Effectiveness of therapeutic exercises for lumbar disc herniation in an athlete

Abstract

Lumbar Disc Herniation LDH affects athletes more than the majority of the general population worldwide. The standard management of lumber disc herniation is a conservative treatment including non-steroid anti-inflammatory drugs and physical therapy however if conservative management fails to improve patient manifestations, surgery is recommended. The goal of this study was to emphasize that, whether the therapeutic exercise intervention for an athlete patient with a lumbar disc herniation complaining of Low Back Pain (LBP) radiating to the lower limb would be effective in return to sports activities. A 37-year-old athlete weightlifter patient was referred to the physical therapy department with a chief complaint of low back pain radiating to the right lower limb for the last year, patient was using a cane as a walking aid since a sports injury almost a year ago. The patient had been diagnosed via Magnetic resonance imaging with L5-S1 disc herniation. The clinical musculoskeletal examination consisted of; a range of motion, muscle manual test, pain severity scale by visual analogue scale, and lower extremity functional index. The patient was handled by a single physiotherapist who is well-experienced in managing sports injuries, our patient had received 24 sessions in 8 weeks, divided into 4 intensity-increasing phases. In the first phase, the goal was to reduce pain, through gentle stretching, and Range of Motion ROM exercises. The exercises increased in intensity gradually throughout each phase. The last phase's goal was to allow the patient to return safely and effectively to the sport, this phase continued with the same given program before in addition to sport-specific exercises. The patient's initial visual analogue scale was 8\10 and Lower Extremity Functional Index LEFI 18\80. In the last session of the treatment program patient scored by the Visual Analogue Scale VAS 2\10, and lower extremity function index LEFI 72\80. The patient was able to carry out the functional activity in a free pain Range of Motion ROM with appropriate posture and he was capable to return to his usual sports activities. This report describes the treatment program of an athlete patient with Lumbar Disc Herniation LDH that resulted in decreased pain, improve motor function, and the ability to return to sport.