A leading tennis physiotherapist discusses Andy Murray’s back surgery:
It’s disappointing that Andy Murray has been forced to undergo minor surgery on his back, especially as it means that he is likely to miss the rest of the 2013 season, but it does not surprise me.
It’s been well documented that Andy has been struggling to manage his back issues for some time and is has already been forced to miss major tournaments like the French Open this year. Back problems and the inflammation, restriction of movement and pain that they can cause can be well managed and will often settle given time and the right treatment. This is not entirely true for athletes, however, especially when you consider the rigours of top level tennis and the immense rotation a player like Murray puts his body through with every shot.
That rotating, twisting motion is more marked on clay, which is why it is possible that last weekend’s Davis Cup tie in Croatia might have been quite hard on Murray’s back. He isn’t my patient so obviously I don’t know the specifics of his case but there are reports that he is to undergo a microdiscectomy, which is keyhole surgery. If that is the case that would suggest that there might be some damage to the disc itself and/or part of the disc could have pushed itself outwards, causing impingement/nipping on the sciatic nerve that runs down the spine and into the legs. When that happens it’s a bit like a finger pressing down onto a very fat, soft and highly sensitive guitar string.
As well as causing discomfort, when there is any problem in or around the discs in the back, it causes inflammation around the nerves, which leads to muscle spasms which lock up the back and hinder movement. When that happens, the body tends to move other parts of the spine to compensate, which pulls the body out of kilter.
The exact nature of Murray’s procedure will depend on the specific issues he has, the overall extent of problem and how much, if any, the nerve is affected. Some surgeries are more invasive than others but the main aim of most procedures like this is usually to ‘tidy up’ the disc and free up the nerve. From there it would be a matter of easing the inflammation and finding a balance between resting and mobilising the back to gradually get it moving again.
The recovery period is also hard to predict and, again, it depends on the severity of the problem. If the nerve has been compressed significantly then it could cause a bit of weakness in the muscles in the lower limbs. This would show in something as seemingly insignificant as being able to lift a toe but sport at the level Murray plays it is all based on tiny margins.
It may only take a few weeks to get back into training, but even so I think it’s very sensible that Murray’s team are already saying that he is unlikely to be back in time for the Barclays ATP World Tour Finals in London in November. Even though this is probably a relatively minor operation, it’s important to manage Murray’s expectations as well as everyone else’s and not rush things.
We tend to find that athletes have a ‘can do’ attitude to their recovery and they always want to push themselves, because that is part of their character. They usually want to push the boundaries at each stage of the recovery period – whether it’s getting rid of crutches too soon or trying to run before the should. Their mental attitude is all about doing things faster and harder but that is not how recovery from injuries works, especially with something as delicate as the back/spinal nerves.
The timing of this procedure could actually be rather beneficial, because Murray has plenty time to recover and, if all goes well, he should be in much better shape for the off-season training block and much fresher mentally and physically for 2014.
Alasdair Jones is Director at Colchester Physiotherapy and Sports Injury Clinic. He is physio to British tennis player Elena Baltacha and oversees screening for players at her Elena Baltacha Academy of Tennis.