Doctor of Medicine, Professor A.L. Dmitriyev
Josef Pilsudski Academy of Physical Education in Warsaw

Keywords: training process, spine, dorsopathy, weightlifters.

Introduction. The number of studies on the development and diagnosis of the locomotorium degenerative-dystrophic diseases is constantly growing. The socio-economic importance of this problem is noted by WHO, announcing a decade from 2000 to 2010 dedicated to this issue. However, despite numerous studies, the causes and mechanisms of development of degenerative changes to the locomotor system have not been fully identified. This refers to sports activities to the full extent. As early as in 1984, experienced specialists in this field G.E. Yumashev and M.E. Furman [4] pointed out that the problem of spine degenerative lesions has been studied for a century, but the etiology questions are still awaiting final resolution. According to some authors, today the identification of key factors for the development of these changes at the molecular level seems to be the most efficient approach to the diagnosis, clinic and treatment of syndromes of damage to the locomotor and peripheral nervous system. Recently, the influence of low-molecular metabolism bioregulators on the structure and function of tissues has been emphasized. It has been established that substances of a peptide nature can influence many metabolic components and physiological processes of the body, as well as that degenerative-dystrophic processes in the connective tissue are systemic and develop as a result of imbalance between synthesis and catabolism of cartilaginous and bone tissue components.

Based on the results of our previous studies, it was demonstrated that during degenerative-dystrophic processes in the locomotor system, marked changes in the concentration of the pool of non-essential and essential amino acids are observed both in connective tissue and almost all physiological fluids of the body and muscular tissue [1]. This allowed to supplement the well-known concepts of degenerative-dystrophic changes development. Unfortunately, it should be noted that the incidence of degenerative-dystrophic diseases in childhood and adolescence tends to increase. Therefore, the diagnosis of osteochondrosis and related dorsopathies in young people should be no surprise. These issues are even less studied in sports practice. The reasons for the development of degenerative processes in cartilaginous and bone tissue of young athletes have not been fully identified. It is beyond argument that at the initial stage of development, these changes are compensatory in nature, and it is important to determine the stage when they become pathological. We usually talk about this when a patient develops pain syndrome and other clinical manifestations. The pain syndrome issue is also ambiguous and requires study [3]. In this regard, the importance of early diagnosis of such changes for improving training and recovery processes with account for the peculiarities of high physical and emotional load influence on the physiological development of the locomotor system in young athletes is on the rise.

Objective of study was to determine the impact of training process of young weightlifters on their spine functional and structural state.

 Меthods and structure of study. A group of 152 young weightlifters (19 girls and 133 boys) aged 15-16 years and doing sport for 3-5 years was examined. They were thoroughly surveyed about the back pain presence during training process; their spine motor function was determined and spine X-ray pictures, done according to indications to clarify the diagnosis, were examined.

Results of study and discussion. The study identified back pain complaints in four girls (21%) and twenty boys (15%). Different manifestation degree of the tension of spine extensors and spine motor function limitation, especially in the lumbar and thoracic regions were clinically determined. Radiograph examination revealed changes in the bone tissue of the vertebral bodies in the form of the so-called osteophytes that were characteristic of degenerative-dystrophic processes. Endplate sclerosing was also determined indicating their blood supply disturbance (Fig. 1). Decreased height of the intervertebral discs allowed to assume that structural changes peculiar for osteochondrosis development occur in the cartilaginous tissue as well. During pain syndrome aggravation, athletes underwent complex conservative treatment, including medication and physiotherapy, massage, manual therapy, etc. Sports activity includes all human capabilities granted by nature and their development as a result of intensive and long-term physical training. Currently, the level of sports achievements depends on a number of factors, primarily on the volume and intensity of training loads. It should be noted that children of an increasingly young age begin to practice sport, becoming the Olympic champions at the age of 16. As a result of this, physical loads on still immature locomotor system significantly increase. At the same time, as noted by well-known American experts in sports medicine, L. Micheli and M. Jenkins [3], it would be unreasonable to ignore the serious negative aspect of sport and physical activity hey-day, namely injuries. What is more, the greatest concern at present is not caused by acute injuries, but a relatively new category – overuse injuries. Most worrisome is the fact that in the face of a growing number of injuries among athletes, repeated injuries become common, which indicates the inadequacy of measures aimed at recovering from injuries. A large number of people are forced to withdraw from training due to the occurrence of long-term complications, such as dorsopathies and others. Therefore, the study of this problem with the purpose of improving diagnostics, early preventing and rendering qualified assistance in such conditions assumes a greater importance. In this regard, it should be noted that radiologic investigations and computed tomography utilized to diagnose changes in the spine, cannot be used often or several times in a row due to negative impact of ionizing radiation on the body. There is much concern about the dynamic monitoring of spine condition and functioning in athletes at different stages of training process. Such an opportunity exists in various centers, including the laboratory of the Warsaw Academy of Physical Education and Sports using the Rasterstereographs (rastersterography) technique [5]. It allows making a photogrammetric assessment of the condition of the spine and its connection with the pelvis. The spinal model obtained during the study is assessed in three projections at once. Anatomical and biomechanical assessment of standard anatomical criteria and comparison of indices with normal values are also possible. Among them, one may determine the level of the pelvis standing, its rotation, the angle of kyphosis and lordosis, evaluate posture and other indices. The technique is non-invasive, safe for the patient and staff. This is a quick, non-contact and automatic method enabling precise assessment of spine condition in various projections.

Thus, the causes of changes in the spine may be different. They are also noted in persons involved in the development of strength capacities at a fairly young age. In this regard, an acute question of early diagnosis of these changes and dynamic observations of them arises. Such observations of structural and functional changes in the spine and locomotor system enable a more efficient training process and prevention of damages.

Conclusions. Prolonged and intensive physical loads aimed at strength development of young athletes first lead to functional and compensatory changes in the locomotor system, which may be followed by the development of degenerative-dystrophic processes peculiar for spinal osteochondrosis. Timely and dynamic diagnosis and prevention of revealed changes allow to reduce the risk of developing clinical manifestations during sports engagement and to extend the time of an active training process.

References

1. Dmitriyev А.L. Manualnaya terapiya bolevogo sindroma pri osteohondroze pozvonochnika [Manual therapy of pain syndrome during spinal osteochondrosis]. Grodno GSMI.  1997. 112 p.
2. Micheli L., Jenkins М. Entsiklopediya sportivnoy meditsiny [Sports medicine encyclopedia]. Saint Petersburg: Lan publ.. 1997. 400 p.
3. Меlzak R. Zagadka boli [A riddle of pain]. Мoscow: Меditsina publ.. 1981.  p.
4. Yumashev G.S., Furman М.Е. Osteokhondrozy pozvonochnika [Spinal osteochondrosis]. Мoscow: Меditsina publ.. 1984. 384 p.
5. Hackenberg L., Hierholzer E., Buliman et al. Rasterstereographie analysis of axial back  surface rotation in standing versus forward bending posture in idiopathic scoliosis. J. Eur. Spine. 2006. No.15. pp. 1144-1149.

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Аbstract. Determining the impact of training process of 15-16 year old weightlifters on the functional and structural state of their vertebral column represented the main objective. In this regard, radiological and other clinical methods of studies were used. The results showed clinical manifestations of dorsopathies in 21% of girls and 15% of boys, whereas some athletes also had radiological manifestations of remodeling vertebrae bone tissue and cartilaginous tissue of the intervertebral discs. The findings allow to suggest that a certain training process orientation probably envisages the development of degenerative-dystrophic changes in the spine of young athletes. This requires methodological and preventive measures to preclude the development of vertebral osteochondrosis signs at a young age.