How do professional athletes get a herniated disk and six weeks later they are back on the field?

Q: How do professional athletes get a herniated disk and six weeks later they are back on the field? I exercise almost everyday but when I got my disk problem, I was out of commission for a good six months. What's "normal" here?

A: Between the vertebral bones of the spine is an intervertebral disc. The discs provide a cushion or shock absorber for the spine. Each disc is made up of two parts. The center, called the nucleus, is spongy. It provides most of the disc's ability to absorb shock. The nucleus is held in place by the annulus. The annulus is a series of strong ligament rings around the nucleus.

People often refer to a disc herniation as a "slipped disc". The disc doesn't actually slip out of place. Rather, the term herniation means that the material at the center of the disc has squeezed out of its normal space. The nucleus presses against the annulus, causing the disc to bulge or prolapse outward. The bulged disc material is still contained within the annulus.

But in some cases, the nucleus pushes completely through the annulus and squeezes out of the disc. This is called a disc herniation or protrusion. Herniation and protrusion are two words for the same thing.

If a piece of the disc breaks off, it's called a sequestered fragment. This is a more serious situation and surgery is almost always needed for sequestration. The loose piece can enter the spinal canal and put pressure on the spinal cord or spinal nerve roots causing serious problems.

So you can see from this brief description, there are different degrees of disc problems that make a difference in treatment and prognosis. Athletes are just as susceptible to disc problems as nonathletic adults. But this problem occurs more often due to trauma rather than degenerative processes linked with aging.

Football players may be quicker to receive intensive physiotherapy antiinflammatory medications, and steroid injections in order to get back on-the-job, so-to-speak. Anyone (athlete as well as nonathlete) who does not respond favorably to conservative (nonoperative) care of this type, may need to consider surgery to remove the disc and possibly fuse the two spinal segments on either side of the diseased disc.

The average amount of time it takes an athlete to have a diskectomy and return to playing sports is about six months. Some take longer (up to a year) and that is with the benefit of a team surgeon, therapist, and athletic trainer all working together to get that player back on his/her feet and on the field or court. So you aren't so far from the norm for athletes as you think!

Reference: Robert G. Watkins, IV, MD, et al. Return-to-Play Outcomes After Microscopic Lumbar Diskectomy in Professional Athletes. In The American Journal of Sports Medicine. November 2012. Vol. 40. No. 11. Pp. 2530-2535.

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