A review of the current Major League Baseball disabled list reveals five players out of action due to injuries affecting the low back.
Low back injuries involve the elements that make up the lower spine in addition to the muscles that provide support and strength. Due to the amount of sports-related repetitious movement involving the low back, injuries are common and very disabling.
The lumbo-sacral spine consists of five bony, lumbar vertebrae and the sacrum. Each vertebra is separated by a cartilaginous disc to provide a cushion. The entire structure is held together by a series of ligaments.
This elaborate design protects the spinal nerves contained within the bony spinal canal. These nerves exit the canal via small holes called foramina and proceed to provide sensory and motor function to the lower extremities.
The low back musculature connects the lower ribs, spine, pelvis and sacrum. It is the muscular system that provides the strength and stamina necessary for repeated movement.
The most common sports-related injuries are caused by sudden impact that compresses the spine and twisting injuries due to torque placed on the muscles and ligaments.
Low back strain results from torn muscle fibers. These injuries are best managed conservatively with rest, anti-inflammatory medications and physical therapy. Baseball players and especially pitchers are prone to these injuries given the need to generate throwing power by twisting.
Injuries that involve the intervertebral discs can result in breakage of the disc and protrusion of the broken piece. If the herniated disc compresses the spinal nerve, the athlete may experience symptoms of weakness, sensory loss and severe pain.
Treatment may involve decompressive surgery and a long rehabilitation. A rigorous regimen of stretching and back strengthening exercises often referred to as a “back program,” is the best way to avoid time on the disabled list.