Lumbar intervertebral disk degeneration in elite competitive swimmers: a case control study.
BACKGROUND
The majority of orthopaedic problems experienced by competitive swimmers are related to pain in the shoulder, low back, and knee. Three of 39 national swim team members were hampered in their performance due to lumbar disk herniation at an international competition in 2001. There has been no previous research into lumbar disk degeneration in elite competitive swimmers.


OBJECTIVE
Excessive competitive swimming activities accelerate lumbar disk degeneration.


METHODS
Case control study; Level of evidence, 3.


METHODS
Fifty-six elite swimmers (high-load group, 35 men and 21 women; mean age, 19.6 years) and a control group of 38 university recreational level swimmers (low-load group, 24 men and 14 women; mean age, 21.1 years) were evaluated for lumbar disk degeneration using magnetic resonance imaging. We compared the prevalence of disk degeneration and the disk level between the 2 groups and further investigated the relationship among their symptoms, swimming styles, and disk degeneration.


RESULTS
Thirty-eight (68%) elite swimmers and 11 (29%) controls had degenerated disks at various disk levels, and the prevalence was significantly greater in the elite swimmers (P = .0002). Comparison between the 2 groups of the prevalence of disk degeneration at each level revealed that the disk level of L5-S1 was significantly more frequently degenerated in the high-load group (P = .026). There was no significant relationship observed among the variables of low back pain symptoms, swimming strokes, and disk degeneration.


CONCLUSIONS
Excessive competitive swimming activities might exaggerate lumbar intervertebral disk degeneration, especially in the L5-S1 intervertebral segment.
Kaneoka
Koji
K
Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan. seikei@md.tsukuba.ac.jp
Shimizu
Ken
K
Hangai
Mika
M
Okuwaki
Toru
T
Mamizuka
Naotaka
N
Sakane
Masataka
M
Ochiai
Naoyuki
N
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology*; D007564:Japan; D008161:Lumbosacral Region / Q000473:pathology*; D008297:Male; D013122:Spinal Diseases / Q000175:diagnosis / Q000209:etiology; D013177:Sports; D013550:Swimming