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LOW BACK PAIN IN ATHLETS -ELEMENTS OF FUNCTIONAL ANATOMY

Saturday, 27 November, 2010 - 08:20
Group 1 - 3

Εισαγωγή

Low back pain is a common complaint of athletes, and accurate diagnosis is essential, since many causes of back problems can lead to disability. If the obvious mechanical causes, such as muscle strain, "kissing spines," and leg-length inequality, have been ruled out, the more serious sources of low back pain, such as disk herniation, Scheuermann's disease, compression fractures of the vertebral body, and stress fractures of the posterior elements, should be considered. Treatment goals for all these disorders include pain relief and prevention of further injury .Aim of this study was to evaluate and to present the basic elements of functional anatomy of low back pain in athlets The vertebrae are separated by vertebral discs that are composed of a gel substance surrounded by outer collagen fibers, which are arranged in a crossed manner. These discs are further supported by the anterior and posterior longitudinal ligaments. Together, the vertebral disc complex resists spinal compression. During axial rotation of the spine, the annular fibers are placed at a mechanical disadvantage. Furthermore, in forward flexion, the anterior vertebral endplates approximate, increasing the pressure of the disc posteriorly. The most common disc herniation is directed posteriorly toward the foraminal window, where the nerve roots exit the spinal canal. As such, a common mechanism of herniation in athletes is combined flexion, rotation, and compression of the spine. There are some sports in which this injury mechanism commonly occurs.In the presence of a disc herniation, forward flexion worsens the herniation. In extension, the opposite occurs. The posterior vertebral endplates approximate, forcing the disc anteriorly, to reduce the herniation. The anatomic structures that have been implicated as pain generators include the vertebral discs, nerve roots, ligaments, zygapophysial joints, sacroiliac joints, and the musculature. Some studies suggest that discogenic pain secondary to annular disruption is the most common cause of LBP vascularized granulation tissue with innervation along a torn annulus fibrosis is thought to be the cause. Inflammatory factors caused by the leakage of nuclear material from annular tears can delay intradiscal tissue healing. These factors include matrix metalloproteinases , phospholipase A2, cyclooxygenase, prostaglandins, nitric oxide, cytokines, interleukins, and macrophages.

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Full Text

Low back pain is a common complaint of athletes, and accurate diagnosis is essential, since many causes of back problems can lead to disability. If the obvious mechanical causes, such as muscle strain, "kissing spines," and leg-length inequality, have been ruled out, the more serious sources of low back pain, such as disk herniation, Scheuermann's disease, compression fractures of the vertebral body, and stress fractures of the posterior elements, should be considered. Treatment goals for all these disorders include pain relief and prevention of further injury .Aim of this study was to evaluate and to present the basic elements of functional anatomy of low back pain in athlets The vertebrae are separated by vertebral discs that are composed of a gel substance surrounded by outer collagen fibers, which are arranged in a crossed manner. These discs are further supported by the anterior and posterior longitudinal ligaments. Together, the vertebral disc complex resists spinal compression. During axial rotation of the spine, the annular fibers are placed at a mechanical disadvantage. Furthermore, in forward flexion, the anterior vertebral endplates approximate, increasing the pressure of the disc posteriorly. The most common disc herniation is directed posteriorly toward the foraminal window, where the nerve roots exit the spinal canal. As such, a common mechanism of herniation in athletes is combined flexion, rotation, and compression of the spine. There are some sports in which this injury mechanism commonly occurs.In the presence of a disc herniation, forward flexion worsens the herniation. In extension, the opposite occurs. The posterior vertebral endplates approximate, forcing the disc anteriorly, to reduce the herniation. The anatomic structures that have been implicated as pain generators include the vertebral discs, nerve roots, ligaments, zygapophysial joints, sacroiliac joints, and the musculature. Some studies suggest that discogenic pain secondary to annular disruption is the most common cause of LBP vascularized granulation tissue with innervation along a torn annulus fibrosis is thought to be the cause. Inflammatory factors caused by the leakage of nuclear material from annular tears can delay intradiscal tissue healing. These factors include matrix metalloproteinases , phospholipase A2, cyclooxygenase, prostaglandins, nitric oxide, cytokines, interleukins, and macrophages.

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