What To Know About Brooks Lee's Back Injury and Disc Herniations in Baseball

[Lucas Seehafer PT]

According to Aaron Gleeman, the Minnesota Twins' top prospect is expected to miss at least another month after recently being diagnosed with a disc herniation in his balky back.

Image courtesy of © Sam Navarro-USA TODAY Sports

A herniation, which often first presents as back spasms as the lumbar musculature contracts to "protect" the injured tissue, occurs when the inner, more fluid portion of the intervertebral disc protrudes outward either against or through the outer, more dense rings of cartilage. Brooks Lee, of course, was first diagnosed as suffering back spasms when he was held back to begin the minor-league season.

The most common mechanism for acute (i.e. "instantaneous") herniation is the forceful rotation of the spine in combination with an axial load. It is no coincidence that the textbook definition of "the forceful rotation of the spine in combination with an axial load" is a baseball swing. If the herniation is large enough, it can compress nearby nerves, or even the spinal cord itself, which can cause numbness, tingling, and weakness in the legs.

However, as concerning as that sounds, disc herniations are exceedingly common--and they typically resolve without surgical intervention. According to previous research, it is estimated that up to 30-40% of elite athletes (depending on their sport) have disc herniations in their lower back, but do not have any symptoms. Among professional baseball players who do have symptoms (i.e. pain, numbness, tingling, etc.), the return-to-play rate is nearly 100%, with athletes who ultimately underwent surgery returning in an average of eight months and those who did not returning in six.

According to Gleeman, Lee is approximately halfway through an eight-week rehabilitation process overseen by Dr. Robert Watkins, one of the foremost back specialists in the United States. Current best practices indicate that athletes should undergo roughly eight weeks of rehab, focusing on improving core and lower back strength while reducing nerve irritation, before even contemplating going under the knife. (It is common for athletes to also receive a cortisone injection, which reduces inflammation of the nerve and surrounding tissue.)

Most symptoms of disc herniation resolve within the above timeframe. Contrary to popular belief, disc herniations (especially those that are relatively small) can be reabsorbed by the body and spontaneously heal on their own. Surgery to remove the disc, known as a microdiscectomy, is viewed as a last resort, as its rate of success is commensurate with conservative treatments and may increase the odds of re-herniation. 

Disc herniations have been reputed to be a significant, career-altering, potentially career-threatening injury, but the research suggests that it isn't that cut-and-dried. The academic studies that have indicated that the condition can seriously impact an athlete's career contain a significant risk for inaccuracy, due to the difficult nature of adequately establishing control groups in professional sports. (They also tend to use statistics such as batting average and runs batted in to measure the impact of the injury. We know better now.)

It is by no means good news that Lee has been diagnosed with a disc herniation but, as the research shows, it also shouldn't be a cause for panic.

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[bean5302]

Back issues for what seems like so many young players these days. It would have been nice to know more about Lee's issue earlier, but the Twins guard info as if each and every player is a starting NFL quarterback the other teams are prepping for on Sunday.

Hopefully, this clears up for Lee. I've never known somebody (and I've known many) people with a disc herniation who never had another problem with it again, but there are times where it doesn't show up for months or a couple years.

[Twins_Fan_in_NJ]

Lee's injury gets lost in the shuffle a little bit because the focus has been on Correa and Lewis, but how different would this team look if Lee was healthy and with the Twins since Lewis went down...

[Mike Sixel]

Thanks for the information! As always, great to have you here. 

[chpettit19]

As someone who had a herniated disk when I was barely younger than Brooks and still playing baseball (only pitching and not nearly at the level he's at, obviously) I can say it is really hard to play through that pain when it's herniated enough to be causing constant pain. I ended up needing a discectomy so I'm hoping Brooks isn't that bad because it is definitely a relatively lengthy rehab to get back to playing, and living, pain free.

He was seemingly playing pain free for much of spring so I'd guess he's in pretty good shape for recovery here. As the article says, most of these things (at least according to my Dr) heal on their own with rehab so hopefully it was a pretty minor one that they seem to have caught pretty early on and he'll do his couple months of rehab and be back to normal.

I was expected to be having surgery every 5 to 10 years because of my situation and continuing to play sports after, but I'm now nearly 20 years removed with no significant struggles beyond flareups here and there. Lots of stretching to help keep things working correctly, but I'm by no means in good shape so there's every reason to believe Brooks can do the necessary maintenance moving forward and this will just be a blip on the radar for him.

[Schmoeman5]

Half way through an 8 week rehab with Dr. Watkins. Hmm. We're just hearing about it. It sounds much more serious than originally reported. Good luck with your health Mr. Lee. I hope you can make a full recovery. 

[jimbo92107]

"It is by no means good news that Lee has been diagnosed with a disc herniation but, as the research shows, it also shouldn't be a cause for panic."

I think I'll panic anyway. It is the end of the world as we know it!

Whew, that felt good.

[laloesch]

1 hour ago, chpettit19 said:

As someone who had a herniated disk when I was barely younger than Brooks and still playing baseball (only pitching and not nearly at the level he's at, obviously) I can say it is really hard to play through that pain when it's herniated enough to be causing constant pain. I ended up needing a discectomy so I'm hoping Brooks isn't that bad because it is definitely a relatively lengthy rehab to get back to playing, and living, pain free.

He was seemingly playing pain free for much of spring so I'd guess he's in pretty good shape for recovery here. As the article says, most of these things (at least according to my Dr) heal on their own with rehab so hopefully it was a pretty minor one that they seem to have caught pretty early on and he'll do his couple months of rehab and be back to normal.

I was expected to be having surgery every 5 to 10 years because of my situation and continuing to play sports after, but I'm now nearly 20 years removed with no significant struggles beyond flareups here and there. Lots of stretching to help keep things working correctly, but I'm by no means in good shape so there's every reason to believe Brooks can do the necessary maintenance moving forward and this will just be a blip on the radar for him.

Back troubles like this typically plague the individual the rest of their life.  I have scoliosis partly due to the fact that I grew so fast to 6'-5" in my youth.  It's not severe, but I have to be very careful how I twist or bend over because that can trigger back spasms and sharp Sciatic nerve pain which hurts so bad it literally feels like someone is stabbing you with a knife.  Really, it's that bad.  I've had multiple back hernia's and they hurt too, but the sciatic pain is 10x worse, omg, shudders. 

Years ago, I was in so much pain from a back strain and a disc hernia I went out and bought one of those Tempur-Pedic beds for $5,000.  People thought I was crazy for spending that much money on a bed but let me tell ya it was absolutely the best thing I ever did.  Have slept like a baby ever since, keeps the spine perfectly aligned during sleep, and is worth it's weight in gold.

Judging by the article he probably has a mild enlarged disc or minor disc hernia.  If it becomes a continual problem he might eventually need fusion or disc removal which is not good.  The good news is that he's young and in top physical condition which helps immensely in recovery.  

[mikelink45]

Back injuries are so common, they have excellent techniques to repair.  I have had 8 herniated disks, still taught XC skiing, whitewater canoeing, mountain climbing and winter camping.  I have had two back operations, but still remember the doctor telling me when I was 17, you will not play sports again.  But I did football, basketball, softball and many more.  It is a matter of developing muscular support like the essay says. 

[JD-TWINS]

Finish re-hab by end of May…….slowly get into baseball activities through June………available after the All-star break……reasonable?

[Kenny Powers]

Oh man...what a horrible development.  This really sucks.  I'm assuming they will figure out a way to get him back on the field.  But it just seems like yet another in a long line of really good prospects that get saddled with injuries.  If we put our heads together we could probably put together a long list going back to Kubel tearing up his knee up along with Mauer doing the same - so on and so forth.

Anyway...sports medicine has never been better than it is now, so I'm certainly not writing him off.  But as many have mentioned...once you have back issues - it's sort of something you will continue to deal with the rest of your life.  Ugh!  Just a terrible break.  No question the kid would be playing in the bigs right now had this not occurred.  

[jkcarew]

John Castino?

[Dave Borton]

Very well written, thanks. Wish you were working on my shoulder right now.

[Dave Borton]

3 hours ago, Kenny Powers said:

@Lucas Seehafer PT...Anyway...sports medicine has never been better than it is now, so I'm certainly not writing him off.  

Lucas, maybe I am misremembering injuries from my youth of the '50s, but I never remember the slew of injuries in baseball which we see today.

Is my memory misleading me or are the athletes of today better conditioned than they were in the past? Has sports medicine really improved the durability of today's baseball players. Thanks in advance.]

[Lucas Seehafer PT]

51 minutes ago, davidborton said:

Lucas, maybe I am misremembering injuries from my youth of the '50s, but I never remember the slew of injuries in baseball which we see today.

Is my memory misleading me or are the athletes of today better conditioned than they were in the past? Has sports medicine really improved the durability of today's baseball players. Thanks in advance.]

This is a tough question to answer. The short answer is yes, sports medicine is better than it was in the past.

The more detailed answer is that injuries are complex. Athletes have never been stronger or faster. They also are specializing in their sport at a much earlier age and are playing year round. In the 50s, athletes played during their season, maybe did some offseason training, and possibly worked a second job. 

Athletes are exposing their bodies to such dramatic forces so frequently these days that they breakdown and do so at earlier ages. 

However, the treatments for these injuries have never been more scientifically based and effective. We know way more now than we did even a decade ago. It's just all the miles the athletes put on their bodies starting as low as age 10 is just too much to compensate for new training and treatment techniques. At least that's my educated guess in a nutshell.

[FlyingFinn]

10 minutes ago, Lucas Seehafer PT said:

It's just all the miles the athletes put on their bodies starting as low as age 10 is just too much to compensate for new training and treatment techniques.

You would think a team would start weighting the amount of time played in their drafting. A kid starts pitching at age 15 and is an equal rating (or maybe slightly below) as someone who started at age 10, both stars. The team would take the kid with less pitches made in his arm.

[Kenny Powers]

14 hours ago, davidborton said:

Lucas, maybe I am misremembering injuries from my youth of the '50s, but I never remember the slew of injuries in baseball which we see today.

Is my memory misleading me or are the athletes of today better conditioned than they were in the past? Has sports medicine really improved the durability of today's baseball players. Thanks in advance.]

I think the other guy hit on it.  We've created athletic freaks of nature that are bigger/faster than ever so it would make sense that it leads to more injuries.  Example:  24 year old Royce Lewis blowing out his quad just running the bases.  I'm 100% confident that I (a middle aged man in slightly above average shape) could run the bases without blowing out anything.  But I couldn't do as fast he does - that's for sure.  It's become a trade off.

But where the advancements come in is when you think of the surgeries and recoveries now.  Example, Adrian Peterson blew out his knee and was back running for 1,000 yards the next season.  Back in the 70/80's those injuries were career ending.  Same with Tommy John surgery.  It's like getting your tonsils taken out now - no big deal.  Most guys come back better than ever where as before they'd be washed up.  It's amazing.

[tarheeltwinsfan]

15 hours ago, davidborton said:

Lucas, maybe I am misremembering injuries from my youth of the '50s, but I never remember the slew of injuries in baseball which we see today.

Is my memory misleading me or are the athletes of today better conditioned than they were in the past? Has sports medicine really improved the durability of today's baseball players. Thanks in advance.]

I believe we are better able to diagnose and treat and prevent sports injuries now. We also have mass media reports of every little hangnail now. 

[Linus]

Lucas - thanks for these articles. Just so helpful to get science based info. Is manual manipulation of the disk part of the therapy?

[Jeff K]

23 hours ago, Bigfork Twins Guy said:

Couldn't have happened at a worse time for Lee and the Twins.  Good luck on your recovery Brooks.

Boy, isn't that the truth.  Our infield hitting has been awful.

[bean5302]

Probably are way more injuries these days. We know pitchers now throw 100% effort and harder than ever. Velocity = arm injuries. Hitters are 20-50lbs heavier than they used to be. Players are faster, stronger, bigger, heavier. Stronger muscles and heavier weights + max effort = injury.

[Lucas Seehafer PT]

On 4/24/2024 at 9:14 AM, Linus said:

Lucas - thanks for these articles. Just so helpful to get science based info. Is manual manipulation of the disk part of the therapy?

Manual manipulation of the spine (aka back cracking) is probably one of the hands-on treatments they're doing as well as soft tissue massage. The back cracking causes nitrogen bubbles with the joints to break up, which reduces pressure in the joints that can be aggravating for the nerves and surrounding tissue. That's why cracking joints feels so good and improves mobility.

[nicksaviking]

On 4/24/2024 at 8:07 AM, Kenny Powers said:

I think the other guy hit on it.  We've created athletic freaks of nature that are bigger/faster than ever so it would make sense that it leads to more injuries.  Example:  24 year old Royce Lewis blowing out his quad just running the bases.  I'm 100% confident that I (a middle aged man in slightly above average shape) could run the bases without blowing out anything.  But I couldn't do as fast he does - that's for sure.  It's become a trade off.

Agree with the first part about pushing biology to the max, but not the second part. I'm in better shape at 45 than I was at 30, but I can throw out my back by sleeping on a new mattress and set off a pain in my knee (arthritis?!?!?) just walking up the stairs. I'd probably end up in the hospital running the bases.