Lumbar Disk Herniation and Degenerative Disk Disease in the Athlete

The most frequent reason for missed playing time in competitive athletes is low back pain (LBP). Lumbar disk herniation (LDH), degenerative disk disease (DDD), and spondylolysis are the most common lumbar conditions that cause symptoms in this patient population. In elite athletes, most lumbar conditions can be managed nonsurgically with excellent outcomes. Surgical treatment is a viable option for athletes in whom nonsurgical treatment has failed. Many elite athletes are able to return to play even after surgical treatment, especially those who require lumbar diskectomy; high-level evidence has shown that they can return to play in 75–100% of cases. Lumbar fusion is not a contraindication for return to play in contact athletes. Return to play is assessed on an individual basis, but athletes should complete a rehabilitation program and demonstrate resolution of symptoms before medical clearance.