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Mets injury update: David Wright and understanding spinal stenosis

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What is spinal stenosis and how worried should the Mets be?

David Wright continues to rehab from spinal stenosis.
David Wright continues to rehab from spinal stenosis.
Brad Penner-USA TODAY Sports

Since being shut down again—this time with spinal stenosis—there has been a lot of discussion about David Wright's ailing back and his seemingly endless recovery timeline. While his future remains uncertain, here's an in-depth look at spinal stenosis that should help us to at least understand the nature of this injury.

What is spinal stenosis?

Spinal Stenosis is a narrowing of joint space in either the central canal (where the spinal cord is) or the intervertebral foramina (where nerve roots leave the spinal column). The compression causes back pain that may shoot down the leg(s) causing muscle weakness, numbness, and tingling. How far the pain, if present, travels down the leg is based on severity and location of the compression. There is also a lack of mobility in the vertebrae of the lower back and muscles become tight as a result; these two factors may also contribute to the degree of pain.

Typically, symptoms are exacerbated when standing, walking, or being in any upright position as the compressive forces from the upper back and upper body add to the already compressed/stenotic portion of the lower back. There are numerous reasons for what caused this narrowing; it can be developmental/congenital in nature or general "wear and tear" and aging.

Spinal stenosis

moveforwardpt.com

How does this affect Wright?

Unfortunately, stenosis is irreversible and the only treatment is effective symptom management. That means finding ways to manage the irritation/inflammation caused by the compression and completing exercises to strengthen weak muscles, add mobility to joints, and loosen any tight muscles. Certain hands-on techniques will be applied to supplement the effects of the exercises and other interventions to facilitate a successful long-term effect.

There has been many comparisons of Wright to David Wilson, the former New York Giant who recently retired because of spinal stenosis. Although Wright and Wilson have the same diagnosis, Wilson was at a much larger risk of further permanent injury since football is a contact sport and any given player can be seriously injured on any particular play. Baseball, on the other hand, is a much safer sport and a player can reasonably play with stenosis. Depending on the severity and careful management of his symptoms, Wright can still play baseball; however, the longevity of his career and his productivity as an everyday player now comes into question.

As mentioned above, patients with stenosis have difficulty being upright and standing while also experiencing a lack of mobility in the vertebrae of the lower back. To play baseball, there is a considerable trunk-rotation component in addition to maintaining an upright position at all times. Obviously this trunk rotation comes into play while batting, but this component is also crucial to fielding as Wright would need to plant his feet and rotate his trunk to effectively throw anywhere around the diamond. Rotation adds on another compressive force to the vertebrae of the spinal column so Wright is more susceptible to injury if he moves in a way that his body is not ready for (i.e., really reaching to hit a ball or making a diving play in the field).

It is worth mentioning that not all people with stenosis have back pain all the time and that stenosis is not always the cause of future back pain. Stenosis is a very manageable condition but requires constant maintenance to prevent any setbacks, especially for athletes.

Bottom Line

Wright's career is by no means over, but there's a good chance that his days as the everyday Mets' third baseman are now shorter than everyone hoped. We still don't know the severity of his condition so it is impossible to predict when he'll return or how the rest of his career will play out. Let's hope that with a bit of luck and some well-managed therapy that Wright can get back on the field soon.