As we eagerly await the start of the the 2016 Major League Baseball Season, The New York Mets and their fans are hopeful for a productive year from their captain, David Wright. The National League Champs have invested millions of dollars on the face of their franchise, and are committed for another five years. But wait, there is the uncertainty of low back pain from spinal stenosis coming back.
David Wright was born with a narrow canal, called congenital spinal stenosis. This is a relatively common condition, which is usually not symptomatic. So why over the past 18 months has it affected this All Star, 33-year-old man? Professional athletes put their bodies through rigorous and strenuous exercises, and have constant injuries. This can lead to wear and tear, which leads to degeneration, including in the spine.
Combination of congenital and developmental stenosis may limit an athlete in performance. Movements such as back extension and rotation cause pain. The Mets are easing David into spring training slowly. As an infielder, in a 9 inning game, he needs to crouch and bend, followed by extend 150 times each game. And this is when the ball never comes to him. On a diving play, he may need to significantly hyperextend his back. At the plate, high force of twisting and rotation is involved.
In order to decrease the chance of injury, the management of spinal stenosis is usually conservative. Most important factors are core strength and flexibility. Postural exercises, pilates, yoga, and tai chi can be considered. Lower extremity muscle stretching, including all hip girdle muscles is necessary. I am certain David Wright and his training staff incorporated some of this routine in the offseason, and he needs to continue to follow it.
Chances are that David will have some days of flare-ups and back pain. Mild symptoms will respond well to anti-inflamatories, ice, rest, and physical therapy. More moderate symptoms may require injections such as trigger point injectionfor tight muscles, or epidural steroid injections if there is nerve root irritation.
New York Mets fans hope that David Wright will require either none or only conservative treatments to get through the season and back to the World Series.
– Michael Y. Mizhiritsky, MD