Back and spinal injuries: features of treatment and rehabilitation

According to the WHO, about 500 thousand people are exposed to spinal injuries every year in the world. At the same time, men of 20–29 years old and over 70 years old are in the group of greatest risk. In 90% of cases, the cause of problems with the spine is precisely the injury, and not another disease. As for athletes, they are subject to various kinds of spinal pathologies due to their professional activities. Thus, among the injuries of the musculoskeletal system in athletes, 11.5% is on the spine.

Among such injuries, acute spinal injuries account for 23.7%, including bruises (2.67%), damage to the capsular- ligamentous apparatus (3.88%), fractures and dislocations (7.63%), muscle damage (9, 52%). In the high-risk group are athletes involved in diving, gymnastics, figure skating, skiing, wrestling, hockey, basketball, football, weightlifting and athletics.

Consequences of spinal injuries

Unfortunately, often athletes who have suffered spinal injuries remain people with disabilities and can no longer continue their professional activities due to spinal cord injury, which occurs in 20-25% of cases. At the same time, in many cases the cause of disability is not so much the injury itself, but rather the incorrectly provided first aid, the unprofessional actions of doctors and late rehabilitation.

Those who managed to avoid the worst development of events can suffer for a long time, and sometimes their whole life, from pain in the place of injury or fracture. In some cases, spinal injuries cause the development of secondary pathologies and various chronic diseases: for example, deep vein thrombosis, urinary tract infections, bedsores, paresis (decreased muscle strength), limb paralysis, spasticity, respiratory system pathologies and other internal organs.

If the spinal cord was injured, the consequences, alas, may be disappointing. Of course, their severity is affected by the extensiveness of the injuries and their localization, the involvement of certain structures of the spinal cord. If only peripheral nerve cells that are responsible for the nearest organs and muscles were damaged , then serious consequences can be avoided – in this case, other, neighboring neurons will take over their functions.

Diseases and injuries of the musculoskeletal system in athletes in 45% of cases are degenerative. The most frequent are pathological changes in the vertebrae and tissues, such as intervertebral osteochondrosis, deforming arthrosis of the spinal joints, spondylosis. In 19.6% there is a deviation in the lumbosacral region.

Types of spinal injuries

Types of sports injuries of the spine are distinguished by localization (cervical, pectoral, lumbar, combined), by involvement of the spinal cord (with and without spinal cord damage), by depth (penetrating and non-penetrating, when the skin remains intact). There are also types of traumatic injury: contusion, dislocation, fracture, rupture.

The cervical spine is perhaps the most vulnerable: it is injured during diving, athletics competitions, powerlifting, various types of wrestling and gymnastics. In this case, sprains, pinched nerves, vertebral displacement and even a fatal fracture can occur. The most common diagnosis for neck injuries is a bruise of the cervical spine. Long jumpers often experience lumbar spine pathology due to flexion- extension deformity during a jump. Hammer throwers are characterized by damage to the back muscles, osteochondrosis, spondylosis and spondyloarthrosis of the spine. In motorcycle and bodybuilding, the lumbar spine is most often injured, and in the race car driver the chest area is affected. Climbers, in turn, often suffer from chronic pathologies: osteochondrosis, spondylosis, and lumbar and thoracic spondyloarthrosis. As we see, each sport has its own particular picture of injuries of the musculoskeletal system and, in particular, of the spine.

11.9% of spinal diseases are accounted for by athletes and representatives of various types of wrestling. The ligamentous apparatus of the cervical spine is most susceptible to disorders. In 70% of cases of injuries in the neck, lesions of the flexion mechanism occur , less frequently flexion-rotational and compressional injuries.

Signs of damage

The main signs of spinal injuries are reduced to back pain of different localization and symptoms of a neurological pathology. As a result of any injury, even if the spinal cord is not injured, swelling will occur at the site of injury, which will compress the nerve endings or the spinal cord itself. The most dangerous symptoms occur when the cervical spine is damaged: difficulty in breathing, heart irregularities and even paralysis of the limbs are possible. Less dangerous injuries are accompanied only by weakening the sensitivity and muscle strength of the limbs or other areas of the body. Muscle spasm may occur due to nerve damage, resulting in movement in the region of the cervical spine.

Thoracic injuries are accompanied by impaired sensitivity and pain in the chest, sometimes the legs, and breathing can also be difficult. Damage to the lumbar spine leads to weakening or paralysis of the lower limbs, reduced reflexes and spastic phenomena. It is also possible violations of the urogenital system.

Back injury treatment

An important condition after a back injury is the correct transportation of the patient (in most cases, the patient cannot be transported while sitting). In case of severe injuries, surgical intervention is required. The most important symptom that indicates the need for surgery is the increasing symptoms of a spinal cord lesion, which means its gradual compression. Immobilization (immobilization) is obligatory after operations. To relieve pain, blockades are carried out with the help of painkillers.

Useful information
Blockades are localized injections of painkillers that are injected directly into the lesion in order to stop the transmission of the pain impulse to the brain. Injections lead to muscle relaxation and restoration of their tone.

Treatment of the cervical region is reduced to complete rest and restriction of movements of the cervical region with the help of a collar. In the case of non-serious injuries, you can do a course of massage, special ointments, thermal procedures. A visit to a manual therapist may be necessary to reduce and stretch the vertebrae.

Rehabilitation after spinal injury

In order to eliminate or minimize the likelihood of complications, the course of rehabilitation should not be neglected even with minor injuries of the spine. It is better to take the rehabilitation program in a specialized center, where the attending physician will be able to prescribe the most effective recovery course and conduct a full-fledged MRI study to determine if the spinal cord has been damaged. Rehabilitation at home is highly undesirable, since the patient must be under constant medical supervision.

The rehabilitation program usually includes medication therapy, training on special simulators, performing a set of exercises (exercise therapy), dieting, various types of massage and manual therapy, physio , ergo , mechanotherapy, etc. The patient’s social, psychological and psychological adaptation is also important. . Each rehabilitation center offers its own set of methods, technologies and procedures for a full-fledged recovery, so when choosing a rehabilitation facility, you should personally familiarize yourself with all the possibilities that are provided to patients. The recovery period, depending on the severity of the problem, can last from several months to several years.

Preventive actions

Of course, not only an athlete, but also any person cannot be insured against back injuries, however, preventive measures can save in many cases. During training, care should be taken to ensure that the load on the spine is symmetrical, vertical and short-term (as much as possible). In addition, it is highly undesirable to expose the spine and especially the neck to excessive cooling and exposure to drafts. A special set of exercises to strengthen the spine will not be superfluous for everyone: it will allow you to evenly load and develop all parts of the spinal column. Finally, the most important condition: regular medical examination and immediate visit to the doctor in case of even the most insignificant back pain. Oddly enough, it is the latter condition that is often not fulfilled: athletes prefer to endure pain, considering it to be normal. However, this approach is fundamentally wrong. Inattention to pain can lead to serious illness in the future.

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