Jasprit Bumrah undergoes back surgery in New Zealand; know all about diagnosis, recovery

What kind of back injuries are athletes susceptible to?

Back pain is one of the most prevalent complaints of athletes at all levels of competition. Dr Pradeep Kocheeppan, sports medicine specialist at Apollo Hospitals, Bangalore who has also been associated with the Indian Hockey Team for the last eight years, said that there are two groups of back pain – with nerve deficits and without nerve deficits. “When it comes to the treatment, pain with nerve deficits need surgery but without nerve deficits, largely to the extent of 99 per cent, does not require surgery,” Dr Kocheeppan told indianexpress.com.

Sport-specific injury patterns exist and some components of the spine and paraspinal musculature are more susceptible to injury and degeneration than others, depending on the sport.

Dr S Vidyadhara, HOD and consultant, spine surgery, Manipal Hospital, Old Airport Road, Bangalore said that fast bowlers, like Bumrah, are prone to get pars interarticularis fracture due to repetitive flexion-rotation-hyperextension injury, or intervertebral disc prolapse which can again be treated conservatively for up to 3 months.

“Pars repair surgery is undertaken when bony injuries do not heal with rest, immobilisation and activity restriction in three months. Like any other fracture, the broken bones are fixed internally and immobilised for 6-12 weeks. Following this, the athlete can start stretching exercises and be ready to play contact sports six months following surgery. Resuming aggressive sports earlier can cause the failure of fracture fixation and implant-related issues,” said Dr Vidyadhara.

He explained that one can opt for microscopic or endoscopic discectomy surgery in case of a slipped disc. “After surgery,  the recovery is faster and patients can get back to contact sports in 3 months’ time,” he mentioned.

Diagnosis

Experts suggest that soft tissue spine injuries are the most common and are usually managed medically with muscle relaxants, pain medication and physiotherapy. “These usually completely resolve within days to weeks but recurrences are common,” shared Dr Ankit Batra, orthopaedic surgeon, Sharda Hospital.

“Whether these injuries can be treated, via medication or surgery, depends on their type, cause and severity, as well as the age of the athlete. The same is true for an athlete who undergoes spine surgery. Return to play is dependent on several factors including the severity of the injury, damage to the spinal cord, delay in getting treatment, co-morbid conditions like diabetes or high blood pressure etc,” Dr Batra added.

Evaluation of the spinal cord and nerves are done to analyse the extent of the injury. “We look for weakness or numbness along with pain in the affected limb. In our examination, we perform stretching of the nerve, and if that is very symptomatic, we are more than likely going to recommend surgery,” Dr Batra told indianexpress.com.

Back pain is one of the most prevalent complaints of athletes at all levels of competition (representative) (Source: Getty Images/Thinkstock)

According to Dr Batra, one of the most common spine injuries seen in athletes is herniation of the disc.

“Athletes with these injuries experience stressful rotation when playing their sport. For instance, some bowling styles in cricket make the structures supporting the spine susceptible to injury and even tears. Stress fractures are also common in athletes due to the repetitive stressors and repetitive actions of bowling or fielding,” noted Dr Batra, adding that if there is a need for stabilisation of the spine or resection of the disc to relieve pressure on the spinal cord, surgery is recommended.

Decompression surgery is an increasingly common operation for the treatment of lumbar spinal stenosis which occurs due to hypertrophy (or increase in the size of cells or tissues) of the joints, said Dr Udit Kapoor, consultant, Metro Hospital, Faridabad.

The compression of the nerve is diagnosed clinically and on the basis of an MRI. Lumbar decompression is usually indicated for a herniated lumbar disc, spinal stenosis, spinal injury or spinal tumours, and when conservative treatment options do not provide relief, said Dr Kapoor.

As with any procedure, lumbar decompression may involve certain risks and complications. Complication rates are less but may cause infection, bleeding, leakage of cerebrospinal fluid, bladder or bowel incontinence, weakness, numbness, and pain.

Recovery

Return to the sport can be tough post-surgery for isolated back pain cases, hence, the decision for surgery has to be considered and discussed in detail with the player, coach and a few specialists together, mentioned Dr Kocheeppan.

According to Dr Kapoor, post-operative mobilisation is supervised by physiotherapists. “Normally, a full weight-bearing walk with a walker under physiotherapist guidance is to be done,” added Dr Kapoor.

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