Goal of the article?
Back pain is very common in people who practice sport at the elite and non-elite levels. In this article 1, the authors look at the existing research to understand how physical exercise can impact biologic and structural changes to the intervertebral disc (IVD) and spine.
What is the IVD?
The IVD is the hydraulic cushion between vertebrae, making up almost one quarter of the spinal column. IVD provides stability by absorbing and distributing the stress and shock of the body during movement and preventing the vertebrae from approximating one another. Each IVD is made up of two parts:
- Annulus fibrosis – this is the outside of the disc, made up of water and elastic collagen fibers
- Nucleus pulpous – this is the inside of the disc, made up of a gel like elastic substance
What did they find?
Research shows that different types of exercises have different outcomes for the IVD and spine. Low-impact and moderate physical exercise are beneficial to IVD as they can promote regeneration and muscle function. For example, regular walking or low demand running can help to improve IVD structure and support by providing nutrition to the IVD in the form of oxygen and lactate.
In contrast, high impact activities that over rotate the spine or force it to overly compress can break down the IVD early and result in back pain. This pain can result in a reduction in muscle strength and muscle activation. It can also result in a worsening of coordination and proprioception (the sense of self-movement and body position). This means that individuals with lower back pain can have a reduced ability to sense how the body is moving and its’ actions.
However, not only does pain have an impact on how a person can move, but it can also result in changes to the brain or what is called cortical neuroplasticity. These brain changes can alter the body’s motor and behaviour control. They can also limit the effectiveness of learning a new skill by reducing the ability of an individual to make necessary adaptions to movements that further deteriorate the spinal tissues.
Why does this review matter?
Back pain is a very common finding in exercise and sport. Therefore, it is important to understand what types of exercise are beneficial to IVD and what types can deteriorate the spine and spinal tissues. Understanding how prolonged back pain can change the way human bodies experience and adapt to pain, and the long-term impacts that can have on learning a new skill, are important to addressing treatments for patients living with back pain.
At Dynamic Disc Designs, we work to model the biology of the spine in a flexible and interactive way so professionals can make the best clinical decisions for their patients.