Are Spinal Changes in Young Rotational Athletes (baseball, golf, and tennis) Good or Bad? Experts Say It Depends
By Dr. John Mishock, PT, DPT, DC
Rotational sports like baseball, softball, lacrosse, and golf push young athletes to develop high-level strength and power in rotational patterns and place unique demands on their spines. Many young players show spinal changes on MRI, including disc degeneration, facet joint thickening, or even stress fractures. Are these signs of damage or high performance?
Adaptation vs. Degeneration: What’s the Difference?
According to Wolff’s Law and the SAID (Specific Adaptation to Imposed Demand) Principle, our bones and tissues adapt to the stresses placed on them. In athletes, some spinal changes reflect positive remodeling: thicker joints, denser bone, and stronger discs. These are normal in elite performers and are often found even in pain-free athletes.
For example, 70% of elite junior tennis players had MRI signs of facet joint thickening, and 39% showed disc changes—yet none had symptoms (Nakai et al., 2023, European Spine Journal).
But Too Much Load Can Become a Problem
Spinal stress becomes harmful when:
- Training volume exceeds recovery
- There’s poor rotation balance
- Or pain persists for weeks
In a study of pro baseball players, 91% of athletes in their 30s had disc degeneration on MRI—compared to just 14% in their 20s (Takazawa et al., 2022, Journal of Medical Investigation). Hangai et al. performed MRIs on 308 college athletes and 71 non-athletes to compare disc health. Baseball players showed a significantly higher prevalence of lumbar disc degeneration (odds ratio ~3.23) compared to non-athletes.
Young Asymptomatic Athletes
Even teenage athletes can show disc changes. In the asymptomatic junior tennis players, 39% (13 of 33) already had disc dehydration (desiccation) and mild bulging, most often at the lowest levels (L4/L5 or L5/S1)Only 5 of 33 had entirely normal scans – meaning >80% had some “abnormal” finding. (Alyas et al Br Sport Med J, 2007) Importantly, these were mostly mild changes (e.g. slight disc bulges) that had not produced any symptoms. This underscores that disc degeneration on MRI does not always equal clinical pain, especially in high-level athletes who may develop adaptive changes.
Golfers are also at risk. The modern power swing has led to a condition called “repetitive traumatic discopathy” (Walker et al., 2019, Sports Health), a breakdown of the spine from years of powerful, repetitive rotation and twisting.
Spondylolysis in Young Athletes
Adolescent athletes can even develop stress fractures in the spine (called spondylolysis), often from overuse. These are common in young baseball players and tennis players—and may appear on MRI before low back pain starts (Sairyo et al., 2006, Sports Med Arthrosc Rev).
The Takeaway: Train Smarter, Not Just Harder
Not all MRI findings are dangerous. Some are signs of adaptation, like calluses from lifting weights. Others warn of overuse or imbalance.
The key is smart, balanced training—focused on core stability, upper and lower extremity strength training, rest, and proper load management.
Coaches and parents shouldn’t fear spinal changes—but they should respect them. When in doubt, consult with a sports medicine professional trained to interpret imaging in the context of athletic demands.
We can help!
If pain is limiting you from doing the activities you enjoy, give Mishock Physical Therapy a call: locations in Gilbertsville (610-327-2600), Skippack (610-584-1400) , Phoenixville (610-933-3371), Boyertown (610- 845-5000), Limerick (484-948-2800) at www.mishockpt.com or request your appointment by clicking here.
Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has also authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon or train2playsports.com.
