Skip to main content
SpringerLink
Log in

The Thoracolumbar Spine in Young Elite Athletes

Current Concepts on the Effects of Physical Training

  • Injury Clinic
  • Published:
Sports Medicine Aims and scope Submit manuscript

Summary

Due to the increased interest in physical fitness and to the fact that athletes start their training at younger ages the risk for injuries to the growing individual has increased. The spine, as with the rest of the skeleton, is at greater risk of injury during growth, especially during the adolescent growth spurt.

Back pain is more common among athletes participating in sports with high demands on the back than other athletes and nonathletes.

Disc degeneration, defined as disc height reduction on conventional radiographs and reduced disc signal intensity on MRI, has been found in a higher frequency among wrestlers and gymnasts than nonathletes.

Abnormalities of the vertebral bodies including abnormal configuration, Schmorl’s nodes and apophyseal changes are common among athletes. These abnormalities are similar to those found in Scheuermann’s disease. Athletes with these types of abnormalities have more back pain than those without.

Spondylolysis has been found in higher frequencies than expected among athletes representing many different sports. Spondylolysis has been reported in up to 50% of athletes with back pain.

Scoliosis has been found in up to 80% of athletes with an asymmetric load on the trunk and shoulders, such as javelin throwers and tennis players. The scoliosis, however, is a small curvature and does not cause back pain.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Alexander CJ. Effect of growth rate on the strength of the growth plate-shaft junction. Skeletal Radiology 1: 67–76, 1976

    Article  Google Scholar 

  • Alexander CJ. Scheuermann’s disease. A traumatic spondylodystrophy? Skeletal Radiology 1: 209–221, 1977

    Article  Google Scholar 

  • Andersson GBJ, Schultz A, Nathan A, Irstam L. Roentgenographic measurement of lumbar intervertebral disc height. Spine 6: 154–158, 1981

    Article  PubMed  CAS  Google Scholar 

  • Arkin AM, Katz JF. The effects of pressure on epiphyseal growth. Journal of Bone and Joint Surgery 38A: 1056–1076, 1956

    Google Scholar 

  • Beadle OA. The intervertebral discs: observations on their normal and morbid anatomy in relation to certain spinal deformities. Medical Research Council 161: 1–79, 1931

    Google Scholar 

  • Begg AC. Nuclear herniations of the intervertebral disc. Journal of Bone and Joint Surgery 36B: 180–193, 1954

    Google Scholar 

  • Bick EM, Copel JW. The ring apophyse of the human vertebra. Journal of Bone and Joint Surgery 33A: 783–787, 1951

    Google Scholar 

  • Blumenthal SL, Roach J, Herring JA. Lumbar Scheuermann’s: a clinical series and classification. Spine 12: 929–932, 1987

    Article  PubMed  CAS  Google Scholar 

  • Bobest M, Furó I, Tompa K, Pócsik I, Kuncz A. A nuclear magnetic resonance study of intervertebral discs: a preliminary report. Spine 11: 709–711, 1986

    Article  PubMed  CAS  Google Scholar 

  • Boone D, Parsons D, Lachmann SM, Sherwood T. Spina bifida occulta: lesion or anomaly? Clinical Radiology 36: 159–161, 1985

    Article  PubMed  CAS  Google Scholar 

  • Brown TD, Yost RP, McCarron RF. Lumbar ring apophyseal fracture in an adolescent weightlifter. American Journal of Sports Medicine 18: 533–535, 1990

    Article  Google Scholar 

  • Burwell RG, James NJ, Johnson F, Webb JK, Wilson YG. Standardized trunk asymmetry scores: a study of back contour in healthy school children. Journal of Bone and Joint Surgery 65B: 452–463, 1983

    Google Scholar 

  • Caine DJ, Lindner KJ. Overuse injuries of growing bones: the young female gymnast at risk? Physician and Sportsmedicine 13: 51–64, 1985

    Google Scholar 

  • Coventry MB, Ghormley RK, Kernohan JW. The intervertebral disc: its microscopic anatomy and pathology: part II. Journal of Bone and Joint Surgery 27: 233–247, 1945

    Google Scholar 

  • Coventry MG, Ghormley RK, Kernohan JW. The intervertebral disc: its microscopic anatomy and pathology: part III. Journal of Bone and Joint Surgery 27: 460–474, 1945

    Google Scholar 

  • Cyron BM, Hutton WC. The fatigue strength of the lumbar neural arch in sondylolysis. Journal of Bone and Joint Surgery 60B: 234–238, 1978

    Google Scholar 

  • Dzioba RB, Gervin A. Irreversible spinal deformity in Olympic gymnasts. Orthopaedic Transactions 8(1): 66, 1984

    Google Scholar 

  • Edgdren W, Vainio S. Osteochondrosis juvenilis lumbalis. Acta Chirurgica Scandinavica (Suppl. 227): 1–47, 1957

    Google Scholar 

  • Ehrenhaft JL. Development of the vertebral column as related to certain congenital and pathological changes. Surgery, Gynecology and Obstetrics 76: 282–292, 1943

    Google Scholar 

  • Endler M, Haber P, Hofner W. Wirbelsäulenvaränderungen und ihre Mechanopathologie bei Leistungsruderern. Zeitschrift für Orthopädie und ihre Grenzgebiete 118: 81–100, 1980

    Article  Google Scholar 

  • Falter EW, Aigner R, Hellerer O, Frey KW. Wirbelsäulenschäden bei jugendlichen Hochleistungsturnern. Fortschritte der Medizin 99: 145–148, 1981

    PubMed  CAS  Google Scholar 

  • Ferguson RJ, McMaster JH, Stanitski CI. Low back pain in college football linemen. Journal of Sports Medicine 2: 63–69, 1974

    Article  PubMed  CAS  Google Scholar 

  • Fidas A, MacDonald HL, Elton RA, Wild SR, Chisholm GD, et al. Prevalence and patterns of spina bifida occulta in 2707 normal adults. Clinical Radiology 38: 537–542, 1987

    Article  PubMed  CAS  Google Scholar 

  • Fredrickson BE, Barker D, McHolick WJ, Yuan HA, Lubicky JP. The natural history of spondylosis and spondylolisthesis. Journal of Bone and Joint Surgery 66A: 699–707, 1984

    Google Scholar 

  • Frymoyer JW, Newberg A, Pope MH, Wilder DG. Clements J, et al. Spine radiographs in patients with low-back pain. Journal of Bone and Joint Surgery 66A: 1048–1055, 1984

    Google Scholar 

  • Ghelman B, Freiberger RH. The limbus vertebra: an anterior disc herniation demonstrated by discography. American Journal of Roentgenology 127:. 854–855, 1976

    PubMed  CAS  Google Scholar 

  • Gibson MJ, Buckley J, Mawhinney R, Mulholland RC, Worthington BS. Magnetic resonance imaging and discography in the diagnosis of disc degeneration. Journal of Bone and Joint Surgery 68B: 369–373, 1986

    Google Scholar 

  • Granhed H, Morelli B. Low-back pain among retired wrestlers and heavyweight lifters. American Journal of Sports Medicine 16: 530–533, 1988

    Article  PubMed  CAS  Google Scholar 

  • Greene TL, Hensinger RN, Hunter LY. Back pain and vertebral changes simulating Scheuermann’s disease. Journal of Pediatric Orthopaedics 5: 1–7, 1985

    Article  PubMed  CAS  Google Scholar 

  • Gussbacker A, Rompe G. Die dyanmische und statische Beanspruchung der Wirbelsäule und ihre möglichen Auswirkungen bei verschiedenen Sportarten. Schweizerische Zeitschrift für Sportmedizin 31: 119–124, 1983

    Google Scholar 

  • Hansson T, Roos B. The amount of bone minteral and Schmorl’s nodes in lumbar vertebrae. Spine 8: 266–271, 1983

    Article  PubMed  CAS  Google Scholar 

  • Hellstadius A. A contribution to the question of the origin of anterior paradiscal defects and so-called persisting apophyses in the vertebral bodies. Acta Orthopaedica Scandinavica 18: 377–386, 1949

    Article  CAS  Google Scholar 

  • Hellström M, Jacobsson B, Swärd L, Peterson L. Radiological abnormalities in the spine of top athletes. Acta Radiologica 31: 127–132, 1990

    Article  PubMed  Google Scholar 

  • Hichey DS, Aspden RM, Hukins DWL, Jenkins JPR, Isherwood I. Analysis of magnetic resonance images from normal and degenerative lumbar intervertebral discs. Spine 11: 702–708, 1986

    Article  Google Scholar 

  • Hilton RC, Ball J, Benn RT. Vertebral end-plate lesions (Schmorl’s nodes) in the dorsolumbar spine. Annals of Rheumatic Disease 35 (2): 127–132, 1976

    Article  CAS  Google Scholar 

  • Horal J. The clinical appearance of low back disorders in the city of Gothenburg, Sweden. Acta Orthopaedica Scandinavica (Suppl. 118): 1–109, 1969

    PubMed  CAS  Google Scholar 

  • Horal J, Nachemson A, Scheller S. Clinical and radiological long term follow-up of vertebral fractures in children. Acta Orthopaedica Scandinavica 43: 491–503, 1972

    Article  PubMed  CAS  Google Scholar 

  • Home J, Cockshott WP, Shannon HS. Spinal column damage from water ski jumping. Skeletal Radiology 16: 612–616, 1987

    Article  Google Scholar 

  • Hult L. The Munkfors investigation. Acta Orthopaedica Scandinavica (Suppl. 16): 1–76, 1954

    PubMed  CAS  Google Scholar 

  • Hult L. Cervical, dorsal and lumbar spinal syndromes. Acta Orthopaedica Scandinavica (Suppl. 17): 1–99, 1954

    PubMed  CAS  Google Scholar 

  • Jackson DW, Wiltse LL. Cirincione RJ. Spondylolysis in the female gymnast. Clinical Orthopaedics and Related Research 117: 68–73, 1976

    PubMed  Google Scholar 

  • Jackson DW. Low back pain in young athletes: evaluation of stress reaction and discogenic problems. American Journal of Sports Medicine 7: 364–366, 1979

    Article  PubMed  CAS  Google Scholar 

  • Jackson DW, Wiltse LL, Dingeman RD, Hayes M. Stress reactions involving the pars interarticularis in young athletes. American Journal of Sports Medicine 9: 304–312, 1981

    Article  PubMed  CAS  Google Scholar 

  • Kono S, Hayashi N, Kasahara T, Akimoto T, Kaneko F, et al. A study of the etiology of spondylolysis with reference to athletic activities. Journal of the Japanese Orthopaedic Association 49: 125–133, 1975

    Google Scholar 

  • Kozar B, Lord RM. Overuse injury in the young athlete: reasons for concern. Physician and Sportsmedicine 11: 116–122, 1983

    Google Scholar 

  • Kozlowski K. Anterior intervertebral disc herniations in children. Pediatric Radiology 6: 32–35, 1977

    Article  PubMed  CAS  Google Scholar 

  • McCall IW, Park WM, O’Brien JP, Seal V. Acute traumatic intraosseous disc herniation. Spine 10: 134–137, 1985

    Article  PubMed  CAS  Google Scholar 

  • McCarrol JR, Miller JM, Ritter MA. Lumbar spondylolysis and spondylolisthesis in college football players. American Journal of Sports Medicine 14: 404–406, 1984

    Google Scholar 

  • Mészáros J, Mohácsi J, Frenkl L, Szabó T, Szmodis J. Age dependency in the development of motor performance. In Rutenfranz et al. (Eds) Children and exercise XII, pp. 347–354, Human Kinetics Champaign, Ill., 1986

    Google Scholar 

  • Meyerding HW. Spondylolisthesis. Surgery, Gynecology and Obstetrics 54: 371–377, 1932

    Google Scholar 

  • Modic MT, Pavlicek W, Weinstein MA, Boumphrey F, Ngo F, et al. Magnetic resonance imaging of intervertebral disk disease. Radiology 152: 103–111, 1984

    PubMed  CAS  Google Scholar 

  • Nachemson A. Lumbar intradiscal pressure: experimental studies on post-mortem material. Acta Orthopaedica Scandinavica (Suppl. 43): 1–104, 1960

    PubMed  CAS  Google Scholar 

  • Ogilvie JW, Sherman J. Spondylolysis in Scheuermann’s disease. Spine 12: 251–253, 1987

    Article  PubMed  CAS  Google Scholar 

  • Resnick D. Degenerative diseases of the vertebral column. Radiology 156: 3–14, 1985

    PubMed  CAS  Google Scholar 

  • Roaf R. A study of the mechanics of spinal injuries. Journal of Bone and Joint Surgery 42B: 810–823, 1960

    Google Scholar 

  • Roche MB, Rowe GG. The incidence of separate neural arch and coincident bone variations. Journal of Bone and Joint Surgery 34A: 491–494, 1952

    Google Scholar 

  • Rogge CWL, Nieman A. Isolated and atypical manifestations of Scheuermann’s disease. Archivum Chirurgicum Neerlandicum 28: 140–160, 1976

    Google Scholar 

  • Rossi F. Spondylolysis, spondylolistheis and sports. Journal of Sports Medicine and Physical Fitness 18: 317–340, 1978

    PubMed  CAS  Google Scholar 

  • Salter RB, Harris WR. Injuries involving the epiphyseal plate. Journal of Bone and Joint Surgery 45A: 587–622, 1963

    Google Scholar 

  • Scheuermann H. Kyfosis dorsalis juvenilis. Ugeskrift for Laeger 82: 385–393, 1920

    Google Scholar 

  • Schmorl G, Junghans H. The human spine in health and disease, 2nd ed., Grune & Stratton, New York, 1971

    Google Scholar 

  • Schneiderman G, Flannigan B, Kingston S, Thomas J, Dillin WH, et al. Magnetic resonance imaging in the diagnosis of disc degeneration: Correlation with discography. Spine 12: 276–281, 1987

    Article  PubMed  CAS  Google Scholar 

  • Stewart TD. The age incidence of neural-arch defects in Alascan natives, considered from the standpoint of etiology. Journal of Bone and Joint Surgery 35A: 937–950, 1953

    Google Scholar 

  • Stokes IAF, Moreland MS. Measurement of the shape of the surface of the back in patients with scoliosis. Journal of Bone and Joint Surgery 69A: 203–211, 1987

    Google Scholar 

  • Swård L, Hellström M, Jacobsson B, Nyman R, Peterson L. Acute injury of the vertebral ring apophysis and intervertebral disc in adolescent gymnasts. Spine 15: 144–148, 1990

    Article  PubMed  Google Scholar 

  • Swård L, Hellström M, Jacobsson B, Nyman R, Peterson L. Disc degeneration and associated abnormalities of the spine in elite gymnasts: A magnetic resonance imaging study. Spine 16: 437–443, 1991

    Article  PubMed  Google Scholar 

  • Swård L, Hellström M, Jacobsson B, Peterson L. Spondylolysis and the sacro-horizontal angle in athletes. Acta Radiologica 30: 359–364, 1989

    Article  PubMed  Google Scholar 

  • Swård L, Hellström M, Jacobsson B, Peterson L. Back pain and radiological changes in the thoraco-lumbar spine of athletes. Spine 15: 124–129, 1990

    Article  PubMed  Google Scholar 

  • Swård L, Hellström M, Jacobsson B, Peterson L. Anthropometric characteristics, passive hip flexion and spinal mobility in relation to back pain in athletes. Spine 15: 376–382, 1990

    Article  PubMed  Google Scholar 

  • Szot Z, Boron Z, Galaj Z. Overloading changes in the motor system occurring in elite gymnasts. International Journal of Sports Medicine 6: 36–40, 1985

    Article  PubMed  CAS  Google Scholar 

  • Sörensen KH. Scheuermann’s juvenile kyphosis. Thesis, Munksgaard, Copenhagen, Denmark 1964

    Google Scholar 

  • Taillard WF. Etiology of spondylolisthesis. Clinical Orthopaedics and Related Research 117: 30–39, 1976

    PubMed  Google Scholar 

  • Tertti M, Paajanen H, Kujala UM, Alanen A, Salmi TT, et al. Disc degeneration in young gymnasts. American Journal of Sports Medicine 18: 206–208, 1990

    Article  PubMed  CAS  Google Scholar 

  • Torgerson WR. Dotter WE. Comparative roentgenographic study of the asymptomatic and symptomatic lumbar spine. Journal of Bone and Joint Surgery 58A: 850–853, 1976

    Google Scholar 

  • Troup JDG. Mechanical factors in spondylolisthesis and spondylolysis. Clinical Orthopaedics and Related Research 117: 59–67, 1976

    PubMed  Google Scholar 

  • Troup JDG. The etiology of spondylolysis. Orthopedic Clinics of North America 8: 57–64, 1977

    PubMed  CAS  Google Scholar 

  • Wassman K. Kyphosis Juvenilis Scheuermann — an occupational disorder. Acta Orthopaedica Scandinavica 21: 65–74, 1946

    Google Scholar 

  • Wiltse LL, Widell EH, Jackson DW. Fatigue fracture: the basic lesion in isthmic spondylolisthesis. Journal of Bone and Joint Surgery 57A: 17–22, 1975

    Google Scholar 

  • Wilcox PG, Spencer CW. Dorsolumbar kyphosis or Scheuermann’s disease. Clinics in Sports Medicine 5: 343–351, 1986

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Östra Hospital, S-416 85, Gothenburg, Sweden

    Leif Swārd

Authors
  1. Leif Swārd
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Swārd, L. The Thoracolumbar Spine in Young Elite Athletes. Sports Medicine 13, 357–364 (1992). https://doi.org/10.2165/00007256-199213050-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199213050-00005

Keywords

Search

Navigation