Degenerative Disc Disease
Dancing Smart Newsletter
April 8, 2005
Question of the week from Margo
question: What would your advise be for a 20 year oldcollege dance major who has just been diagnosed with degenerative disc disease?
Challenging question, Margo. This is certainly a wake up call for this young dancer, asgenerally, the diagnosis of degenerative disc disease isn't given to manypeople in her age bracket. Having said that, degenerative disc disease does not have to be lookedupon as a sentence that has been handed down in which no change ispossible. Quite the contrary. Let's start with some basic discinformation.
The discs act as shock absorbers between the bones of thespine. You've got these(hopefully) plump pillows between the bones that rotate or bend when youmove. Remember bones carrythe weight of the body and movement takes place between the bones at thejoints. The discs are consideredto be a joint between two bones where the movement capability of each is small,but when working together, the movement capability of the spine is quitelarge. There are 23 discs in ourspines, with the discs in the lower back more prone to disc problems.
Each disc has two parts to it. The firm outer part is called the annulus fibrosus. This portion contains nerves and can bepainful when there are tears in this area. The inner part of the disc has a soft, jelly-like core,called the nucleus pulposus. Whenthis area tears, fluid can leak out also causing great pain. This area is important for shockabsorption.
The discs are composed of collagen (cartilage), protein, andwater. The inner nucleus is about80% water, and the outer part is around 65% water. In order for the discs to function properly they MUST have ahigh water content. I remember adoctor talking about how the body prioritizes its water usage with theessential organs getting first dibs, and rightfully so! We want the heart and other organs tokeep pumping efficiently! When thebody begins to get dehydrated it will pull available fluid from -– youguessed it –- the joints and discs. (Being dehydrated will also make your brain fuzzy and harder to focus asscience has well proven the connection between optimal brain functioning anddehydration)
That brings me to the first suggestion for anyone with discissues, no matter what their age, to drink more water. Not soda, not juice, not coffee, butwater.
Let me use an analogy that may help you to visualize therole of the disc. Let's imaginethe bones of your spine like vanilla wafers and the discs as marshmallows. When the discs are well hydrated youcan gently press two vanilla wafers together and the marshmallow would gentlycompress and then expand out to its original shape. If you let marshmallowsstay out on the counter for a few hours (drying out) they begin to get stifferand more brittle. No longer arethey as flexible. If you let marshmallows dry out even longer then they beginto crack at the edges and get smaller. Like marshmallows, our discs need to maintain a level of hydration tostay flexible.
Did you know that normal discs get measurably larger duringthe night when you are non-weight bearing? (This is why you are slightly shorter in the evening, aftergravity has done it's number on our body.) That is, if the body has enough water to do it'shousekeeping chores at night and plump up those discs. No, I'm not suggesting that we drinklost of water before bed - who wants to be going to the bathroom all night -but starting off the day with a tall glass of water and getting your quart ormore in during the day is incredibly important.
Getting a diagnosis of DDD (Degenerative Disc Disease) makesone think that it is going to be an ongoing process of deterioration, but thisisn't necessarily so. It is truethat over time our discs are subject to wear and tear over time as part of thenormal aging process. This doesn'tmean that all elderly people will exhibit symptoms of degenerative discdisease.
Besides hydration, what are other influences to thedisc? Chronic microtrauma can be acause. I have a strongrecollection of a young gymnast who was give DDD as a diagnosis. She had hypermobile joints, and wasconstantly dropping her weight into the lower back as she flipped andturned. Her abdominal strength wasnot in balance with her extreme flexibility and she had to stop gymnastics foralmost 6 months to allow her back to heal while doing physical therapy to bringher musculature into a better balance. I helped her put what she learned inphysical therapy into her regular life and her gymnastics. Translating, so to speak, the muscularchanges into postural changes so she didn't continue the pattern of trauma. The good news is she was able to returnto gymnastics, and is now a dancer in NYC, and doing very well.
It is possible for bone spurs to develop on the vertebra,which could create pain around the disc. Disc space can be compressed or compromised by chronic poorposture. Even dancers, whenoutside of class, don't always have the best posture. If one has poor mechanics in their daily life, thosepatterns must be addressed to complete the rehabilitation process. Good posture, like health, is somethingthat is much easier to maintain with a daily focus, rather than healing from amajor injury or disease. Lifestyleinfluences such as the amount of rest, stress, good nutrition, (or not), areall important to your dancer's rehabilitation.
Now that this dancer has been given the diagnosis, her orshe will be doing physical therapy and watching their water intake. I hope that this dancer doesn't getdiscouraged with such a serious sounding condition that he/she misses theopportunity to make positive changes in his/her health and lifestyle. The DDD diagnosis is a way ofdescribing the condition of the disc/discs at this point in time. The body has amazing healing propertiesand I want them to hold the possibility of ultimately coming away from thissituation stronger and healthier.
My warmest wishes for a speedy recovery!
Deborah