By: Dale J. Buchberger, PT, DC, CSCS, DACBSP
The subject of “back spasms” has been prominent in the news recently because every Syracuse University Basketball fan wants to know when Jerami Grant will play again. According to almost every news outlet and sports reporting source he has not been playing because of “back spasms”. On March 8th, a disc jockey on the Auburn radio station 99.3 The Wall reported that “Jerami Grant’s back spasms are just one of those things that you have to let run its course”. The first thing that the sporting world needs to understand is that back spasms, is not a diagnosis. There is always a reason (be it mechanical, physiological, or both) for anyone to experience back spasms.
While it is rare for young athletes to experience these types back issues, it is not unheard of. When you have tall athletes that are fast, strong, and mobile, the forces on their bodies are magnified. When they twist or fall, everything is amplified. What we perceive on television to be a minor incident may have actually been quite forceful. Since the mechanism is usually multidirectional, several different structures can be injured at the same time, making it difficult to approximate the recovery time. While diagnostic tests such as MRI have revolutionized diagnostic medicine, not every disorder is visual. Many times the injury is a matter of function that renders the expensive test useless.
Degenerative joint disease and degenerative disc disease are common causes of back spasms in the older population but they are unlikely causes in the young, athletic population. It is not completely out of the question to have a young athlete with premature degenerative disc disease but it falls fairly low on the diagnostic totem pole. These conditions cause the surrounding muscles to overload and fatigue, resulting in a reactive spasm. Sometimes degenerative changes in the spine can compromise nerves exiting the spine and this nerve irritation results in the muscles going into spasm.
Younger athletes may have spondylolisthesis and/or spondylolysis of the lower back. These are spinal defects that the athlete may have been born with or possibly acquired through athletic activity. If the athlete has a preexisting “spondylo”, it can be aggravated through a fall and twist. Once it is symptomatic it can be quite slow to settle down enough to return to play. A “spondylo” can result in a slightly unstable segment of the lower lumbar spine segments. This instability causes the muscles of the back to prematurely fatigue and the fatigue results in spasm. Most of these cases are treated with strengthening the unstable segments and improving flexibility to the adjacent areas, such as the hips and legs.
A herniated disc is also a common injury to the lower back in high-level athletics. Long hours in the weight room, lifting heavy weight with quick motions repeatedly, pounding up and down the court, falling and twisting, etc., can add up over time and make athletes susceptible to disc damage and or herniation. Since the disc itself has nerve endings, any damage can send messages of irritation to the surrounding muscles resulting in spasm to protect the area. A herniation can put direct or indirect pressure on a specific exiting nerve and this can likewise send messages of protection to the surrounding muscles resulting in spasm.
The lumbar spine is quite complex in structure. There is an intricate network of muscles, tendons and ligaments that keep the lumbar spine structurally sound and mobile. The faster and more forceful an athletic endeavor is performed increases the chances of a small imbalance or defect rearing its head. So the faster an athlete performs, the more likely it will be to identify an imperfection. The faster you drive, the easier it is to figure out that your tires are out of balance. This is the case for high-level athletes.
Often times athletes are focused on getting bigger, stronger and faster that they forget to do simple things that can keep them playing and reduce injury risk. Take time to stimulate and strengthen the small muscles of the body that hold the system together. A motor with tons of horsepower can’t run without a solid frame. Athletes need a strong frame or stability system to match the horsepower they have developed.
With everything that a Division-I basketball program like SU does on a daily basis from conditioning to game planning, there are always things that individual athletes will need to do on their own because practice time is limited by the NCAA. Each athlete may have his or her own little imperfection that requires extra attention off the court. As far as Jerami Grant’s back spasms go, until the Syracuse University athletic department releases more information to the media, what we know about his back is that it hurts. Why he has back spasms remains a mystery to the public.