by Michael Nieraeth, DPT, SCS, OCS, CSCS
Back surgeries can be some of the hardest surgeries to return from when considering return-to-sport. This is partly because there is a wider range of involvement in surgeries performed on the spine. A microdiscectomy may require 2-3 months of time off from your respective sport and then a slow, gradual return to sporting activities. A back-fusion surgery may take over a year to return to sport, as bone growth must occur and the hardware needs time to help generate stability in the spine.
During any sport, the spine is the most important structure. The spine connects the arms to the legs and the supporting muscles create most of the force and stability for any athletic movement. There are rotational and compressive forces occurring at the spine with all movements and therefore, the spine is almost constantly under stress, even during some of the most basic movements.
Because of the timelines and the importance of the spine, back surgeries should be avoided if possible. The source of pain from the spine is not as easy to pinpoint, unlike pain in the shoulder or knee. There are most likely several levels in the spine causing the pain, or it could even be a referral pain from another joint. Studies where an MRI taken of people with and without back pain show that 40% of those without back pain had positive findings of disc pathology.
Return-to-sport can occur when there are no symptoms going down the leg. You should be able to pass the previously discussed return-to-sport tests for the arms and return-to-sport test for the legs. Endurance should also be tested. Below are specific return-to-sport tests for the spine that should be used in conjunction with the aforementioned tests.
This is an endurance test for the back extensor muscles. You should be able to hold the position for 176 seconds. With help from your PT, the lower legs and then hips should be strapped to a table. Have a chair or stool available to help before the test. The test begins when you lift the trunk and cross arms over the chest.
Keeping the shoulders down and back and without letting the back arch or hips sag, you should be able to hold this position for 2 minutes.
Seated Rotational Medicine Ball Toss
Sit on the ground with your legs straight. Rotate and throw the medicine ball as far as you can to one side. Turn and repeat on the other side. The distance of tosses should be within 90% of each other.
Please reach out for an appointment with a physical therapist to assist with testing and additional return-to-sport programming.