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    Spine Insult and Injury   

The definition as to just what actually constitutes a spine injury varies considerably .  We typically think of the word "injury" in reference to "trauma" but most injuries actually occur in a cumulative fashion over a period of years.  If continued injury occurs slowly enough there many be no associated signs or symptoms and no disability evident.  This is because Mother Nature does a wonderful job of adjusting to this damage in her attempt to keep the individual functional.  The classic example of this phenomenon is the individual presenting with headache of one week's duration is found, on MRI scan, to have a benign brain tumor, the size of a large orange, which had been present for perhaps 20-30 years.  This also explains why, in the same individual, that a minor head injury can be "the straw that breaks the camel's back" and produce unconsciousness or death.

Clearly, it is a better situation for the individual to be made aware of these impending disasters before Mother Nature's remarkable ability to compensate for slowly progressive insult is lost.  In the example given above the patient's "Brain Savings Account" had reached zero without their having been alerted to this.    
Ejecting from a jet fighter is aptly described by  pilots as having "a rocket up your butt".  The amount of sudden force is so great that serious and permanent spine injuries (including compression fractures) may result.  This is a classic example of a severe and sudden insult.  Sudden trauma such as this example and auto accidents represent the minority of spine injuries.
The most common variety of spine injury is the repetitive type.  The classic example of this is that of continued occupational insult (i.e. truck driving) over a long period of time.  In many ways the gymnast "sticking" a dismount with the spine hyper extended demonstrates a prime example of cumulative and repetitive trauma.  Although the force of each insult is less than a pilot ejecting from a plane  the accumulation of insult and resulting harm may actually end up being more disabling to the individual in the long run.    
Many professional gymnasts, as they enter adult mid-life, are seriously incapacitated from their accumulated injuries.  Particularly those in whom genomic problems were not identified early in life.  It is truly unfortunate that national gymnastic organizations have made a point of not identifying or discussing these problems with their members in the attempt to avoid "bad press".
Who would believe that the "sedentary" activity of golf is injurious to the spine?  But, does anyone know a golfer who doesn't have back problems?  We don't.  Being a professional golfer goes along with chronic back complaints and problems.  Spines just don't like being power twisted and untwisted ....unfortunately that's how golfers gain their driving prowess.  Back problems are occupational hazards for golfers. 
Again, few, if any, professional golf organizations identify this or discuss these perils.  This is sad because with awareness comes understanding and effort directed toward prevention.  Without awareness and understanding prevention is not possible.
Shown to the left is an example of a single page, low-cost, MRI scan being used for screening purposes.  Such studies, when of high quality, can be highly valuable in determining the presence of disease, particularly, in the early appreciation of genomic disorders.
This close-up image from the screening study shown above clearly demonstrates that this young individual has an underlying spinal genomic condition.  This is shown by the presence of multi-level disc degeneration and the loss of normal spine curvature (lordosis).  The endplate abnormalities which are also present indicate that this genomic problem is a case of "juvenile discogenic disease".

By the early identification of this disorder a person then has the opportunity to turn to preventive spine care to avoid future disability and the need for surgical intervention.

The new discipline of "prospective" care combines the use of clinical information and diagnostic studies as a means of identifying people who are at high risk of having significant problems in the future and taking action now to prevent this.

We have to face the reality that individuals with even the most optimally developed spines can experience incapacitating insult and injury, some of which is only gradually accumulated over time.  For those born with imperfect or inadequate spines the challenge is much greater.  These folks are at greater risk but they don't know it, and few have stepped up to the plate to tell them this important tale.

There are many among us whose occupational and professional survival depends upon their taking care of their bodies.  The professional athlete has only a limited window of opportunity during their life to optimize their performance and realize appropriate remuneration for it.  The saddest sight is the superbly trained and talented athlete whose career comes to a sudden end because of factors which could have been identified and prevented beforehand.