Herniated lumbar disk associated with running. A review of 10 cases.

This paper studies the courses of treatment and recovery in 10 runners with acute back and leg pain. All ran at least 20 miles/week, had pain during or shortly after running, and were diagnosed for herniated lumbar disk for myelogram, electromyogram (EMG), or objective motor weakness and reflex changes. Two or more high-risk factors contributed to the disk syndrome in each runner. These included being 30 to 50 years old (9 runners), being under 72 inches tall (6 runners), having tight joints (6 runners), changing running style (5 runners), and having a previous herniated lumbar disk (3 runners). Early diagnostic problems led to incorrect initial diagnosis in three runners. The conservative treatment program consisted of controlled rest, anti-inflammatory medication, alternative exercises, and a gradual return to running in 6 to 12 weeks. All runners were treated with Williams' exercises. Eight were put in traction as inpatients, and seven were given injections of epidural steroids. Three required laminectomies; two of these resumed active running. The return to sports participation was excellent in this group. Eight returned to active running and one became a marathon bicyclists. Only one runner was unable to return actively to sports.