OK, baseball fans, what comes to mind when you hear the following three words: back, back, back?
No doubt, many of you thought of ESPN's Chris Berman, who has made it a catchphrase while describing countless highlights of outfielding exploits. For our purposes, however, it's an answer to this challenge: Name an injury issue that Josh Beckett has dealt with during the 2008, '09 and '10 seasons.
While that would appear to be a troubling trend, the fact is that it's really not all that unusual.
"The vast majority of Americans -- 85 percent, in fact -- will have at least one episode of acute low back pain at some point in their lives," says Dr. Kevin McGuire, co-director of the Spine Center at Beth Israel Deaconess Medical Center in Boston. "Some of those injuries are the 'I threw my back out trying to move the couch' variety, which often resolve on their own in a few days and require little more than rest and over-the-counter pain relief. On the other end of the spectrum are serious structural or neurological issues that might require surgery. In between, there are a bunch of people who will have intermittent, repetitive episodes with no clear triggering event."
It certainly appears as though Beckett falls into the latter category, although perhaps in his case, might it be logical to make a connection between what he does for a living and the fact that he's been forced to live with recurring problems?
"The answer to that is yes and no," according to McGuire. "The act of pitching, especially at the level we're talking about, does place enormous strain on the body, including the lumbar spine. That being said, pitchers are much more prone to shoulder and elbow problems. I haven't seen any research that indicates pitchers are more prone to back problems than you or I might be."
You would think that a guy like Beckett, whose livelihood depends on his body being in top physical form, would do everything he could to minimize the chances of these episodes occurring. Well, guess what, he probably does.
"That is a source of frustration for many of the patients we see at the Spine Center. They've done exercises to strengthen their core muscles; they are out walking and improving their cardiovascular health, they've lost the weight that was putting such a strain on their backs, and still, periodically, they'll experience back pain," said McGuire. "Of course, they want a cure, but the percentage of patients that will benefit from surgery is actually very small. It's a very difficult conversation to have with a patient when you have to tell somebody that the best we can do is learn to manage the problem."
Much like a person with diabetes can learn to take diet and daily activity into consideration when managing blood sugar levels, those who are prone to intermittent back pain are best served by taking precautionary measures and learning what things to avoid, McGuire said. They can do things like strengthening, stretching and exercising that will give them the greatest chance of having fewer episodes.
"I tell folks that there will be good days and bad days, good weeks and bad weeks, good years and bad years," McGuire said. "It's tough as a physician not to be able to offer a cure to everybody that comes to you, but we can offer treatment and strategies that offer a great deal of relief."
As a pitcher, Beckett would be among the first to tell you, never underestimate the value of the guys who can offer good relief.
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.