Athlete Driven Research

Boulder Neurosurgical & Spine Associates practices evidence-based medicine by integrating clinical experience and patient values with the best available research information and technology. We sponsor and actively participate in several ongoing research projects. Recently, we published results of our epidemiological study that was performed to identify risk factors associated with the occurrence of neck and back pain in triathletes and to establish the lifetime incidence of such disorders in multi-sport athletes. This landmark study was one of the first comprehensive studies of neck pain and overuse injuries in multisport athletes. Information was collected about physical characteristics, training habits, athletic status, number of races completed, and neck or low back pain among triathletes. The study population consisted of triathletes who lived and trained in the Boulder, Colorado area.

The lifetime incidence of low back pain was 68% with 24% possibly being of the discogenic origin. The lifetime incidence of neck pain was 48%, with 21% being consistent with intervertebral disc involvement.

Sports medicine enthusiasts initially thought that triathlon would be associated with less overuse injury due to more balanced stress distribution in the musculoskeletal system. Instead, our study demonstrated that triathletes tend to train more hours per week compared to any other group of single sport athletes, which leads to a higher incidence of injury.

Early back pain symptoms should not be ignored, even if they last less than seven days and lead to spontaneous recovery. Our study demonstrated that some triathletes reported that their back pain was not sports-related, but related to and/or exacerbated by overuse injuries and intense repetitive loads during training and competitions.

Recurrent symptoms or persistent and chronic back pain that lasts longer than three months is more typically associated with degenerative lumbar disc disease, spondylolysis, spondylolisthesis, traumatic injuries to the intervertebral disc, lumbar facet syndrome, or even fractures. Fortunately, the majority of sports-related back problems resolve with conservative, nonsurgical management.

The etiology of even minor injuries in triathletes should be professionally evaluated in order to modify the cycle of overuse-associated injury and increase training time devoted to flexibility and muscular balance. A different approach is needed when treating athletes due to their high activity levels and expectations to return to sports. Therefore, extensive conservative measures should be exhausted before considering any invasive procedure.

Please click the following links to read our recent published articles in Neurosurgical Focus (PDF) and
J Neurosurg Spine (PDF) on Neck and Back Pain in Triathletes. The findings of the epidemiological study on neck pain in triathletes were also summarized this poster (PDF). This study was presented at national and international presentations including 2007 Annual Congress of Neurological Surgeons (CNS) Meeting, 2008 Euro Spine meeting in Geneva, Switzerland, 2008 American Association of Neurological Surgeons (AANS) Annual Meeting, 23rd Annual AANS/CNS Section on Disorders of the Spine and Peripheral Nerves Meeting, and 21st Annual Neurosurgery in the Rockies Meeting.