Neuroscience and Chronic Pain in Athletes - a more comprehensive approach

Study Title: A Neuroscience Approach to Managing Athletes with Low Back Pain
Authors: E. Puentedura & A Louw
Journal: Physical Therapy in Sport
Date: 2012
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Summary:

• I have written previously on the importance of respecting neuroscience with managing athletes suffering from pain. While many injuries are acute in nature, especially in collision sports, chronic pain and injuries are certainly very prevalent in the athletic population. This particular paper (not an actual study) provides an excellent review and summary of the rationale for utilizing a "neuroscience approach" when managing athletes suffering from pain, especially of the chronic variety.
• Puentedura and Louw suggest a complete biopsychosocial approach to management that, in addition to anatomy, biomechanics and tissue pathology, incorporates the integration of pain mechanisms in interactive care. In my opinion, this is probably the most concise paper I have read to date that explains the rationale and one that is an appropriate introduction for those unfamiliar with this paradigm.
• Among the explanations described for using such an approach, the authors describe the contributions of environmental (situational) influence, sensitization mechanisms, and the role of cognitive states. They also explain the role of representation maps in the brain as well as triggers for "neurotag" activation. Many images were provided to enhance the readers understanding of this approach and the parallel relationship as "outputs of the brain" between pain and sports performance were discussed.
• Finally, suggestions were made for appropriate treatment of athletes with chronic pain utilizing this neuroscience approach, although it is my opinion that such an approach may also be taken when managing athletes who suffer from acute injuries as well.
• Overall, I really enjoyed this paper not only because it was all encompassing in nature, but also because it can be of great benefit to those who may be novel to the idea that pain and injuries may not solely be of the tissue variety.

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Puentedura, EJ & Louw, A. (2012). A neuroscience approach to managing athletes with low back pain. Physical Therapy in Sport.
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