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Herniated disc - And how to avoid it

Athlete's enema no.1

Hardly any injury is as feared among athletes as problems with the intervertebral disc. It not only hurts like hell, but often requires a long forced break. Even after that, it is not always certain whether the old level of performance can actually be fully regained. That's why you shouldn't let it get that far in the first place. Here you can find out exactly what happens when a herniated disc occurs, what the symptoms and treatment options are, and how you can avoid them. 


The problem

A herniated disc (BSP/ disc prolapse) is a degenerative disease of the spine. In healthy people, the individual vertebrae are connected by flexible structures made of fibrous cartilage. The human spine has a total of 23 of these intervertebral discs. They consist of an outer fibrous core, the so-called anulus fibrosus, and the inner gelatinous core (nucleus pulposus). The latter is a cell-poor tissue which, like a water cushion, is deformable but not compressible. The intervertebral disc serves as a pressure and impact cushion. At the same time, it ensures the mobility of the spine. 75% of the forces are absorbed by the fiber ring. Long-term incorrect loading, weakness of the muscles located next to the vertebrae, but also due to genetic weakness, the nucleus pulposus can penetrate into the spinal canal in which the spinal cord is located. He tears the anulus fibrosus. 


symptoms

Many herniated discs are symptomless. It is therefore important, before starting therapy, to determine whether the symptoms actually stem from a disc prolapse. A diagnosis can be made using magnetic resonance imaging or computed tomography. Myelography is rarely indicated. Often only a physical and neurological examination is carried out, which is not always sufficient to rule out other causes with certainty. Laboratory tests can also help differentiate a herniated disc from infectious diseases that cause similar symptoms. 

Most symptoms are rather diffuse, such as back pain, which can radiate to the arms or legs. Depending on the severity, numbness is also possible if nerves have been pinched. According to the AWMF guideline, the following symptoms require urgent action: 

-previous accident, osteoporosis

-Fever

-weight loss

-Progressive nerve deficits

-Pain increase at night

-incomplete paralysis

-Problems with bowel movements or urination


therapy

Due to the high complication rate of the procedure, an operation is only recommended in the rarest of cases. Instead, the aim is to maintain or rebuild mobility as far as possible, if necessary with the appropriate pain medication. Except in the acute stage, targeted physiotherapy can bring relief. Sports that put a strain on the intervertebral discs should be avoided under all circumstances. Instead, engaging in moderate activities such as cross-country skiing, cycling, or backstroke swimming is recommended. Other loads should only be carried out in consultation with the attending physician. 

However, even after successful treatment of other intervertebral discs, another prolapse can occur between the other vertebral bodies. For this reason, special attention should be paid to training the supporting muscles.


prophylaxis

Even if the prognosis is much better thanks to a variety of new treatment methods than it was a few years ago, the primary goal is of course not to let it get that far in the first place. The best protection against a prolapse is above all a well-developed core musculature. Exercises such as the plank, L-sit, or leg raises can help strengthen them. The same applies here: technique is key. Not only will you be able to handle a lot more weight with the right exercise, e.g. the deadlift, you will also protect yourself from unpleasant consequences. Therefore: Keep the back straight and tightened. Weight lifting belts are not always your friend here. This tool is often misunderstood and used in the wrong way, and in the wrong product design. The result is a weakening of the back muscles and an increased risk of a herniated disc. So until you can't lift at least twice your own body weight with a straight back, don't do it. At the same time, however, it is also important to ensure that you do not fall into poor posture due to tension in everyday life, which is why stretching should not be neglected.

Take home message

Sure, a herniated disc is really uncool. We totally agree with you. But does that mean that you should rather switch to a "lower risk" sport? Certainly not. Train cleanly and always improve as part of your possibilities. This is how you create the best basis for training safely and injury-free in the long term. 

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