Athlete's chest and back pain
Introduction
Brief introduction of athletes' chest and back pain Chest and back pain are common diseases in young people above the age of young adults, especially in countries with high industrial development, the incidence can be as high as 20% or more. Before the evaluation, prevention, and treatment of chest and back pain, the primary focus should be on clarifying the causes of the symptoms. The shoulders, neck, and back pains of other causes have been fully explained in the previous sections. But for athletes, the cause is often related to many factors. In addition to general factors, such as poor sleep position, lack of physical exercise, smoking, long-term sitting and working, and so on, including the physical state, eager to recover mentality and possible damage again and other issues need to be fully considered. In addition, the difference between the chest and back pain of the athlete and the general case is mainly due to the fact that most of the former suffers from the occasional high-intensity injury. Of course, repetitive minor injuries can also cause the disease. The impact of this disease on athletes is more spiritual, especially for athletes who are playing, there will be a huge psychological shadow. Due to the possible consequences of fear, many athletes deny or narrow the complaint, including the fear of losing their status and value in the sports team. Therefore, each clinician should understand these factors in detail and build mutual trust, understanding and support relationships with the athletes to facilitate treatment. Otherwise, the treatment will be complicated and it will be difficult to receive satisfactory results. Directly affect its play in the sports field. basic knowledge Sickness ratio: 0.05% Susceptible people: common among young people above the age of young adults Mode of infection: non-infectious Complications: lumbar disc herniation
Cause
The cause of athletes' chest and back pain
(1) Causes of the disease
Injury to the chest and back and lower back due to repeated or acute overload.
(two) pathogenesis
Many athletes' persistent chest and back pain are caused by obvious anatomical and physiological changes. Some people compare the spine to a pile of stacked bones, separated by cartilage gaps between the bones; It is a two-articular joint; the front vertebral body and the posterior vertebral body form a triangular three-joint complex, and the upper and lower complexes form a motion segment with activity and support function by means of an intervertebral disc annulus connected therebetween, and can also be regarded as a The complex, the combination of multiple segments constitutes the activity and internal stability of the spine, while the exogenous stability of the spine comes from the paravertebral muscles and the chest and abdomen muscles. Some people compare these muscles to the mast of the sailboat. Cable, to maintain the vertical role of the mast, while maintaining the sequence of spine alignment, endogenous and exogenous stable structure allows the curvature of the spine, side bends and rotation in all directions, etc., any damage to the supporting structure will Destroying the balance of this structure, therefore, the degeneration of the disc and facet joints, sprains of the muscle ligaments and other abnormal changes will cause a series of adverse consequences, although Most athletes have good physical condition, but the damage of the support system caused by repeated or acute overload will directly constitute the main cause of the disease.
Prevention
Athlete chest and back pain prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Athlete chest and back pain complications Complications lumbar disc herniation
Adolescents with lumbar spondylolysis and spondylolisthesis often involve intervertebral disc herniation (or bulging) in adults.
Symptom
Athletes' chest and back pain symptoms Common symptoms Low back pain, back pain, forced position
1. Clinical features
(1) Overview of medical history:
First of all, the medical history should be comprehensively collected, including the accidents in the training and competition. The past treatment and medication history should be understood in detail, because it is directly related to the occurrence and development of the disease, and it is also the correct diagnosis and treatment. The main basis of the program.
(2) Pain:
Pain is the chief complaint of athletes and the main reason for their consultation. Therefore, it should be asked in detail, including when the pain is onset, whether there are predisposing factors and whether there are the same symptoms in the past. Most acute chest and back pain can relieve itself. The prognosis of recurrent chronic chest and back pain is not ideal, and it is also the main obstacle affecting the training and improvement of performance. A comprehensive understanding of the time of pain and the nature of pain can help to find the cause of the symptoms, which is directly related to the sudden onset of pain. The injury may be a small fracture, a muscle sprain or a ligament sprain. From the mechanism of the injury, the type of injury can be inferred. The over-extension of the lumbar vertebra can cause excessive stress on the isthmus of the vertebral arch; the over-flexion causes compression on the intervertebral disc and the vertebral body. The rear ligament structure is subjected to tension. The injured part depends on whether the vertebral joint is subjected to compression or traction. This force mode can cause damage to the anterior or posterior column of the spine. Flexion, rotation and axial pressure are also easy to make the disc annulus. The complex is stressed and can cause tearing of the annulus or disc herniation. At the same time, it should be clear whether the pain is a gradual attack or It is derived from a specific cause, including a specific forced position on the playing field, which is often associated with repeated injuries, which can trigger stress responses, commonly referred to as overuse syndrome.
(3) Systemic status:
The systemic symptoms of the patient can be present at the same time as the local manifestations. The fever is more common, especially in the adolescent group, often showing signs of infection or various arthritis. In addition to understanding the kidney area, the athletes with low back pain who have a history of hematuria In addition to traumatic conditions, kidney stones, infections and tumors should be ruled out, especially for rugby athletes with strong external strength. They may have severe low back pain after being attacked on their lower back. There are many signs of hematuria, which are mostly caused by kidney contusion. In addition, attention should be paid to the presence or absence of other manifestations of the body, including cardiopulmonary status.
2. Characteristics of lesions in different age groups
(1) Infant group: The juvenile group refers to young children athletes under the age of 14 who are more likely to participate in sports such as gymnastics, swimming and acrobatics. Athletes with chest and back pain in this age group should conduct detailed and comprehensive examinations. In addition to attention to the presence or absence of trauma, attention should be paid to the presence or absence of infection and tumors. Congenital or traumatic spinal vertebral arch fractures should also be considered. In the general population, the incidence of asymptomatic vertebral arch fracture is approximately 5%. Fractures of cartilage structures should also be considered, especially fractures (green branches).
(2) Youth group: The youth group refers to adolescents around the age of 18, and the athletes in this age group develop fast and grow fast. Therefore, in this rapid growth stage, the symptoms of chest and back and low back pain appear fast. The transient rapid growth syndrome found in young athletes has been recognized by everyone. At this time, the growth of the spine bones is faster than the growth of soft tissues attached to them. Most of them involve the fascia of the chest and lumbosacral region. Lumbar vertebral arch fracture and spondylolisthesis also occur in this period, idiopathic scoliosis, Scheuermann's disease, central disc herniation (detachment) and posture round back are also seen in this period, in addition, this age group Athletes are prone to cartilage endplate damage and fractures. Disc herniation is not common in this age group, but once it occurs, clinical symptoms are atypical, and more imaging studies are needed.
(3) Youth group: The youth group refers to young people aged 20 to 30. Athletes of this age group can exert tremendous strength when engaging in activities such as football, weightlifting, basketball, volleyball, table tennis, gymnastics and ice hockey. It is transferred from the periphery to the spine, causing acute or chronic damage and strain on the annulus fibrosis structure. In addition, the bony structure and soft tissue are also susceptible to damage.
(4) Adult group: The adult group refers to the adult population over 30 years old. The athletes in this age group have the same disease type as the general population in the same age group, but because of the damage in the past, the situation is more than that of ordinary people. The development of the disease is more serious. In younger athletes, intervertebral disc disease is the most common. With the increase of age, the incidence of secondary spinal stenosis increases year by year. Compared with the general population, the incidence is relatively high. .
Examine
Athlete's chest and back pain check
X-ray examination is a must, and some small fractures require MRI to confirm the diagnosis.
Diagnosis
Diagnosis and identification of athletes' chest and back pain
The diagnosis of athletes' chest and back pain is basically similar to that of general cases. It is mainly based on medical history and clinical findings, but it is directly related to the extent of injury, excessive exercise and over-limit activity. It should be detailed in the medical history and repeat tiny. Injury or repeated strain is another feature that causes sports injuries and should be noted in diagnosis.
