Spine problems in the athlete - cont.

sume competition. Recurrent symptoms mandate careful follow-up and may well precludefurther athletic participation. For brachial plexus injuries, prevention is centered on an aggressive neck and shoulder strengthening program. Neck rolls, high profile shoulder pads, and devicessuch as the horseshoe collar help prevent injuries by restricting range of motion.24

Conclusion
Athletic performance is frequently compromised by dysfunctional status of the spinal column. Most athletic back and neck injuries are self-limited soft tissue injuries that respond to conservative measures. Effective rehabilitation programs tailored to athletes stress a graduated return to a competitive activity level and sports-specific preventive measures. 25 Athletes who do requ ire spinal surgery are not necessarily facing the end of their career. There is an increasing cohort of athletes, both professional and amateur, who have been treated successfully with newer, less invasive procedures.

References

1. Nicholas JA. Hershman EB. The Lower Extremity and Spine in Sports Medicine. St. Louis. MO: C. V. Mosby; 1986.
2. Tall RT .DeVault W. Spinal injury in sport: epidemiologic considerations. Clin Sports Med 1993:2:441-448.
3. Haher TR. O'Brien M. Kauffman C. Liao K. Biomechanics of the spine in sports. Clin Sports Med1993;12:449-464.
4. Gracovetsky S, Fartan H. Lamy C. The mechanism of the lumbar spine. Spine 1981 ;6:249-262.
5. Flory PD, Rivenburgh OW, Stinson JT. Isokinetic back testing in the athlete. Clin Sports Med 1993;12:529-546.
6. Aggrawal N. Kaur R, Kumar S. Mathur DN. A study of changes in the spine in weight lifters. Br J Sports Med 1979;13:58-61.
7. Brady TA. Lahill BR. Bodnar LM. Weight training-related injuries in the high school athlete. Am J Sports Med 1982; 10:1-5.
8. Ferguson RJ. McMaster JH. Stanitski CL. Low back pain in college footballlinemen. J Sports Med 1974;2:63-69.

9. Goldberg MJ. Gymnastics injuries: .Orthop Clin North Am 1980;11:717-726.
10. Hresko MT, Michelli LJ. Sports medicine and the lumbar spine. In: Floman Y, ed. Disorders of the Lumbar Spine. Aspen, CO: Rockville: 1992.
11. Jackson DW, Wiltse LL. Low back pain in young athletes.
Physiology and Sports Medicine 1974;2:53.
12. Jackson DW. Wiltse LL. Cirincione RJ. Spondylolysis in the female gymnast. Clin Orthop 1976; 117:68-73.
13. Hoffman HJ Childhood and adolescent lumbar pain. Clinical Neurosurgery 1980;27:553-576.
14, Webb JH, Svien HJ, Kennedy RL. Protruded lumbar intervertebral disks in children. JAMA 1954;154:1153-1154.
15. Schmorl G, Junghans H. The Human Spine in Health and Disease. New York, NY: Grune and Stratton; 1971.
16. Frymoyer JW, Pope MH, Kristiansen T. Skiing and spinal trauma. C/in Sports Med 1982; I :309-318.
17. Nelson CL, Janecki CJ, Gildenburg PL, Sava G. Disk protrusions in the young. Clin Orthop 1972;88: 142-150.
18. Gomori JM, Margolies MD. Radiology of the lumbar spine. In: Floman Y, ed. Disorders of the Lumbar Spine. Aspen, CO: Rockville; 1992.
19. Wiltse LL. Widell EH. Jackson DW. Fatigue fracture: the basic lesion in isthmic spondylolisthesis. J Bone Joint Surg Am 1975:57:17-22.
20. Hoshina J. Spondylolysis in athletes, PhysiologyandSports Medicine 1980;8:75.
21. Stinson JT. Spondylolysis and spondylolisthesis in the athlete. Clin Sports Med 1993;2:517-528.
22. Micheli LJ, Hall JE, Miller ME. Use of the modified Boston brace for back injuries in athletes. Am J Sports Med 1980;8: 351-356.
23. Buck JE. Direct repair of the defect in spondylolisthesis. J Bone Joint Surg Br 1970;52:432-437.
24. Torg JS,Reilly PJ. Injuries to the cervical nerve roots and brachial plexus in athletes. In: Renne WR, Herndon JH, eds. Current Opinion in Orthopaedics. Philadelphia, PA: Current Science; 1994.
25. Hopkins TJ, White AA. Rehabilitation of athletes following spine injury. C/in Sports Med 1993;12:603-619.
658
MMJ Vol 45 No 8