It seems like every week brings news of another young athlete being severely injured or dying from injuries suffered while participating in organized sports. While football is blamed for many of these heart-breaking stories, many participants who are involved in hockey, soccer, gymnastics, lacrosse and cheerleading have also suffered traumatic injuries.
Amateur sports are supposed to teach life-lessons about the importance of teamwork, goal attainment and sportsmanship. They are not supposed to cause life-altering injuries in young athletes. The most prevalent injury among young athletes is a concussion. However, the incidence of spinal injuries has also risen considerably among this group.
Since Texas Back Institute is internationally recognized for knowledge in this area, we spoke with Dr. Michael Hisey, a spine surgeon at the clinic to get his thoughts on the problem and the prevention of spinal injuries. Dealing with this problem starts with understanding its extent.
The Numbers are Scary
The Center for Disease Control and Prevention (CDC), the federal agency charged with tracking public health issues in the U.S., estimates as many as 20,000 spinal-cord injuries occur annually. The agency adds that sports account for about 12 percent of these injuries and most of the new cases come from the 15 to 35 year old group.
The Medical Director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill, Dr. Robert Cantu, was quoted in a recent Wall Street Journal (9.16.13) article on this subject. While noting that the number of reported cervical-spine injuries leading to permanent or temporary neurological damage such as partial or complete paralysis remains small, this number appears to be rising. He notes new rules put into place in 1976 to discourage headfirst contact in football (known as “spearing”) are not consistently followed.
The Center’s Annual Survey of Catastrophic Football injuries in high school and college last year found that in four of the previous 10 years, the number of such injuries which led to some paralysis was in the double-digits (e.g. 14 in 2008) after dropping to the single digits throughout the 1990s. To understand what is causing this increase we talked with Dr. Hisey about what he and the other spine specialists at Texas Back Institute are seeing in their examining rooms.
Athletic Injuries of the Spine
Because of his specialization in spine surgery and the role that Texas Back Institute plays with professional sports teams such a FC Dallas, the Frisco Rough Riders and consulting with the Dallas Mavericks on back injuries, Dr. Hisey sees many young athletes after they have experienced various levels of trauma. As such, he is in an excellent position to offer some analysis on the problem and prevention of spinal injuries among young athletes.
The most common type of back injuries that Dr. Hisey treats among athletes are sprains and strains. While these can be painful and require the athlete to refrain from activity, they seldom lead to long-term disability and chronic pain. “However, injuries to the lower back in young athletes can lead to problems later in life,” he noted.
Dr. Hisey said, “Spondylosis is a condition which occurs most often among gymnasts and linemen in football. Because of the high impact that these two groups experience in their lower backs, a small type of fracture occurs and the bone in this area doesn’t seal up when it heals. At age 40 or so, these individuals, who are now adults, can experience considerable pain from this injury sustained when they were teens.”
He continued, “The best way to treat this condition is to accurately diagnose it when it occurs and curtail physical activity immediately. Later, a carefully considered rehabilitation program should be undertaken. Later in life, relieving this pain can require injections and even surgery to repair these slipping bones.”
Dr. Hisey noted other injuries that are common among young athletes. “Stingers, which are short-term, numbing pain that result from stretching nerves in the neck, are very common among young athletes. Whiplash, where a blow causes the head to go forward and the back and neck muscles stretch can also occur with frequency, particularly in sports such as football and hockey.”
“Fractures of the vertebrae are very uncommon in most sports activities. They are more likely to occur in sports such as cheerleading and equestrian sports such show jumping events and barrel racing,” Dr. Hisey said.
Always Use Caution
It has been noted by the National Athletic Trainers Association only two-thirds of U.S. secondary schools with athletic programs have access to full or part-time athletic trainers. This leaves hundreds of schools without emergency medical staff available for on-field emergencies. This put added pressure on coaches and parents to have knowledge of what should be done to avoid exacerbating a spinal injury.
“The most important action that can be taken if an athlete has been involved in a collision that could cause spinal cord damage is to immediately immobilize him or her until emergency medical personnel or a physician arrives. Secondary injuries or permanent paralysis can occur if a vertebra is broken and the spinal cord is damaged by moving the person.”
How can coaches and parents help young athletes avoid these spinal injuries? “Training in proper techniques of the sport is the best prevention tactic,” Dr. Hisey said. “If you play football, don’t lead with your head – either running with the ball or tackling. If you’re cheerleading, practice the proper way to fall. If you are a diver or gymnast, use proper safeguards such as harnesses to practice.”
Dr. Hisey is the team spine doctor for FC Dallas, the Major League Soccer team in the Dallas-Fort Worth area. He has seen many of these players after they have experienced injuries from games or practice. We asked him if a more mature player such as those on a pro team versus a high school team have more or fewer back injuries.
He said, “Actually, these FC Dallas players are about the same age as high school and college players and have very similar occurrences of back injuries. They have about the same number and types of sprains. However, since they have been playing more years, the wear and tear on their discs is more likely to cause overuse injuries such as herniated discs.”
In summing up his advice, Dr. Hisey said, “Good technique and outstanding conditioning will keep most spine injuries from occurring. However, every parent should know that when a young athlete plays at a high level in high school or college, he or she is at risk for injuries. Hopefully, these are just sprains and muscle strains, if they seem to be more serious, make an appointment to see a back specialist.”