Issue: March 2006
March 01, 2006
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Participation in ‘heavy’ sports shown to increase risk of disc degeneration

Issue: March 2006
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Hockey players, weightlifters and other athletes who consistently place heavy stress on their spine face a greater risk of disc degeneration and spine abnormalities than nonathletes.

A group of Swedish investigators used MRI to examine 71 randomly selected athletes competing at a national level. Their test results were then compared to those of a group of nonathletes who also underwent MRI examination. Researchers also asked participants to complete a self-assessed, structured questionnaire regarding back pain.

Most commonly, all types of abnormalities were found in ice hockey players and wrestlers, while thoracic and lumbar spine abnormalities were significantly higher in all athletes.

Researchers found disc degeneration more often in athletes (92%) than nonathletes (48%), but all of the weightlifters and hockey players displayed some type of disc degeneration, said Adad Baranto, MD, orthopedic surgeon at Gothenberg University in Sweden.

According to Baranto, 78% of the athletes (52 of 67) and 38% of the nonathletes (eight of 21) reported experiencing back pain at some point in their life, but there was no statistical correlation between the MRI findings and back pain.

“The etiology of disc degeneration is multifactorial, and factors that have been shown to be associated with its occurrence are age, gender, occupation, cigarette smoking, exposure to vehicular vibrations and sports with heavy loads on the spine,” he said. “Of course, age is still the major cause [of disc degeneration], but despite these reasons, athletes still have a high frequency of disc degeneration.”

Common problems

In this study, three of the problems found most commonly in athletes were: Scheuermann’s disease, which included having an irregular vertebral endplate, decreased disc height and one or more vertebrae wedged 5° or more; Schmorls’ node or herniations of the intervertebral disc through the vertebral endplate; and spondylolysis.

Baranto said these disc degeneration problems are not exclusive to athletes, but research has shown a higher occurrence among competitive athletes, “which is why we believe the main cause is trauma or overuse.” It is also possible to have each of these degenerative disc problems alone or simultaneously, and all can be diagnosed through MRI or X-ray.

Baranto said disc degeneration problems occurred most frequently in the thoracolumbar junction, specifically the lumbosacral junction. Also, “Results from the pain assessment showed that MRI-confirmed disc degeneration, disc height reduction and disc bulging were significantly correlated with back pain,” he added.

Due to the heavy training involved in off-season workouts as well as actual competition, hockey players and weightlifters are at particular risk for disc strain and stress. Baranto said flexion, extension and rotation loads could specifically cause disc degeneration.

“Hockey players had the highest frequency of disc degeneration, which is probably a reflection of the high energies involved in high-speed skating in combination with forceful contact [with the boards or other players], often in off-balance situations,” Baranto said.

Making it to the national level in sports requires a lifetime of intense training, which places an even greater stress on the spine, he added.

“MRI abnormalities occur during the growth spurt in young athletes and only deterioration of these abnormalities occur later in life,” Baranto said. “These results indicate that the growing spine is highly vulnerable to trauma.”