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There is evidence in animal populations that loading and exercise can positively impact the intervertebral disc (IVD). However, there is a paucity of information in humans. We examined the lumbar IVDs in 308 young athletes across six sporting groups (baseball, swimming, basketball, kendo, soccer and running; mean age 19yrs) and 71 non‐athletic controls. IVD status was quantified via the ratio of IVD to vertebral body height (IVD hypertrophy) and ratio of signal intensity in the nucleus to that in the annulus signal (IVD nucleus hydration) on sagittal T2‐weighted MRI. P‐values were adjusted via the false discovery rate method to mitigate false positives. In examining the whole collective, compared to referents, there was evidence of IVD hypertrophy in basketball (P≤0.029), swimming (P≤0.010), soccer (P=0.036) and baseball (P=0.011) with greater IVD nucleus hydration in soccer (P=0.007). After matching participants based on back‐pain status and body height, basketball players showed evidence of IVD hypertrophy (P≤0.043) and soccer players greater IVD nucleus hydration (P=0.001) than referents. Greater career duration and training volume correlated with less (i.e. worse) IVD nucleus hydration, but explained less than 1% of the variance in this parameter. In this young collective, increasing age was associated with increased IVD height. The findings suggest that basketball and soccer may be associated with beneficial adaptations in the IVDs in young athletes. In line with evidence on other tissues, such as muscle and bone, the current study adds to evidence that specific loading types may beneficially modulate lumbar IVD properties. peerReviewed

(1) Background: Assessments of intervertebral disc (IVD) changes, and IVD tissue adaptations due to physical activity, for example, remains challenging. Newer magnetic resonance imaging techniques can quantify detailed features of the IVD, where T2-mapping and T2-weighted (T2w) and Dixon imaging are potential candidates. Yet, their relative utility has not been examined. The performances of these techniques were investigated to characterize IVD differences in asymptomatic individuals with distinct physical activity histories. (2) Methods: In total, 101 participants (54 women) aged 25&ndash, 35 years with distinct physical activity histories but without histories of spinal disease were included. T11/12 to L5/S1 IVDs were examined with sagittal T2-mapping, T2w and Dixon imaging. (3) Results: T2-mapping differentiated Pfirrmann grade-1 from all other grades (p &lt, 0.001). Most importantly, T2-mapping was able to characterize IVD differences in individuals with different training histories (p &lt, 0.005). Dixon displayed weak correlations with the Pfirrmann scale, but presented significantly higher water content in the IVDs of the long-distance runners (p &lt, 0.005). (4) Conclusions: Findings suggested that T2-mapping best reflects IVD differences in asymptomatic individuals with distinct physical activity histories changes. Dixon characterized new aspects of IVD, probably associated with IVD hypertrophy. This complementary information may help us to better understand the biological function of the disc.

Background context Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear. Purpose To examine whether exercise can beneficially affect IVD characteristics. Study design/setting This is a single-blinded 6-month randomised controlled trial (ACTRN12615001270505) in an exercise and physiotherapy clinic. Patient sample Forty patients with chronic non-specific low back pain (NSCLBP) are included in this study. Outcome measures The primary outcome was lumbar IVD T2 time (MRI). Secondary outcomes included IVD diffusion coefficient and IVD expansion with short-duration lying. Methods Twenty patients progressively loaded their lumbar IVDs (exercise) via an exercise programme involving progressive upright aerobic and resistance exercises targeting the trunk and major muscle groups and were compared to twenty patients who performed motor control training and manual therapy (control). Testing occurred at baseline, 3 months and 6 months. Results Seventeen exercise and fifteen control patients completed the interventions. There were no group-by-time differences in T2 time of the entire IVD (exercise 94.1 ± 10.0 ms vs. control 96.5 ± 9.3 ms, p = 0.549). Exercise patients had shorter T2 time in the posterior annulus at 6 months (82.7 ± 6.8 ms vs. 85.1 ± 8.0 ms, p = 0.028). Exercise patients showed higher L5/S1 apparent diffusion coefficients and decreased IVD height at 3 months (both p ≤ 0.050). After adjustments for multiple comparisons, differences lost statistical significance. Per-protocol and intent-to-treat analyses yielded similar findings. Conclusions This trial found that 6 months of exercise did not benefit the IVD of people with NSCLBP. Based on this index study, future studies could investigate the effect of exercise on IVD in different populations, with different types, durations and/or intensities of exercise, and using different IVD markers. peerReviewed

PURPOSE: Cycling is widely practiced as a mode of transportation, a leisurely pursuit and a competitive sport. Approximately half of cyclists experience low back pain. Yet, there has been limited study of spine tissue adaptations due to cycling. METHODS: To investigate potential risk factors for spinal pain, we compared 18 high-volume cyclists (>150 km per week for ³5 years) to 18 height-matched non-sporting referents. Participants had no history of spinal pathology. Magnetic resonance imaging was used to quantify intervertebral disc (IVD) morphology and hydration; and psoas, erector spinae, quadratus lumborum and multifidus muscle size and fat content. Endurance of trunk muscles (flexors and extensors) were measured and physical activity levels assessed objectively using accelerometry. RESULTS: Cyclists IVD showed prolonged T2-time (+10.0(17.3)%; p=0.021), implying better IVD hydration and glycosaminoglycan content, compared to referents. Lower thoracic and upper lumbar IVD T2 time were longer in cyclists (p≤0.029) but not at the lower lumbar spine. T2-time differences were larger in the nucleus pulposus compared to the annulus fibrosus. Cyclists showed larger psoas muscles with less fat content compared to referents. Cyclists also exhibited longer isometric trunk endurance times (p≤0.036) and higher physical activity levels (osteogenic index, p=0.038). CONCLUSION: Despite previous studies reporting higher than average prevalence of back pain in cyclists, the high-volume road cyclists in our cohort showed no anatomical or functional deficiency in spinal structures. In contrast, we found evidence for beneficial adaptations to the intervertebral discs and psoas muscles in high-volume cyclists compared to referents. These data support the notion that cycling is not detrimental to the spine; rather, in contrast, may be associated with beneficial changes at the spine. peerReviewed

Purpose Cycling is widely practiced as a mode of transportation, a leisurely pursuit, and a competitive sport. Approximately half of cyclists experience low back pain. Yet, there has been limited study of spine tissue adaptations due to cycling.Methods To investigate potential risk factors for spinal pain, we compared 18 high-volume cyclists (>150 kmwk(-1) for 5 yr) to 18 height-matched nonsporting referents. Participants had no history of spinal pathology. Magnetic resonance imaging was used to quantify intervertebral disc (IVD) morphology and hydration, and psoas, erector spinae, quadratus lumborum, and multifidus muscle size and fat content. Endurance of trunk muscles (flexors and extensors) was measured, and physical activity levels were assessed objectively using accelerometry.Results Cyclists' IVD showed prolonged T2 time (+10.0% 17.3%; P = 0.021), implying better IVD hydration and glycosaminoglycan content, compared with referents. Lower thoracic and upper lumbar IVD T2 time were longer in cyclists (P 0.029) but not at the lower lumbar spine. T2 time differences were larger in the nucleus pulposus compared with the annulus fibrosus. Cyclists showed larger psoas muscles with less fat content compared with referents. Cyclists also exhibited longer isometric trunk endurance times (P 0.036) and higher physical activity levels (osteogenic index, P = 0.038).Conclusion Despite previous studies reporting higher than average prevalence of back pain in cyclists, the high-volume road cyclists in our cohort showed no anatomical or functional deficiency in spinal structures. By contrast, we found evidence for beneficial adaptations to the IVD and psoas muscles in high-volume cyclists compared with referents. These data support the notion that cycling is not detrimental to the spine, rather, by contrast, may be associated with beneficial changes at the spine. Refereed/Peer-reviewed