Disc degeneration on MRI is more prevalent in young elite skiers compared to controls

Abstract

PurposeEvidence-based facts regarding spine abnormalities and back pain are needed in order to develop rehabilitation programs and prevent spine injuries in young skiers. The aim therefore is to identify MRI changes in the thoraco-lumbar spine and the lifetime prevalence of back pain, as well as the association between them, in young skiers compared to non-athletes.MethodsSeventy-five young elite alpine and mogul skiers, age range 16–20 years, were compared with 27 non-athletic controls. All subjects underwent spinal MRI and answered back pain questionnaires.ResultsFifty-six percent of skiers had at least one disc Pfirrmann grade ≥3 compared to 30% of controls (p = 0.027). Schmorl’s nodes (46%) and disc height reduction (37%) were significantly more prevalent in skiers compared to controls (0%) (p < 0.001). When all parameters were combined together, skiers had significantly higher rate of radiological changes than controls, 82% compared to 54% (p = 0.007). The mean number of discs with Pfirrmann grade ≥3 was 1.1 per individual in skiers (median 1, range 0–6) versus 0.6 in controls (median 0, range 0–3). There was no significant difference in lifetime prevalence of back pain between skiers (50%) and controls (44%) (n.s.). MRI abnormalities in skiers did not correlate with lifetime prevalence of back pain. Skiers had a better health perception than controls (p = 0.026).ConclusionAlpine skiers have more degenerative disc changes compared to non-athletes, but these changes do not correlate with the lifetime prevalence of back pain. Lifetime prevalence of back pain is not significantly different between the groups; however, skiers report more severe pain on VAS score.Level of evidenceII.

Recording injuries only during winter competitive season underestimates injury incidence in elite alpine skiers

“…These factors are known to be related to high spinal disk loading, 28 as well as the high peak loads encountered on the slope due to snow hardness and the ski discipline itself 29,30 . Therefore, repeated impacts on immature spine may have led to chronic endplate lesions 15 . Two factors may have attenuated the increase in back lesions across the last year studied.…”

“…The age distribution of participants was relatively narrow and specific, and the generalizability to other athletes’ levels cannot be ascertained. Indeed, the rate of back lesions may currently be lower in more experienced skiers 15 (World Cup: 43% (15/35) vs 64% (18/28) in Europa Cup, unpublished data over season 2016/2017). Due to low sample size, the increase in spine lesions was not statistically significant.…”

“…Moreover, the FIS started to include European Cup injuries since 2013/2014 but limited information exists on the injury profile of younger ski racers 9,14 . Importantly, these athletes seem particularly affected by disk degeneration with arising back pain complaints since a few years 15,16 . The aim of this study was therefore to prospectively investigate the rate and pattern of injuries over 5 years among competitive European Cup alpine skiers and to compare winter competitive season with the summer off‐season.…”

Stress Injuries of the Spine in Sports

“…Multiple studies demonstrated the higher incidence of Schmorl's node in athletes compared with nonathletes. 1, [67][68][69] For example, Witwit et al reported an incidence of 46% in skiers compared with 0% in a control group, 68 and Swärd et al demonstrated a 71% incidence in gymnasts, compared with 44% in nonathletes. 1 Axial loading is thought to play a role in the formation of Schmorl's node, accounting for their observation in sports such as diving, weightlifting, and even ice hockey (axial loading is thought to be produced in high-speed skating and forceful midair tackles).…”

MRI-detected spinal disc degenerative changes in athletes participating in the Rio de Janeiro 2016 Summer Olympics games

“…Several studies have shown associations between competitive sports activities and degenerative pathology of the spine [1][2][3][4][5][6][7][8][9][10][11][12][13] . Olympic sports are no exception since Olympic athletes spend a considerable amount of time training and competing relying on strength, speed, force, bending, and twisting in their sport.…”