Association
between adolescent sport activity and lumbar disc degeneration among young
adults.
between adolescent sport activity and lumbar disc degeneration among young
adults.
Takatalo J,
Karppinen J, Nayha S, Taimela, Ninimaki J, Sequeiros RB, Tammelin T, Auvinen J,
and Tervonen O. Mohtadi N, Barber R, Chan D, and Paolucci EO. Scan J Med Sci Sports. 2017. [Epub Ahead of Print].
Karppinen J, Nayha S, Taimela, Ninimaki J, Sequeiros RB, Tammelin T, Auvinen J,
and Tervonen O. Mohtadi N, Barber R, Chan D, and Paolucci EO. Scan J Med Sci Sports. 2017. [Epub Ahead of Print].
Take
Home Message: Survey participants who reported frequently running and swimming had
greater signs of lumbar disc degeneration than those participants who were
inactive in those sports.
Home Message: Survey participants who reported frequently running and swimming had
greater signs of lumbar disc degeneration than those participants who were
inactive in those sports.
Greater involvement in sports is a risk
factor for long-term degeneration of lumbar intervertebral discs. Understanding
the impact of sport involvement in lumbar disc degeneration will help
clinicians develop strategies to mitigate the impact of sport on lumbar disc
degeneration. Therefore, Takatalo and colleagues evaluated the association between
sport involvement and lumbar disc degeneration in an exploratory study. A total
of 9,479 children were identified via the Northern Finland Birth Cohort
(expected birth between July 1985 and June 1986). Participants received 2
surveys of sporting activity when they were 16 and 18 years old respectively. The
authors invited participants who responded to both surveys (1987 participants) to
a physical examination and magnetic resonance imaging. A total of 558
participants completed both surveys and completed the magnetic resonance imaging.
Magnetic resonance images were grades on a scale of grades 0-5 (0-2 = normal,
3-5 = LDD) by 2 blinded musculoskeletal radiologists. Researchers controlled
for body mass index, lifestyle factors, other sports, and socioeconomic status.
Overall, 301 (54%) participants were classified with lumbar disc degeneration. Highly
active runners/joggers (> 2 times/week) were 3 more likely to have greater
lumbar disc degeneration than inactive participants. Furthermore, highly active
swimmers were 5 more likely to have greater lumbar disc degeneration than
inactive participants. Skaters were less likely to have lumbar disc
degeneration.
factor for long-term degeneration of lumbar intervertebral discs. Understanding
the impact of sport involvement in lumbar disc degeneration will help
clinicians develop strategies to mitigate the impact of sport on lumbar disc
degeneration. Therefore, Takatalo and colleagues evaluated the association between
sport involvement and lumbar disc degeneration in an exploratory study. A total
of 9,479 children were identified via the Northern Finland Birth Cohort
(expected birth between July 1985 and June 1986). Participants received 2
surveys of sporting activity when they were 16 and 18 years old respectively. The
authors invited participants who responded to both surveys (1987 participants) to
a physical examination and magnetic resonance imaging. A total of 558
participants completed both surveys and completed the magnetic resonance imaging.
Magnetic resonance images were grades on a scale of grades 0-5 (0-2 = normal,
3-5 = LDD) by 2 blinded musculoskeletal radiologists. Researchers controlled
for body mass index, lifestyle factors, other sports, and socioeconomic status.
Overall, 301 (54%) participants were classified with lumbar disc degeneration. Highly
active runners/joggers (> 2 times/week) were 3 more likely to have greater
lumbar disc degeneration than inactive participants. Furthermore, highly active
swimmers were 5 more likely to have greater lumbar disc degeneration than
inactive participants. Skaters were less likely to have lumbar disc
degeneration.
We can take from this study that some
activities (e.g., highly active running and swimming) may have detrimental
effects on lumbar discs, while other activities may be protective (skating). It
should be noted that this study was exploratory in nature and did not attempt
to quantify how much activity would elicit these effects. This limits clinicians
from using the current study to influence clinical decision making or
counseling. This dose-response association should be looked at further to
better help clinicians, parents and athletes fully grasp the impact that
certain sports have on lumbar disc degeneration. In the meantime, clinicians
should take note that some athletes may be a greater risk for lumbar disc
degeneration before 20 years of age. It may be beneficial to ensure these
athletes are participating in strengthening programs that may help reduce their
chances of developing low back pain. We may need low back pain prevention
programs for athletes in certain sports much like how we’ve deployed lower
extremity injury prevention programs.
activities (e.g., highly active running and swimming) may have detrimental
effects on lumbar discs, while other activities may be protective (skating). It
should be noted that this study was exploratory in nature and did not attempt
to quantify how much activity would elicit these effects. This limits clinicians
from using the current study to influence clinical decision making or
counseling. This dose-response association should be looked at further to
better help clinicians, parents and athletes fully grasp the impact that
certain sports have on lumbar disc degeneration. In the meantime, clinicians
should take note that some athletes may be a greater risk for lumbar disc
degeneration before 20 years of age. It may be beneficial to ensure these
athletes are participating in strengthening programs that may help reduce their
chances of developing low back pain. We may need low back pain prevention
programs for athletes in certain sports much like how we’ve deployed lower
extremity injury prevention programs.
Questions for Discussion: Have you encountered patients
in this age range with lumbar
disc degeneration? If so, do you believe their activity was a factor in lumbar disc degeneration development?
in this age range with lumbar
disc degeneration? If so, do you believe their activity was a factor in lumbar disc degeneration development?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban
Related Posts:
Back on Track? – What Effect does Vertical Traction have on Chronic Low Back Pain?
Takatalo, J., Karppinen, J., Näyhä, S., Taimela, S., Niinimäki, J., Blanco Sequeiros, R., Tammelin, T., Auvinen, J., & Tervonen, O. (2017). Association between adolescent sport activities and lumbar disc degeneration among young adults Scandinavian Journal of Medicine & Science in Sports DOI: 10.1111/sms.12840
This is an interesting topic and one that I have often wondered about. In my experience with collegiate athletes, I have observed more American football players, specifically offensive linemen, struggle with disc pathologies. Because of my own clinical experiences, I was surprised to see the results of this study suggest lumbar disc degeneration may be associated with running and swimming at least twice a week. However, the authors did address the lack of popularity of American football in Finland as being a limitation to the generalizability of their results.
Overall, I agree that this article does little to impact clinical practice and I am skeptical of the results. Although running, swimming, and to a lesser degree, floorball, were found to be significant, the confidence intervals are wide indicating less precision. On a different note, the authors omitted posture from their analysis and I believe it deserves some consideration. The authors only discussed posture as it relates to a working environment and excluded it on the premise of low work exposure in young adults. However, forward head posture, thoracic kyphosis, lumbar lordosis, or scoliosis as observed in a standing position alter the dispersion of forces down the spinal column and subsequently, the integrity of intervertebral discs. All in all, I second the need for a dose-response exploration…correlation does not mean causation.
B_Green,
Thanks for the comment. I think many of your points are very sound. I think factoring in posture is the most important factor here. I also think that controlling for the level of activity could be helpful in understanding the role of activity. In your clinical experience, do you feel that you have noticed any specific postural deficits that may be linked to disc pathology? Thanks again for the great comment and I look forward to hearing more about your clinical experience with this.
Kyle Harris