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Sport Related Back Injuries

by Christian Jacomine, PA-C


People of all age groups participate in competitive sport and recreational activity. Unfortunately, accidents occur in these activities with various injuries. The human spine can be the site of such injury. It is important to understand the types of injury that can occur. With this knowledge injuries can be reduced and in some cases prevented. Also of importance is to recognize when these injuries occur. Sports and recreational activities play a major role in injury of the spine. It is estimated that almost 15% of spine injuries in the United States are related to sport or recreational activity (Fayssoux and Rhee, 2012). The type of injury to the spine depends of the mechanisms and load on the spine with different activities showing different patterns of injury. These injuries include muscloligamentous injury, disk herniation, fracture, subluxation, dislocation, burners, and spinal cord injury.

Musculoligamentous injuries are injuries to the muscle and ligaments in and around the spine. These injuries are common in sport and are similar to whiplash injuries from motor vehicle accidents. They are usually caused by violent bending and/or rotation of the neck. These injuries are common in high impact and high speed activities such as football and skiing.

The participants wear helmets and the force is transmitted to the neck. These types of injuries to the mid-back and low back can occur in these activities as well. Disk herniation is not a common sports injury, but can occur. This type of injury can present as just neck or back pain, radiating pain to the arm or legs, injury to the spinal cord or a condition called cauda equina syndrome. These injuries are usually the result of pressure and twisting on the spine. Fractures, dislocations, and subluxations (partial dislocations) of the spine can occur depending on the mechanism of injury (Fayssoux and Rhee, 2012).

Injury to the nerves and spinal cord also occur in sport or recreational activity. One of the more common injuries to occur is neurapraxia. Neurapraxia is commonly known as a burner or stinger. This injury occurs from a traction or stretch injury to the nerves near the neck or arm. Up to 65% of college football players are affected during a four year college football career. These injuries can also occur in non-contact sports. A baseball player sliding head first into a base is a good example. Although a rare occurrence spinal cord injury injuries in sport and recreational activities are the second most common cause of spinal cord injury in developed countries. Injuries can include a complete disruption of the spinal cord or partial disruption. The location of the injury to the cord can have varying effects. Neurapraxia of the cervical cord can also occur. This can lead to a temporary paralysis. As previously stated, injury to the thoracolumbar cord can result from large disk herniations. This can occur in activities such as downhill skiing and snowboarding (Fayssoux and Rhee, 2012).

“The education and athletes, coaches, and referees in sport-specific dangers, the use of proper athletic equipment and safe venues, and the preparation of medical staff are all important to providing a safe environment for athletic competition (Fayssoux and Rhee, 2012).” Prevention of sport related back injury is aimed at decreasing the incidence and severity of injury to participants. Supervision, protective equipment, sport-specific athletic training, and preparation should all be considered to help prevent injury. If a suspected spine injury does occur the first goal is to prevent further damage. In order to do this a high index of suspicion needs to be present. Finally, a person with new severe neck pain, back pain, neurologic symptoms, or unconscious should be treated as an unstable spine fracture until proven otherwise (Fayssoux and Rhee, 2012).

Sport and recreation should be enjoyed and is a healthy past time for most people. Good judgment, awareness of potential injury, proper safety equipment and overall preparedness are a necessity. If a suspected injury does occur, remember the aim is to prevent further damage. Spine injuries are medical emergencies and need to be evaluated by qualified healthcare professionals.

Sources:
Fayssoux, R. S. & Rhee, J. M. (2012). Spine Injuries in Sports. In Rao, R. D. & Smuck, M. (Eds.), Othopedic Knowledge Update Spine (4th edition, pp.273-279). Rosemont, IL: American Academy of Orthopaedic Surgeons.