Disc Degeneration in Athletes

Lumbar Intervertebral Disc Degeneration in Athletes
Mika Hangai, MD, PhD
Koji Kaneoka, MD, PhD
Shiro Hinotsu, MD, PhD
Ken Shimizu, MD
Yu Okubo, PT
Shumpei Miyakawa, MD, PhD
Naoki Mukai, MD, PhD
Masataka Sakane, MD, PhD
Naoyuki Ochiai, MD, PhD

Background
Several studies have reported that physical loading related to competitive sports activities is associated with lumbar intervertebral disc degeneration. However, the association between types of sports activities and disc degeneration has not been clarified.

Hypothesis
The frequencies of disc degeneration may vary with the competitive sport because of the different postures and actions specific to each sport.

Study
Design Cross-sectional study (prevalence); Level of evidence, 3.
Methods Study participants were 308 well-trained university athletes (baseball players, basketball players, kendo competitors, runners, soccer players, swimmers) and 71 nonathlete university students (reference group). Disc degeneration was evaluated using T2-weighted magnetic resonance imaging. A self-reported questionnaire concerning low back pain was also conducted.

Results
The proportions of the participants who had disc degeneration among the baseball players (odds ratio, 3.23) and the swimmers (odds ratio, 2.95) were significantly higher than among the nonathletes using logistic regression analysis. When all patients were grouped together, the association between lifetime experience of low back pain and participants with disc degeneration was significant, and a linear association between the degree of severest low back pain experienced and participants with disk degeneration, analyzed by a Cochran-Mantel-Haenszel test, was also significant.

Conclusion
Continuous competitive baseball and swimming activities during youth may be associated with disc degeneration. Furthermore, the study indicates that the experience of severe low back pain might be a predictor of disc degeneration in youth. The authors hope that preventive measures and management to protect against disc degeneration and low back pain in athletes will be established by further studies based on these results.