Lower Back – Is the most common site of back injuries in biathlon. Back is made of bones, muscles, ligaments and other tissue extending from neck to pelvis. Ligaments are tough, fibrous connecting tissues that connect the muscles to the joints. Damage to the muscles and ligaments in the low back can give rise to numerous injuries. There are two types of lower back injuries: 1) Muscle Strains 2) Lumbar Sprains. A muscle strain occurs when a muscle in the back is overstretched. A lumbar sprain occurs when ligaments are stretched too far. Back injuries can be prevented in biathletes by maintaining a healthy weight, using lower-back support when performing skiing, and wearing protective clothing.
Parts of the Back - The spine is a complex structure of bones with four segments- the sacrum (tailbone area), lumbar (lower spine), thoratic (middle spine), and cervical (upper spine). The disks (intervertebral) that lie between the vertebrae absorb shock and resist compression during activity. The muscles of the trunk and neck attach to the spine and provide both a wide range of movement and some much needed stability.
Anatomy - There are two mechanism of the typical lower back strain in sports activities. The first happens from a sudden extension contraction on an overloaded, unprepared, or underdeveloped spine, usually in combination with trunk rotation. The second is the chronic strain, commonly associated with faulty posture, that involves excessive lumbar lordosis. However, other postures such as flatback posture or scoliosis can also predispose an athlete to strain.
Diagnosis - Evaluation should be preformed immediately after injury to rule out the possiblity of fracture. Discomfort in the low back may be diffused or localized in the one area. In the case of muscle strain, pain will be present on active extension and with passive flexion. There is no radiating pain farther than the buttocks or thigh and no neurological involvement that causes muscle weekness, sensation impairment, or reflex impairments.
Treatment - In the acute phase of this injury, it is essential that cold packs and/or ice massage be used intermittently throughout the day to decrease muscle spasm. An elastic wrap or corset-type brace will help to compress th area. A graduated program of stretching and strengthening begins slowly during the acute stage. Progressive strengthening exercises should concentrate on extension, whereas stretching should focus on both flexion and extension. Injuries of moderate-to-severe intensity may require complete bed rest to help break the pain-muscle spasm cycle. The physician may prescribe oral analgesic medication. Cryotherapy, ultrasound, and an abdominal support are often beneficial following the acute phase. Exercise must not cause pain. Proper exercise and flexibility programs are necessary for the muscles surrounding and supporting the spine, especially the abdominal muscles.
Herniated Disc - Disc herniation describes the protusion of the gelatinous material of the disc (nucleus pulposus) through the annulus fibrosis. Several studies have shown gradual resorption and disappearance of herniated discs on serial MRIs with out surgical intervention. The larger disc herniations were found to have had more resorption. This favorable natural history shows why up to 50% of patients with confirmed, painful herniated discs recover
Return to Activity - The athlete can return to play after the pain goes away and are not having any trouble any more.
Parts of the Back - The spine is a complex structure of bones with four segments- the sacrum (tailbone area), lumbar (lower spine), thoratic (middle spine), and cervical (upper spine). The disks (intervertebral) that lie between the vertebrae absorb shock and resist compression during activity. The muscles of the trunk and neck attach to the spine and provide both a wide range of movement and some much needed stability.
Anatomy - There are two mechanism of the typical lower back strain in sports activities. The first happens from a sudden extension contraction on an overloaded, unprepared, or underdeveloped spine, usually in combination with trunk rotation. The second is the chronic strain, commonly associated with faulty posture, that involves excessive lumbar lordosis. However, other postures such as flatback posture or scoliosis can also predispose an athlete to strain.
Diagnosis - Evaluation should be preformed immediately after injury to rule out the possiblity of fracture. Discomfort in the low back may be diffused or localized in the one area. In the case of muscle strain, pain will be present on active extension and with passive flexion. There is no radiating pain farther than the buttocks or thigh and no neurological involvement that causes muscle weekness, sensation impairment, or reflex impairments.
Treatment - In the acute phase of this injury, it is essential that cold packs and/or ice massage be used intermittently throughout the day to decrease muscle spasm. An elastic wrap or corset-type brace will help to compress th area. A graduated program of stretching and strengthening begins slowly during the acute stage. Progressive strengthening exercises should concentrate on extension, whereas stretching should focus on both flexion and extension. Injuries of moderate-to-severe intensity may require complete bed rest to help break the pain-muscle spasm cycle. The physician may prescribe oral analgesic medication. Cryotherapy, ultrasound, and an abdominal support are often beneficial following the acute phase. Exercise must not cause pain. Proper exercise and flexibility programs are necessary for the muscles surrounding and supporting the spine, especially the abdominal muscles.
Herniated Disc - Disc herniation describes the protusion of the gelatinous material of the disc (nucleus pulposus) through the annulus fibrosis. Several studies have shown gradual resorption and disappearance of herniated discs on serial MRIs with out surgical intervention. The larger disc herniations were found to have had more resorption. This favorable natural history shows why up to 50% of patients with confirmed, painful herniated discs recover
Return to Activity - The athlete can return to play after the pain goes away and are not having any trouble any more.