Athletes Guide to Healthy Back

The Athlete's Guide To A Healthy Back

Let's focus about one of our most precious non-renewable resources...it's not petroleum, it's the human body. If you are a professional athlete you will pay a significant price for your endeavors. Few athletes begin their careers with any true understanding of the nature of the challenge and even less information regarding possible congenital anatomic limitations. Quite frankly there has not been much interest in this subject but glimmers of hope have emerged. The term "overuse injuries" has now been coined in regard to young athletes (Pennington B: Old before their time: Overuse injuries afflict the young. Int. Herald Tribune, Feb. 23, 2005).

The single most precious of our non-renewable resources is our brain. Each and every time a professional fighter is punched in the head there is a permanent loss of at least hundreds of thousands of neurons and this loss is cumulative. The term "punch drunk" means that continued brain loss has become so severe that the individual's brain reserve has disappeared and the fighter is left with only those brain cells upon which basic function depends. Moreover, with the normal process of cell loss is combined with aging one realizes that even without additional insult there is progressive brain cell loss each day. It has been estimated that we actually use only about 3% of our brain cells during our lifetime with the rest being held in reserve. If this is true we have to loose 97% before basic brain function starts to deteriorate.

John Elway, upon retiring, admitted something that most athletes find difficult to own; that "their bodies, after years of pounding, can no longer perform at a top level" (N.Y. Times, Mike Freeman). For the non-pugilist the greatest accumulated trauma is typically directed to the knees and spines. All knees tend to be pretty much the same at birth. The same is not true for spines.

Even congenitally "normal" spines resent being mistreated. Everyone understands that contact sports are tough on the body but few recognize that endeavors like gymnastics and golf are also highly injurious. The game of golf is nothing more than deriving power from constantly coiling and uncoiling the spine. Spines simply don't like to be twisted. Any professional golfer who tells you they do not have back problems may have a good scorecard but they also possesses a Pinocchio nose. An expert's advice on improving one's golf game is basically guidance as to how to better insult your spine. Professional golfers can be classified into three distinct groups as to the nature of the abuse:

Upper-Body Players (i.e. Palmer, Stadler, Allem) Power derived from rotation of upper torso.
Leg Players (i.e. Stewart, Daly, Woods) Power derived from rotating entire spine and body.
Combination Players (i.e. Hogan, Nicklaus, Norman) Strong spine coil with delayed release.

The key for providing one's spine with help is to be more aware of the state of the spine including any congenital liabilities and to then construct a means of maintaining low back health.

The greatest price paid by any athlete clearly appears to be that of a professional gymnasts following many years of competition. When a gymnast gracefully spins through the air and "sticks" a landing the trauma incurred is not dissimilar to that of a fighter pigreat deal being ejecting from a plane. The only real difference is that the professional gymnast does this every day. Scientific evidence of this is that spondylolysis (usually fracture of the pars portion of the 5th lumbar vertebrae) occurs in 20% of gymnasts, as opposed to an incidence of 5-6% in the general population.

In a October 11, 1993 interview with USA Today Mary Lou Retton candidly expressed a concern. She stated that, in regard to gymnastics, "I think we are reaching a physical limit in this sport." And added: "I think it's getting dangerous, really." There is no doubt that gymnastics today is a dangerous activity which is highly traumatic to the spine and the body as a whole. This is particularly true for those who start out with imperfect spines.

A case in point is this example of a 18 year old gymnast who presented with the complaint of low back pain and serves as a "poster child" for "overuse injury." The gymnast's MRI shows a host of congenital abnormalities of development of the lumbar spine including:

    Grade 1 Isthmic Spondylolisthesis
    Juvenile Discogenic Disease
    Lateral Spinal Stenosis
    Disc Herniation
    Degenerative Changes in the Facet Joints

This young gymnast is clearly heading for disabling back problems simply from the activities of daily living, let alone gymnastics. As a gymnast without special considerations being extended to the spine her future is certain to be bleak. It is essential for all athletes who have a strong family history of spinal problems to clarify their own status in regard to back pain. Even without the onset of problems imaging evaluation is necessary so that appropriate treatment and preventive programs can be planned. Good health maintenance programs presently exist, some sophisticated, others quite simple.

Fortunately, for the athlete there now exist valid and readily available means, i.e. MRI imaging, by which they can assess the basic anatomy of their spines and use this information to allow them to continue in their professional endeavors. Sometimes, as in the case of gymnastics, the sport itself must be modified to protect its participants. This takes a willingness on the part of the gymnastic organizations to acknowledge that there are some serious problems. This information has been brought to the attention of the gymnastics hierarchy during the past decade but they have chosen to respond by not yet acknowledging or addressing the concerns being expressed.