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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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