Protect your back from a lumbar disc lesion.
By Rene Naylor, Men's Health
What is it?
The discs in your back are made up of a “yolk” (called the nucleus), which is surrounded by fibres known as the annulus fibrosus. The structure of the gel-like nucleus is made up of mostly water. A lumbar disc herniation, sometimes given the misleading term of a “slipped disc”, means there is a tear in the outer, fibrous ring (annulus fibrosus) that allows the soft, central portion (nucleus pulposus) to bulge out. The waterbinding capacity of the nucleus has been singled out as a critical factor as without it, the disc could not act as a shock absorber.
The injury mechanism
A lumbar disc herniation can occur from either:
1) Normal degeneration, which causes the discs to dry out, shrink and lose elasticity and flexibility. Sometimes a part of the outer covering of the disc wears away or tears, allowing some of the disc’s contents to press on the spinal nerve roots. In this instance, the disc has lost its water-absorbing capacity.
2) Sudden impact to the soft disc or twisting motion of the spine. In an acute injury a “pop” or “snap” is often felt in the back, accompanied by lower back pain. It is characterised by a sharp, burning, stabbing pain that radiates down the posterior or lateral side of the leg to below the knee. Increased pain with coughing, sneezing and straining is also consistent with this pain.
The risk of disc herniation increases when you lift a heavy object with poor posture, or participate in an occupation where excess strain and twisting is placed on the spine. Weightlifting, golf and diving are examples of sporting activities that may increase the risk for lumbar disc herniation. In golf, lower back pain is most likely to develop because of the axial rotation of the lumbar spine at the top of the backswing, with the subsequent uncoiling and hyperextension through the downswing and follow-through.
Three pain preventers
Prevention requires correct lifting techniques, a healthy weight, correct seating if seated for long periods and good core stability
1. Core stability
Lie on your back with your knees bent. Suck your navel towards your spine and hold for six seconds, breathing continuously.
Slowly lift your foot off the floor while keeping the knee bent. Always keep the hips level as you lift and lower your foot. Repeat with opposite leg (10 to 15 reps per leg).
Assume a front-support position, resting your weight on your forearms. Straighten your legs out behind you and lift up your hips to form a straight line from your shoulders to your ankles. Don’t arch your back or drop your shoulders, and hold for one minute (you can progress to two minutes).
3. Side Plank
Lying on your side, prop yourself on your left elbow placed directly under your shoulder. Lift yourself off the ground while supporting your body on your left elbow and foot. Keep your body in one flat line. Hold for 30 to 45 seconds, repeating twice either side.
Rene Naylor is the head physiotherapist for the Springboks.
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