Wednesday, 15 August 2012

Silent spinal fractures in Olympic athletes

This month I wrote an article for the New Hamburg Independent looking at one downside to the very strenuous training some Olympic athletes go through.  It's a pretty basic summary of the issue, but a good start nonetheless.  Feel free to e-mail me or comment on the post if you have any questions.  Enjoy!

Silent spinal fractures in Olympic athletes

With the 2012 Olympic Games coming to a close,  it is a great time to be inspired by what the human body can achieve through hard work, discipline and complete dedication.  While this high volume of training helps these athletes perform at an unbelievable level, it also can potentially come with some negative implications.

Believe it or not, some of these athletes may be walking around with training-induced fractures in their spines, and not even know it. 

One of the more impressive events undoubtedly is gymnastics.  The strength and balance put on display by these athletes is astounding.   Yet, have you ever noticed how throughout many of their routines, the athletes rapidly bend backwards throughout their lower back?

While this repeated extension may score them more points, it also increases the odds of developing fractures and forward displacement of bones in their spine.  This condition is called spondolytic spondylolisthesis.

An intact spine showing the area that breaks (LEFT), The initial fracture (MIDDLE), The vertebrae sliding forward (RIGHT)
“A broken back” sounds quite scary, and it is associated with fears of paralysis among other issues.  However, contrary to what you may think, most types of spondylolisthesis are quite common and benign.   In fact, this type of fracture is so stable, many people are completely asymptomatic and have no idea their vertebrae are not intact.

If symptoms do occur, they most commonly include low grade low back pain, a low back that tends to have an accentuated curve into extension, and tight hamstring muscles.  Patients may also experience intermittent electrical shooting pain down the leg relating to pinching the nerve roots as they exit the spinal column. 

So how do gymnasts develop this condition?  It is thought that as these athletes train throughout their younger years, the repeated extension put through their spines causes microscopic stress fractures in a specific part of the vertebrae in their lower back.  These stress fractures, while completely benign individually, start to accumulate, and completely split the vertebrae in half. 

Interestingly, this condition is not exclusive to high-end athletes.   Similar conditions can develop relating to arthritis in older individuals, and even one-time traumatic events such as a bad fall, a tough hit in hockey, or even hitting the bottom of a shallow pool during a dive.  It can even be a congenital issue that you are born with.  So if you suffer from any of the symptoms above, and past treatments for your low back pain have failed, spondylolisthesis may be worth looking into as a possible explanation.

If you do suffer from a spondylolisthesis, and you are one of the individuals who experience associated symptoms, there is plenty you can do to help manage your condition.  In fact, most cases can be managed with some simple manual therapy and specific exercises that will help to target and stabilize the affected vertebrae.

For instance, the gymnasts who induce this injury with their training often have no symptoms at all during their competitive years.  It is only when they retire, and their core musculature starts to detrain that symptoms tend to arise.  Presumably, this is because the stability their muscles once provided is no longer there.

Spondylolisthesis is therefore a condition that more often than not can be managed without surgical interventions.  Like most types of low back pain, core musculature training goes a long way.  So do yourself a favour, use these amazing Olympic athletes as inspiration, and add some back exercises into your daily routine.

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