Rest in time to save spine

Spending hours a day playing tennis may give young, elite players a competitive edge, but all that activity may come with a price - spinal injuries.

A recent MRI study of 33 English tennis players, aged 16 to 23, found that 28 had injuries, such as stress fractures, disc degeneration and facet joint arthropathy, a degeneration of the joints that allow the spine to move forward, backward and twist.

Not matured enough

"It struck us that these young tennis players' bodies have yet to mature, but they are subjected to doing vigorous sports [for] about five to six hours a day," says Dr David Connell, a musculoskeletal radiologist at England's Royal National Orthopaedic Hospital and lead author of a study recently published in British Journal of Sports Medicine. Because none of the players studied showed any symptoms of spinal injuries, Connell and his fellow researchers did not expect to find any when they scanned the players.

Instead, they found facet joint arthropathy in 23 of the subjects and 13 had disc degeneration, caused when the discs lose water and shrink, putting added stress on the facet joints.

The same number of subjects also had disc herniation, which occurs when the inner core of the disc pushes into the spinal canal.

Nine showed evidence of stress reactions or stress fractures and ten had synovial cysts - benign sacs of fluid that appear in the facet joints as they begin to degenerate.

Free of symptoms

The fact that the tennis players were symptom-free does not surprise Dr Robert Watkins Jr, an orthopaedic spine surgeon at the Marina Spine Centre in Marina del Rey, California.

"Certainly all that stress while they're growing can be hard on their bodies," he says, "but because they're in good shape, it's less likely those things will become painful."

Dr Arya Nick Shamie, a spine surgeon at
the Santa Monica-UCLA and Orthopaedic Hospital in Southern California, found the high incidence of injury ‘troubling'.

However, he and Watkins, who work with elite and pro athletes, say that some of the damage could be extremely minor. "Many surgeons may not even consider it abnormal," Shamie says.

"We have got to be careful about excessive training in young, promising athletes, because we want them to reach their full potential," Connell says. "This is a critical time for them."