With Commentary by Gerard J. Girasole, MD

In baseball parlance, David Wright turned on it.

By slgckgc on Flickr (Original version) UCinternational (Crop) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

The New York Mets’ third baseman torqued his body, uncoiled his bat and turned on a 90-mph fastball from Phillies' starter Adam Morgan. He sent a full-range-of-motion moon shot into the Philadelphia night. You could be forgiven if you thought it might be heading for Geno’s Steaks before crash landing in Citizen Bank Park’s second deck.

It was the biggest moment during an emotional night for the ever-smiling, good-natured Met. Wright’s homer was the first of a team-record eight round-trippers the National League East-leading Mets hit Monday in their 16-7 victory.

The home run, the win, even the feeling of being back in a major league uniform for the first time since being diagnosed with spinal stenosis – it all left him fighting back tears at points in the game.

 “I had to be careful, I almost pulled a Wilmer Flores out there,” Wright said, referring to the Mets shortstop, who cried on the field last month when he thought he had been traded. “You’ve got to keep your emotions in check. You’re proud you got back to this point. You’re happy. You’re satisfied. But at the same time, you realize we’re in the middle of a pennant race.”

It had been a long, sometimes grueling road back to the big leagues since the Mets placed Wright, 32, on the disabled list April 14 with a hamstring injury. Weeks later, his rehab efforts were hampered by a stiff back. In May, assistant general manager John Ricco revealed that Wright had been diagnosed with spinal stenosis.

Wright’s Diagnosis: Low Back Spinal Stenosis
Spinal stenosis, or a narrowing of the spine, can be serious, said Stephania Bell, the resident medical expert on ESPN’s “Baseball Tonight.” She noted, however, that Wright’s stenosis wasn’t congenital, which could have threatened to end his career. Bell said that Wright has lumbar spinal stenosis, which was brought on by degenerative changes to his spine. At its root, there is an inflammation in the nerves in his lower back.

Typically, people with the condition can expect to feel pain or cramping in their legs when they stand for long periods or when they walk. As it progresses, they could experience persistent pain, numbness or weakness in their back, legs or arms. Treatments range from stretching and exercise, to epidural injections and oral medications to reduce the pain and inflammation, to surgery.

With his brilliant career -- he’s the Mets’ all-time leader in hits, runs, total bases, RBI and walks – at a crossroads, he sought out two men.

Treatment Game Plan
First, he headed to California to meet with Dr. Robert Watkins and work with his physical therapy staff. They began an exercise regiment aimed at strengthening his core muscles.

He rarely spoke with the media over the next few months. About all he would divulge was that he was undergoing physical therapy seven days a week and meeting with Dr. Watkins once a week.

He also reached out to former Yankee legend and current Dodgers manager Don Mattingly, who was once on the fast track to the Hall of Fame until years of back problems sapped him of his considerable power.

Whatever Mattingly’s advice was, we may never know, but Wright acknowledged that “it was very calming and influential to have a guy like that, who had the success that he had with the same condition, discussing his routine and having some advice for me. It was beneficial in the recovery, probably more mentally than physically.”

Physically, though, Wright and Dr. Watkins didn’t rush things. Wright was able to throw and hit off a tee for the first time July 29. Two weeks later, he played in his first game, albeit with the Mets’ minor league team in Port St. Lucie, FL. (He went 1-for-3 with a walk).

On the eve of being summoned back to the Mets, Wright said he was determined to “make sure I do all my stretching, my therapy work and my core exercises. I know there are going to be some ups and downs, especially when I start playing, but this is pretty encouraging.

Managing the Condition
“It’s not an injury, it’s a condition,” Wright told the New York Post’s Kevin Kernan. “It’s something I am going have to manage. With that being said, some days you wake up and you are going to feel good, and there are some days you wake up and you feel OK and with therapy and the stretching I do, I can get the needle moving more towards good. And some days, the doctor told me, it’s just going to be bad.”

Commentary by Gerard J. Girasole, MD

What happened to David Wright is not common in a young athlete—rather, lumbar spinal stenosis is usually seen in adults who are middle-aged or elderly. However, due to the nature of his condition, which his doctors call degenerative, and being a high-intensity athlete with years playing baseball to reach pro status, there is significant wear and tear on the spine that has prematurely caused his condition.

The treatment in the elderly population is no different than in people of David Wright’s age. The options include aggressive physical therapy with back strengthening and core building exercises along with increasing range of motion of the lumbar spine’s extensor muscles. In more advanced cases of low back stenosis, epidural steroid injections have been found to be very helpful to relieve associated inflammation.

They key point here is that no matter what age or activity level, proper exercise with a concentration on core strengthening is important to try to avoid degeneration of the spine.

Dr. Girasole is the author of the book, The 7 Minute Back Pain Solution; 7 simple exercises to heal your back without drugs or surgery in just minutes a day.