Citation: Carrick FR, Behrendt BR and Esposito S (2015). Recalibration of oculomotor and cerebellar activity to reduce low back pain in a professional tennis player. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: TBI and Neurodegeneration. doi: 10.3389/conf.fneur.2015.58.00045 Received: 30 Oct 2015; Published Online: 02 Nov 2015.
Background: On-going moderate low back pain (LBP) in a sixteen-year-old world class professional tennis player received neurological care at our clinic.
Methods: MRI, CT, and X-RAY findings of his low back were inconclusive except for mild posterior disc bulging at L3/4, L4/5 and L5/S1. Neurological examination revealed abnormal cerebellar output and oculomotor breakdown. Notably, there was right hyperopia, which was reduced with vestibular-ocular head movements (VOR); left coractasia; left accommodation spasm; slower rightward saccades and hypermetric leftward saccades with irregular phase profile and normal re-fixation; initial gaze-shifting downward produced retrocolic activity during normal viewing and during tennis. Cerebellar findings included slower alternating hand movements on the left; sluggish myotatic stretch response (MSR) in his left brachioradialis and left achilles; a right patellar MSR which was pendular. He was treated with multi-axial rotation to affect the vestibular apparatus, brainstem and cortical connections, oculomotor therapy, laser therapy and manual manipulation of joint mechano-receptors.
Results: After fourteen days in a multi-day treatment program aberrant eye movements improved: He was able to maintain gaze holding; pursuits at 0.01 Hz were within more normal range; optokinetic responses during saccades improved; his accommodation spasm was absent; spontaneous facial movement was abated; retrocolic neck reactions diminished; V:A ratios improved; low back pain was relieved.
Conclusion: Intensive multi-day therapy which incorporates therapies (vestibular, occult-motor, mechanoreceptor stimulation) to improve the reflexogenic systems may help alleviate impairments in athletes. This tennis player’s symptoms were improved and he was able to return to play. The authors recommend further investigation into the utilization of a multi-modal vestibular, ocular and motoric programs to correct performance among athletes.