What is a disc protrusion or hernia?

When we talk about the spine we have to know that the vertebrae are separated from each other by a fibrocartilaginous structure called intervertebral disc, whose function is none other than to cushion and absorb impacts, allowing the movement of the skeleton.

Inside this intervertebral disc there is a gelatinous, water-rich compound called nucleus pulposus, surrounded by a fibrous ring external that protects and shapes it.

Mechanical overload or degeneration of the intervertebral discs can lead to one of these two injuries:

• Disc protrusionThe nucleus pulposus bulges out of the annulus fibrosus, but the annulus itself does not rupture. It can cause pain due to chemical inflammation or compression of nerve tissue.
• Herniated disc: Occurs when the annulus fibrosus ruptures and its contents (nucleus pulposus) extrude outward. It can cause severe pain, radiating pain, tingling, or weakness.

In both cases we say that 'can cause pain´ since having one of these two pathologies does not always justify the symptom. There are patients with asymptomatic protrusions or hernias and patients without disc problems who experience back pain.

Therefore, the most important thing is not to be alarmed by the imaging diagnosis, send yourself positive messages, and keep moving, since rest doesn't cure and hypervigilance is often a major problem when it comes to recovery.

Why do hernias or protrusions appear in athletes?

Herniated and bulging discs are common in athletes due to the stress placed on the tissue by certain uncontrolled movements. Some causes that can lead to them include:

• Lack of core stability: Deficit of the CORE and deep stabilizing muscles of the spine that cause movements of the vertebra-disc-vertebra assembly.
• Lifting weight without proper technique or using excessive load: Very common in sports such as weightlifting, CrossFit, or bodybuilding.
• Repetitive movements involving flexion and rotation of the trunk: such as golf, tennis, or paddle tennis.
• Continuous impact: such as running or contact sports.
• Overload, overtraining or lack of rest: They promote disc degeneration.

However, I have good news for you again, because the problem isn't the sport you practice, but rather not achieving a strong body with specific spinal exercises and adapting the load to your current situation.

Sometimes these pathologies occur accidentally, but in most cases it is due to not being strong enough to endure the exercise.

Finally, it should be noted that sitting in an office for eight hours a day is aggravating for disc disease. The patient should exercise and change positions during the workday.

Symptoms How do I know if I have a hernia or protrusion?

Symptoms vary depending on the severity and the affected area. The most common are:

• Lower back or neck pain that increases with activity.
• Pain radiating to the legs or arms.
• Tingling or numbness in the extremities.
• Loss of strength.
• Stiffness and blockage in the back.
• Loss of sensation.
• Burning or stinging.
• Interscapular pain (cervical hernia).

If you experience any of these symptoms that worsen with certain postures or movement, it's important to undergo a physical therapy evaluation and confirm the diagnosis with an imaging test, such as an MRI, to determine the severity of the injury.

Can you train or continue playing sports with a herniated or bulging disc? Recommendations

It depends on the severity of the injury. In acute stages, we must first reduce the inflammatory process and reduce exercises that compromise and place greater demands on the spine.

Recommended exercises for herniated and protruding discs

• Core strengthening (isometric exercises such as plank, dead bug, bird dog, pallof press).
• Strengthening of paravertebral muscles (extension, rotation and lateral flexion of the spine against resistance).
• Glute strengthening (bridge, hip thrust).
• Dorsal mobility and gentle, controlled flexion-extension exercises.
• Low-impact sports such as weight training, Pilates, or swimming.
• Strength of lower and upper limbs.

Exercises to avoid with herniated and protruding discs

• Heavy weight lifting.
• Deep spinal flexions (traditional abdominal crunches).
• Axial load exercises.

Is it possible for a hernia or protrusion to heal, shrink, or disappear over time?

The answer is yes. Over time and with appropriate conservative treatment, it is possible for a protrusion or herniation to disappear where it once was. Spontaneous regression of herniated disc material has been documented in numerous studies. Furthermore, we can attest to this fact after having experienced it with actual patients who have visited our clinic.

• Disc sequestration: Up to 96% of cases may experience regression.
• Disc extrusion: Around 70% of cases may show improvement.
• Disc protrusion: Approximately 41% can be reduced over time.

These data suggest that, in many cases, the body can reduce or eliminate the disc injury without surgical intervention.

Based on our experience, before a patient undergoes surgery for a disc problem, we must assess the severity of the problem and opt for conservative physical therapy whenever possible.

Treatment and recovery from disc protrusion and hernia. Leading sports physiotherapy clinic in Alcalá de Henares

At the Evolution Advanced Physiotherapy Clinic, we treat patients with back pain daily. When the problem is caused by a disc, we opt for physiotherapy.

Our physiotherapists and physical therapists have extensive knowledge of sports-related pathologies. Having worked in elite settings with professional and amateur athletes, they are leaders in the healthcare sector, employing advanced physiotherapy techniques that help the patient achieve a complete recovery from their injury, minimizing the risk of recurrence.

Therefore, if you are looking for the best sports physiotherapy in your city, Alcalá de Henares, Schedule your appointment with us and we guide you through the entire process.

Recovery stages of a disc disease:

• Pain and inflammation control:
  1. Application of cold/heat.
  2. Manual therapy techniques.
  3. Diathermy.
  4. Ultrasound-guided functional percutaneous neuromodulation.

• Active rehabilitation:
  1. Active exercises to improve mobility and reduce compression.
  2. Muscle strengthening.
  3. Postural re-education and improvement of habits.
• Progressive return to sport:
  1. Progressive introduction to training, avoiding excessive loads.
  2. Adaptation and improvement of the sports gesture.
  3. Preventive work (stability-mobility).