Oh, Danny Boy….
Danny Briere is out indefinitely with an upper back contusion after absorbing a malicious, yet clean hit from Pittsburgh’s Joe Vitale. Briere said yesterday, that his back was in spasm and there is no timetable for his return. He is hopeful that he can return for the playoffs.
Muscle spasm result from inflammation in or near the muscle. When it occurs in the back, it can be excruciatingly painful and particularly debilitating. The nerves that carry pain signals in the back also connected to the nerves that control the muscles of the back. So when the nerves sense pain, it will often cause the surrounding muscles to spasm, which is an efficient, albeit painful, way for the body to protect the injured area.
Inflammation in the back can result from an injury to the bones, ligaments or muscles. When a muscle is overstretched or torn it is called a muscle strain. Briere said that he saw Vitale just before impact and attempted to brace himself and in doing so, he probably tried to tighten up his core muscles. The impact and jarring of the hit can stretch these muscles while they are contracted, which often results in a strain.
These muscle strains, if severe enough, can cause some bleeding of the muscle, which results in a contusion, or bruise. Fortunately, muscle strains usually heal with some conservative treatment and time. It could be a couple of days or as long as a couple of weeks. The muscles have an excellent blood supply, which works in their favor, and often people can do as much activity as they can tolerate without pain.
Pain medications may be taken for severe pain and usually, in the initial 48 hours after the injury, ice may be applied. There are various opinions of ice versus heat in a back injury. Some people value ice alone; some value heat alone. Some people suggest alternating ice and heat may be able to stop the pain and spasm cycle. Muscle relaxant medication may also be used to ease the spasms (and likewise, the pain), hut there is also varying opinions of using these medications. Since the underlying cause of the spasms, is the inflammation in the area, treatment of the inflammation will likely cure the spasms. Rest, ice and anti-inflammatory medications are the mainstays.
Back spasms will often not occur during an activity. There may be some soreness after the activity, as Briere has described. The spasms occur after resting for a bit and can hit suddenly. Unfortunately, they are especially unpredictable and there is no way to know when Briere will be back. In 2008, Matt Carle missed around 10 days and 5 games with what was described as upper back spasms. Just this year, Dallas Stars’ Steve Ott missed just 1 game and 3 days with back spasms. Detroit Red Wings goaltender, Joey MacDonald missed a game with what was thought to be just back spasms, however an MRI revealed that MacDonald has a bulging disc in his back. MacDonald had back surgery in 2006 to repair a bulging disc.
The most important thing one can do to protect against back spasms is to maintain good posture and stability of the core muscles, the abdominals as well as the back muscles. The funny thing about the back, is that it can sometimes be a very normal movement that strains the muscle and causes back spasms. Take for instance, one of the funniest injuries I have heard of, LA Kings’ Dustin Penner, who fell victim to a back strain suffered as he was sitting down to enjoy some homemade pancakes. The situation, which was affectionately dubbed “pancake-gate” by some fans and media as it was described by Penner:
“I woke up fine, sat down to eat and it locked right up. It never happened to me before. I couldn’t stand up. I was probably at the third stage of evolution. So my wife helped me get dressed, and then I drove to the rink here, to hope they could do some magic and get it opened up. Kinger just looked at me and said, `Go home.’ So I got some treatment and went home.
Apparently it’s one of those mysterious things, where you can throw it out (from) sneezing. I just leaned over to dip into some delicious pancakes that my wife made. It’s just like it [the pain] wraps around you and squeezes. … So it was disappointing. Hopefully it’s just an isolated incident, and not something that’s going to become chronic.”
Such are the pitfalls of delicious pancakes, I suppose. Penner at least had a good sense of humor about the whole thing. He only missed 1 game.
Briere should take the last 2 regular season games to rest and we’ll all hope he is ready for the playoffs in a week.