Q: Is it possible to return to sports after a spinal injury?
A: Not only is this possible, but it is encouraged and desired. Depending on the type and severity of injury, time for recovery and return to sports varies.
There are several different types of spinal injuries: The most common spinal injury is a sprain. A sprain is a tear of ligaments which are the tissue that connect bone to bone. A sprain can be mild, moderate or severe. Most people begin activity immediately following a mild sprain. Severe sprains are sometimes associated with a disk injury where the tissue can displace into the spinal canal and pinch a nerve. Though the majority of these injuries heal without surgery, recovery can take longer.
Although less frequent, spine fractures may occur with the most common being a compression fracture. As we mature, our bones lose density and become more susceptible to fractures with even mild injuries. Compression fractures are stable but can take up to 6 months to completely heal. Again, early activity as tolerated is recommended.
When my patients have a spinal injury I always recommend a daily back exercise program that takes 5-7 minutes in the morning and 5-7 minutes in the evening. I suggest they supplement that with activities such as jogging, swimming, and cycling. Other sports tolerated include golf, bowling, low impact aerobics, a supervised weight lifting program and skiing (which can be hazardous for beginners). More risky activities that should be performed ONLY with proper medical clearance include football, soccer, volleyball, ice hockey, and trampoline.
Remember that overall fitness is vital both before and after injuries and requires exercise, proper weight, good diet, control of stress, and other healthy life choices:
- Don’t Smoke! Smokers are at risk for more severe and longer lasting back attacks. Why? Smoking reduces circulation in small vessels including those that nourish the spinal disks.
- Good nutrition is important! Most people need to reduce fat intake and increase vegetables, fruits, and whole grains.
- Take your vitamins! Calcium and vitamin D help reduce Osteoporosis. Vitamin C aids in building collagen needed by disks.
- Drink water! Staying well hydrated will slow the disk degeneration process.
- Exercise! Whole body exercise is a part of fitness. Aerobic exercise beginning at 15 minutes building to a goal of 30 minutes a day is recommended. This is best accomplished through walking, swimming, bicycling.
Q: What is a growth plate injury?
A: First things first…to understand a growth plate injury, let me first give you a better understanding of what a growth plate is:
Growth plates are the regions of the bone where growth occurs. They are located at the ends of the bones near the joints. The growth plate itself can be broken down into four separate layers or zones.
- Zone 1 is the resting zone and is made up of inactive cartilage cells.
- Zone 2 is the proliferative zone and is made up of actively growing cartilage cells.
- Zone 3 is the mature cartilage zone and is made up of enlarged mature cartilage cells that produce the cartilage matrix.
- Zone 4 is the zone of calcifying cartilage and is a thin layer where the cartilage cells have died and are surrounded by a calcified matrix. This is the weakest area of the growth plate and is where new bone is added.
Growth plate injuries/fractures are classified by the severity of the damage to the growth plate and effect on future growth.
- Type I fracture is a separation of the growth plate without involvement of bone. This occurs through the zone of calcification away from growing cartilage cells and usually heals without affecting future growth.
- Type II fracture involves separation of the growth plate in the zone of calcification…a variable distance, out through the adjoining bone. This is the most common type of growth plate fracture and is away from growing cartilage cells. It usually heals without affecting future growth.
- Type III fracture is through all layers of the growth plate and extends into the joint. This is an uncommon injury, but requires restoration of a normal joint surface. An operation is usually necessary.
- Type IV fracture occurs when the break extends from the joint surface through all layers of the growth plate and a portion of the bone on the other side. An operation is usually necessary to restore the joint surface and alignment of the growth plate.
- Type V fracture is the result of a crushing force through the growth plate. This is uncommon and usually involves the region around the knee or ankle. Initial x-rays may appear normal yet as the cartilage cells die from the crush injury, growth ceases. This injury has a poor prognosis but fortunately is uncommon.
The type of injury and age of child help to determine prognosis with a growth plate injury. The older the child (less growth left to occur) and the lower the fracture type, the better the prognosis.