Sports and Spine Injuries | What is the Common Cause?
Athlete with Spine Injury

Spine injuries in sports are unfortunately very prevalent among athletes of all ages and skill levels. Understanding the anatomy of the spine, the mechanics behind sports injuries, and strategies to prevent injury are all crucial for keeping athletes safe and healthy. This guide will provide an overview of the most frequent spinal conditions affecting athletic participants across various sporting disciplines.

Introduction

The human spine, also referred to as the vertebral column or backbone, consists of 33 vertebrae interspaced by discs and cushioned by surrounding muscles, tendons and ligaments. This intricate structure allows flexibility for dynamic movement while providing support for the head and protection of the delicate spinal cord running through its center.

When participating in sports, especially those involving collisions, awkward landings or repetitive motions, the spine is vulnerable to strain. Common spine injuries in sports encompass damage to the cervical, thoracic and lumbar regions. Symptoms can range from muscle soreness to severe fractures or spinal cord injuries leading to paralysis. Proper conditioning, technique training, protective equipment and medical support are all essential preventative measures.

Types of Spine Injuries

The most prevalent spine conditions affecting athletes are focused in the cervical, thoracic and lumbar areas. The symptoms and severity vary amongst the different classifications of trauma.

Cervical Spine Injuries

The cervical section of the spine corresponds to the neck region. Sports putting participants most at risk for cervical injury include football, wrestling, gymnastics, hockey, rugby, and winter extreme sports.

  • Stingers and Burners: Also referred to as cervical nerve root neuropraxia, these conditions involve irritation of the nerves exiting the cervical spine. Athletes describe sensations of burning, numbness or tingling radiating from the neck into the arm. While symptoms are often transient, stingers and burners warrant medical evaluation to assess for more severe nerve damage.
  • Cervical Cord Neuropraxia: More extreme irritation, inflammation or bruising of the cervical spinal cord itself. These “spinal concussions” cause temporary neurological deficits affecting muscle strength and coordination in all four extremities. As symptoms mirror more catastrophic injury, expert assessment is mandatory prior to cleared return to activity.
  • Fractures and Dislocations: Sudden trauma from collision or blow to the head/neck can fracture cervical vertebrae or damage supporting ligaments. Spinal instability or deformity places the athlete at high risk for spinal cord injury. These scenarios constitute medical emergencies necessitating spine specialist evaluation and surgical stabilization when indicated.

Thoracic Spine Injuries

The thoracic spine injury most prevalent in sports participants is spondylolysis. This overuse condition stems from repetitive extension and rotation, gradually weakening the bones and joints. Afflicted athletes often report localized mid back pain exacerbated by activity. If caught early, spondylolysis typically responds well to conservative treatment. Delay in diagnosis raises risk of progression to spinal fracture.

Lumbar Spine Injuries

Encompassing the lower back, the lumbar spine withstands significant weight bearing forces. Intense athletic maneuvers can overexert structures or cause discs between vertebrae to herniate. Common lumbar spine athletic injuries include:

  • Sprains and Strains: Ligaments and muscles surrounding lumbar vertebrae bear repetitive stress during routines involving flexion, extension and twisting. Microtears lead to inflammation and debilitating pain.
  • Disc Herniations: Forceful acceleration/deceleration with the spine flexed can cause protrusion, bulging or complete rupture of the gel-filled intervertebral discs. Leaked disc material then inflames/irritates adjacent spinal nerves.
  • Fractures: Similar to cervical fractures, high energy impacts may break lumbar vertebrae as well – though less frequently. Chance of concurrent neurological injury is lower given distance from the spinal cord.

Causes and Mechanisms

While some amount of injury risk while participating in sports is unavoidable, understanding the common causes behind spine trauma empowers both athletes and coaches to take preventative action.

Direct blows to the spinal column during collisions, awkward landings placing abnormal strain on vertebrae, and repetitive overuse from intense training may all inflict damage. Contact sports like football and hockey have the highest spinal injury incidence, though repetitive overhead motions in tennis, demanding tumbling passes in gymnastics, and risky dives or vaults in diving also pose threats to spine health.

Road cyclists lean aggressively when navigating turns, predisposing the spine to abnormal forces should accident or falls occur at speed. Equestrians are at the mercy of their horses – thrown riders often land directly on their backs. Baseball catchers repeatedly squat and rise while wearing heavy protective gear, while golfers, swimmers and rowers all endlessly arch their spines to power performance.

Such patterns applied over long periods incrementally weaken bone, muscle and connective tissues until athletes cross over an invisible threshold where overt injury manifests. Medical staff must maintain keen awareness of high risk athletes while vigilantly tracking complaints possibly stemming from overuse.

Diagnosis and Testing

Initiating appropriate treatment relies upon securing an accurate diagnosis through medical history, physical exam, and selective testing. Early detection facilitates the best outcomes, though often proves challenging as many sports injuries imitate one another in symptoms.

A physician thoroughly documents the inciting incident or activity linked with new symptoms, explores additional contextual health factors, palpates the spine eliciting points of tenderness, then methodically tests motor, reflex and sensory function in the neck, arms, abdomen, legs according to distributional patterns of key nerves. Athletes provide subjective percentage ratings quantifying experienced deficits.

Results then dictate optimal imaging modalities to visualize tissue pathology. X-rays quickly capture vertebral fractures while computed tomography and magnetic resonance imaging better characterize soft tissue injuries. Electrodiagnostic studies measure how well nerves and muscles communicate – values inform spine stability and healing prognosis.

Treatment and Management

Treating athletic spine injuries mandates strategic tailoring to properly address diagnosed pathology while enabling athletes to safely resume sport with minimized risk of recurrence.

Non-Surgical Treatment

Mild cervical and lumbar sprains, thoracic spondylolysis, early disc disease or protrusions with minimal neural compression commonly respond well to conservative care:

  • Rest and activity modification alleviate strain on injured structures to prevent progression. Athletes modify – not completely cease – training.
  • Medications like non-steroidal anti-inflammatory drugs relieve swelling and pain, aiding natural healing mechanisms. Specific nerve related prescription agents also prove useful adjuvants.
  • Rehabilitation exercise progressively restores flexibility, strength and stamina at a pace aligned with the biological repair process. Physical and occupational therapist guidance prevents reinjury.
  • Braces and external supports supplement the spine’s native stability while healing ligaments regain integrity. These devices remind athletes to adjust movements protecting vulnerabilities.

Conservative treatment efficacy is monitored clinically through symptom reports and functional testing. Persistence despite a diligent regimen prompts consideration of surgical solutions.

Surgical Treatment

In specific circumstances where conservative methods fail or instability necessitates urgent correction to prevent neurological decline, spine specialists turn to surgical options:

  • Spinal decompression involves carefully removing damaged disc material, bone spurs or ligaments compressing the spinal cord and nerves to alleviate inflammation and provide more space.
  • Spinal fusion permanently joins two or more vertebrae together using bone grafts and metal implants for stability allowing nerves and tissue to heal.
  • Artificial disc replacement exchanges a severely herniated disc for an implant preserving spine flexibility better than fusion that adjoins vertebrae.

Surgeries carry defined risk profiles – infection, bleeding, lack of pain relief, limited mobility – which surgeons discuss at length with patients. Costs and insurance coverage likewise require due diligence exploring. Still, despite best planning and care, a subset of complex injuries unfortunately permanently impede athletic careers.

Return to Play Considerations

Rehabilitation following both surgical and non-surgical spine injury treatment must be gradual and strategic. Pushing progress too aggressively courts reinjury – and depending upon sport, dire secondary consequences . Football players risk quadriplegia charging back onto the field before cervical fractures and spinal cord contusions fully mend while competitive surfers flirt with drowning dashing to catch monster waves before the body properly reconditions.

Athletes work closely with physical therapists and trainers to methodically rebuild strength, flexibility, coordination and stamina without overtaxing healing tissues. Follow up imaging helps confirm recovery milestones as well. Even after clinical clearance, players often take additional weeks further solidifying form, kinesthetic awareness and confidence before actual game return.

Injury Prevention Strategies

While exciting and thrilling, sports must be grounded in safety – specifically for youth athletes with developing bones, joints and neural tissues more vulnerable to damage from excessive contact or strain. Coaches and leagues uphold athlete welfare by enacting protocols addressing preparation, training processes, protective equipment, and emergency response preparedness.

  • Proper conditioning specific to sport demands and athlete baseline status focuses on balanced flexibility, strength and endurance. Gradual preseason ramp protects bodies adjusting to new stresses.
  • Safe technique training minimizes dangerous movements during play associated with higher injury risk. Coaches vigilantly monitor athletes reinforcing proper form.
  • For contact sports, protective equipment fitting athletes correctly works with – not impedes – natural motion while shielding collisions. Regular maintenance ensures continued functionality.
  • Rule Changes like prohibiting head first slides in baseball help change culture and expectations. Instant video replay helps referees better officiate high risk plays.
  • Medical oversight via school, league or team athletic trainers and consulting physicians provides expert guidance balancing student passion with health. Trainers actively survey fields diagnosing brewing issues, while team doctors have final say clearing participation after injury.

While some factors behind spine injury lie beyond control, focusing energy toward those within grasp makes sports safer – and more enjoyable.

Conclusion

The bottom line is that spine health should be a top priority for athletes. Seeking timely medical care for concerning symptoms can make a big difference in injury recovery and getting back on the field safely.

Working closely with your orthopedic specialist, physical therapist, athletic trainer and coaching staff builds a support team that has your best interests in mind. Don’t try to downplay injuries or rush back before you’ve fully healed – that’s an easy way to end up right back on the injured list.

While some risk comes with playing sports, especially contact sports, there’s a lot athletes can do to prevent issues. Making injury prevention part of your training regimen through strength and flexibility work is key. Coaches also set the tone by teaching proper, safe technique from an early age. And sports organizations continue to update rules and require protective gear to protect players.

Sure injuries are frustrating, but take comfort knowing that sports medicine has come a long way in getting athletes back to pre-injury performance levels. Stay focused on building your body back stronger than before, and remember keeping long term health in perspective over short term gains. Smart planning and patience now pays off for a lifetime of active living ahead.

Written by Dr. Tony Mork
Orthopedic Spine Surgeon

I’m Dr. Tony Mork, MD, a Minimally Invasive Orthopedic Spine Surgery Specialist in Newport Beach, California. With over 40 years of experience, I’m dedicated to providing information for all topics that involve neck and back pain.

February 12, 2024

Recent Comments

No comments to show.

Contact a Spine Specialist Near You!

Related Articles

Lower Back Pain | An Overview

Lower Back Pain | An Overview

Lower back pain is an exceedingly common affliction that affects up to 80% of adults at some point in their lives. Understanding the underlying causes of lower back pain is key to finding the appropriate treatment and relief. Anatomy of the Lower Back The lower back,...

Degenerative Disc Disease | Causes and Risk Factors

Degenerative Disc Disease | Causes and Risk Factors

Degenerative disc disease describes age-related wear and tear to the rubbery spinal discs cushioning the vertebrae that can lead to chronic back or neck pain. While partly genetic, there are also lifestyle factors and injuries that accelerate disc degeneration over...

Upper (Thoracic) Back Pain | What is Causing My Pain?

Upper (Thoracic) Back Pain | What is Causing My Pain?

Upper back pain is a surprisingly common affliction, affecting up to one-quarter of the adult population at some point. While not as prevalent as lower back pain, discomfort in the thoracic region still accounts for a substantial slice of musculoskeletal complaints...