into all of that information you once learned.

Thankfully, x-rays and MRI’s came back unremarkable and the young boy had responded favorably to the rehab they had been doing for three weeks.

Dealing with spine pain in youth

Why do young patients have back pain?

In my opinion, it’s a simple answer.

Why are kid’s backpacks so heavy?

Have you seen a middle schooler?

In some cases the backpack filled with their books weighs just as much as the child.

Did they progressively load the backpack??

I am not saying kids are fragile, but there are natural laws at play here.

Society makes a fuzz when kids are introduced to weight training… but they expect kids as early as 8 years old carry almost half of their bodyweight on their back and walk with it, then stand with it for minutes?

I digress…

Youth spine pain is becoming more “normal” in today’s youth.

From prolonged postures playing video games, to heavy loads on the spine from backpacks.

While educating parents and patients in different ways to combat this, one of the best ways to do so, is to introduce the younger population to better movement patterns.

Here are my three favorite movement patterns to teach the young ones.

1. McKenzie press up. We call them the cobra push up. Helps improve low back mobility and when done properly also begins to increase their upper body strength. Soon majority of them are wanting to do big-boy pushups. Which is a great progression.

2. Spider walks. Who doesn’t like spiderman? We utilize this one to develop motor control of the spine and limbs while making it fun. Try to stay as low to the ground so Dr. Octopus doesn’t get ya!

3. Crab walks. Let’s fire up the glutes y’all. While these don’t always engage the glutes like a hip thrust, or a deadlift. These walks, when done correctly, ensure younger patients are utilizing their glutes to keep their hips elevated and not their back. It’s also a killer on the arms.

Food for Thought

There are two things that need to happen to reduce spinal pain in youth patients is simple.

1. Kids should develop strength, conditioning, motor control and body awareness through play and sports.

2. Backpacks need to become lighter, there is no need for students to carry that many books.

While every patient is different, this is a great way to get younger patients involved in better health while keeping it fun.

Until our next issue!

In health and strength,

P.S. If you have questions or comments, feel free to respond to this email. I reply to all emails personally.

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