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  • Noteworthy Injuries

Marcus Trufant

10-21-2011

Seattle Seahawks cornerback Marcus Trufant has been placed on injured reserve with a "back injury".


It’s not currently known if Trufant will need surgery but it is known that he is done for the season. In 2009 Marcus had a lumbar disk issue that cost him the first six games of the season. His latest problem popped up last week, and coach Pete Carroll said Trufant was unable to bend over to tie his shoelaces.

 

Originally, Carroll called it a bruised sacrum, but now he says it’s now looking similar to what Trufant suffered in ’09. “This is for lifelong care," Carroll said. "We've got to take care of this guy or this could be a problem that could bother him forever."

 

After spasms calm and you cannot bend over to tie your shoes it is most commonly a facet (joint) injury or lower lumbar disk issue. Lower lumbar sprains and disk injuries off the field for the normal popoulation are one of the most common injuries that are seen in physical therapy clinics. It is estimated 60% to 80% of the US population will experience back pain during their lifetime.

 

The Seahawks team physician Dr. Stan Herring will most likely handle the the care of Marcus whether they opt for conservative management (no surgery and just PT) or surgical intervention (dissectomy).

 

Disc Injuries

The intervertebral disc is one of the most common sources of low back pain. Intervertebral discs are structures in between the lumbar vertebrae that act as shock absorbers for the spine. They help aid trunk motion, transmit loads from one vertebral body to the next, and help protect various structures in the low back such as the lumbar vertebrae and nerve roots.

 

The intervertebral disc is made up of two parts, the annulus fibrosus and the nucleus pulposus. The nucleus pulposus contains a gel made primarily of water and proteoglycans and acts to resist axial compression and distribute compressive forces. The annulus fibrosus is made primarily of collagen fibers and encloses the nucleus pulposus; which helps withstand tension within the disc. There are several theories as to the source of pain generation in a disc injury involving an intervertebral disc that is either degenerative or herniated. Mechanical compression and an inflammatory response is one hypothesis to explain pain from a disc injury. Compression of a nerve alone is not necessarily painful although if the nerve is inflamed than it can cause severe pain with very little compression.

 

The most common presentation of lumbar pathology involving the intervertebral disc is a disc protrusion resulting in radiculopathy. This will typically involve unilateral leg pain, increased pain when sitting and decreased pain when standing or walking. Lower extremity weakness may also be present due to myelopathy. Forward trunk bending, rotation, or a combined trunk flexion-rotation movement usually causes this type of injury.

 

Possible Treatments in Physical Therapy

1. Manual Intervention: to focus on improving lumbar ROM, normalize mechanics of the spine and sacrum.

2. Soft Tissue Mobilization: as indicated to reduce muscle guarding and soft tissue overload to restore normal resting muscle length and full pain free ROM.

3. Strengthening: with activities emphasizing segmental mobility and strengthening emphasizing lumbar stabilization. Postural training and reconditioning.

4. Traction: manual and/or mechanical traction of the lumbar spine will help reduce compressive forces on the herniated disc by unloading the lumbar spine.

5. Modalities: as indicated to reduce pain and inflammation at the lumbar spine.

 

 

Author:

Ben Wobker, PT, MSPT, CSCS

 

Other Injuries:

(click here)

 

Photos:

Larry Maurer, DPM

 

Sources:

Orthopedic Physical Assessment, 4th Edition. David J. Magee, 2006. Physical Rehabilitation: Assessment and Treatment, 4th Edition. Susan B. O’Sullivan and Thomas J. Schmitz, 2001. www.emedicine.medscape.com/article/94554-overview

 

 

Trufant

Trufant

Disc

Disc

 

Disc


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