Surgeons tackle NFL linemen's disc injuries

Surgeons tackle NFL linemen's disc injuries
by Shari' N. Welton

They are symbols of brute strength.

They block. They tackle. They manhandle the opposition.

But the bone crushing blows NFL linemen inflict on their opponents have pushed many of them into the operating room.

Disc surgery has become increasingly common among NFL linemen, but the surgery that was once believed to be career-ending is saving NFL careers.

Eighty-percent of NFL linemen, whose spines were at risk for degeneration, were able to return to the field and compete after undergoing disc surgery, according to a new study conducted by Northwestern University researchers.

NFL linemen are vulnerable to disc herniation because they spend a significant amount of time in squatting stances while competing, straining their spines, said Dr. Joseph Weistroffer, a spine surgeon at Northwestern Memorial Hospital.

He sifted through 20 years of records with Northwestern researchers and concluded that 80 percent of NFL linemen were able to play at least one game after having disc surgery.

Most linemen averaged a 33-game competitive stretch during the three years following the surgery. Over half of the players also became or returned to the field as starters, according to the study, which will appear next month in the Journal of American Sports Medicine.

When a person has a herniated disc, the nerve root becomes pinched between a disc in the spine and the bone behind it.

Weistroffer, an assistant professor of orthopedics and neurological surgery at Northwestern University Feinberg School of Medicine, addressed a misconception about the pain associated with disc herniation.

"A disc herniation will cause a person to have leg pain that is worse than back pain, he said, "Most people that just have back pain probably don’t have a disc herniation."

Weistroffer said patients may choose to have disc surgery when their leg pain becomes unbearable and their ability to participate in day-to-day activities is affected.

The objective of the surgery is to free the nerve root, which would then relieve the leg pain.

During the surgery, doctors lay the patient on their stomach and make an incision in the back. They then remove a portion of the bone or ligament that is trapping the nerve root. The disc material, or gel-like substance, that spurted out from the disc over time is also removed.

Encouraged by the progress of NFL linemen following disc surgery, Weistroffer said the "average person" who chooses the operation should be optimistic about resuming physical activity.

Weistroffer referred to studies he observed that show an 82 percent "return to work rate" for the average patient, along with a 90 percent satisfaction rate following the operation.

But even with proven success comes a level of uncertainty.

Weistroffer said regardless of doctors’ efforts, there is no way to determine how each patient will recover from disc surgery.

He compared the operation and recovery to a thumb getting closed in a car door.

"The surgery is like taking pressure off of the thumb, Weistroffer said, "We expect the thumb to get better, but we don’t know."

There are also options for people with disc herniation who choose not to have surgery.

Also an advocate for nonsurgical recovery, Weistroffer said over time the human body can compensate for injuries such as a disc herniation. "Our great design is to recover, Weistroffer said, "The body’s natural intent is to heal itself."

A sports chiropractic physician with Sports Injury Centers in Chicago, Chris Bocci said "most disc cases can be treated conservatively."

He described a "pre-op" technique called spinal decompression that he conducts with patients who have herniated discs.

Decompression is a noninvasive procedure, which helps decompress disc material in between the two vertebrae in the spine. This decompression takes the pressure off the nerve, creating a vacuum effect that brings nutrients and increases the blood supply to the disc. Pressure is then taken off the nerve and surrounding disc material, helping to heal the injury and give the patient relief.

Aside from decompression, Bocci said muscle stimulation is vital to the recovery process. To ensure that his patients are strengthening their back muscles, Bocci takes them through a routine called "active release therapy."

The method comprises specific strengthening and soft-tissue techniques that help balance the muscle. As patients undergo active release therapy muscle tissue is loosened, making it easier to get the disc back in place.

Along with different therapeutic programs, Bocci said core stability and strengthening are also critical to the rehab process.

Whether a patient chooses disc surgery or a rehabilitation program, Weistroffer stressed that the operation should be considered on a "case by case" basis.

"Surgery isn’t the best choice for everyone, "Weistroffer said," People should try to get better on their own."