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04/03/08 3:00 PM ET

Strong backs keep Sox in the lineup

Strengthening core muscles can save players, you from injury

Here are a couple of health facts to consider: 1) Baseball isn't easy on the arms. 2) Life isn't easy on your back.

Let's address the arms first. If you take a glance at the injury reports for all 30 Major League ballclubs, you'll find that more than half the injuries listed involve the upper extremities. The majority of those are some kind of shoulder problem. Not very surprising when you consider the nature of the game.

For the Red Sox, however, their two biggest early season injury concerns -- to Josh Beckett and J.D. Drew -- both involved back problems. That wasn't at all surprising to Dr. Kevin McGuire and Dr. Michael Groff, co-directors of the Spine Center at Beth Israel Deaconess Medical Center.

"Most of us, 85 percent of us actually, will have at least one episode of acute back pain sometime in our lives," said McGuire.

"With those numbers, it's easy to understand why back issues are the second-most-common reason that people seek healthcare -- right behind the common cold," added Groff.

The fact that back problems are not more prevalent among athletes might be attributed to a combination of factors. Elite athletes generally invest a great deal more time than the rest of us working out and strengthening their "core" muscles specifically to avoid such injury. Then there's the fact that their genes probably gave them a head start.

"I like to say that some people are born with better tires," said McGuire. "Some people get steel-belted radials and some people get retreads. Athletes are high-performance machines. Their bodies are better equipped to handle the tremendous stress and strain of their sport."

"These guys have better and more immediate access to treatment and therapy," Groff pointed out. "If they have a twinge, they can jump on the table and get a massage, and that helps. But, honestly, the same physical therapy that helps them helps our patients."

While the biomechanics of most of the body's muscle structures are fairly simple, the back muscles are a complex, layered network that is constantly working to keep us upright and balanced while allowing us to bend, twist and fold in almost every direction.

When back pain is the result of muscle strain, letting things settle down is the first priority. Even when a herniated disc impinges on nerves, surgery is rarely the first option.

"In our practice at the Spine Center, we usually opt for physical therapy and then strengthening exercises," said Groff. "I would say about 80 percent of those patients get better. Of course, to keep them pain free we encourage them to make those exercises a part of their daily routine. It's not like taking antibiotics for 10 days and that's it."

I'm going to go out on a limb here and guess that the real world is getting in the way of most reader's plans to get back in shape and recapture the magic of that year in Little League when they batted .600 and made the All-Star team. There's a pretty good chance your midsection is more of a "spare tire" than a steel-belted radial and the scouts aren't beating down the door. Would you settle for a pain-free evening after an afternoon of yard work? If so, McGuire suggests, "strengthen the stomach to help support the back. Pelvic stabilization really helps you avoid lower back injury."

With that "yes" to sit-ups comes a "no" to lighting up.

"Smoking is a huge factor," McGuire said. "Smoking shuts down the vessels that supply blood to the discs and elevates the risk of injury."

Of course, despite your best intentions, you may find that someday you need the services of the Spine Center at Beth Israel Deaconess Medical Center. McGuire and Groff will be prepared to offer both treatment and sympathy.

"A long day on my feet in the [operating room] can really get to me," said McGuire. "I could probably use some yoga or a few more crunches."

"Yeah," added a smiling Groff, "we're certainly not immune to back pain."

So you see, while most sufferers will never end up in the operating room, these docs are quite willing to cut you some slack.

Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of the Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.