This article is more than 5 years old. Information may no longer be current.
Some elite athletes at risk for disc problems
Researchers saw abnormalities on MRI in 92% of athletes, including weightlifters and ice hockey players.
Click Here to Manage Email Alerts
The
effects of impact and loading activities to the spines of top Swedish athletes
predispose them to increased risk of disc degeneration and spinal
abnormalities.
According to the results of a Swedish prospective, blinded study, those spine problems were directly related to the back pain that study participants reported.
“Athletes in sports with severe or moderate demands on the back run a higher risk of developing disc degeneration and other abnormalities of the spine than nonathletes,” said Adad Baranto, MD, in the department of orthopaedics at Sahlgrenska University Hospital in Gothenburg, Sweden. He presented results during the 2003 International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress at Auckland, New Zealand.
Swedish investigators reviewed spine MRIs of Swedish male athletes actively competing in four top-level sports and analyzed any noticeable disc abnormalities. They compared their findings to MRIs of same-aged male nonathletes.
Investigators found that 92% of the athletes who competed in weightlifting, orienteering, wrestling and ice hockey had signs of disc degeneration compared to 48% of nonathletes.
MRIs analyzed
---Problems
detected in the lumbar spine of this 23-year-old male ice hockey player on
T2-weighted MRI include severely reduced signal intensity in discs at L2-L3 and
L4-L5 and moderate disc height reduction at L2-L3.
COURTESY OF LEIF SWÄRD
Elite athletes were selected because their training is typically intense with heavy loads. Research has shown that their radiological abnormalities and back pain tend to be greater than in lower level athletes.
Baranto said he and his colleagues used MRI because it is more sensitive than radiography to such disc changes as reduced height, bulging and degeneration.
Twelve to 13 years ago, investigators imaged the lower thoracic, starting at T6, and the entire lumbar spine in 71 top Swedish male athletes (aged 18 to 37 years), as well as a reference group of 21 male nonathletes (aged 22 to 26 years). There were 21 weightlifters, 13 wrestlers, 18 orienteerers and 19 ice hockey players.
Athletes were active at the national elite level in their respective sports and played their sport competitively at least 10 years. Nonathletes could not be involved in any competitive sports. “The athletes and the control group were chosen without any knowledge about their previous spine or back history,” lead investigator Leif Swärd, MD, told Orthopaedics Today.
To relate back pain with the abnormalities seen, investigators had the participants complete structured self-assessment back pain questionnaires, including the Oswestry Low Back Pain measure and two Swedish spine assessment instruments.
Multilevel problems in weightlifters
All of the weightlifters and ice hockey players had signs of disc degeneration on MRI. There was severely reduced signal intensity in the discs of 13% of the athletes. The signal was completely absent in seven of 21 weightlifters (33%) and eight of 19 ice hockey players (42%). Many weightlifters had one or more discs with completely reduced signals, Swärd said.
Signal intensity was most frequently reduced at the thoracolumbar and lumbosacral junctions. Problems in these areas on MRI corresponded to back pain as identified by the questionnaires. “Disc degeneration, disc height reduction and disc bulging were significantly correlated with back pain,” Swärd said.
Next year, investigators plan to follow the same subjects to determine whether new spine abnormalities have developed and to identify and quantify any current back pain. “We think the important thing is to advise adolescents to take it easy and possibly not do any heavy competition and exercise until they are 16 or 17 years old in order to reduce abnormalities or trauma in the spine,” Baranto said.
For your information:
- Swärd L, Hellstrom M, Lundin O, Nyman R. Disc degeneration and abnormalities of the spine in top athletes. #176. Presented at the 2003 International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine Congress. March 10-14, 2003. Auckland, New Zealand.