NSJ-Spine january 2004

408 J. Neurosurg: Spine / Volume 7 / October, 2007 ECK pain is a common complaint in the general population with about 20% of people reporting it in the past year7 and 66% reporting it at some point in their lives.6 Chronic neck pain is also very common,10 although its incidence has not been thoroughly evaluated in multisport athletes. Conceived in the early 1970s, the sport of triathlon consists of swimming, biking, and running, with a varying distance for each activity. Triathlons have gained worldwide recognition with the creation of Ironman-length triathlons and with its inclusion in the Olympic Games beginning in Sydney during the summer of 2000. Sports medicine enthusiasts initially thought that triathlons would be associated with less frequent overuse injuries due to more balanced stress distribution in the musculoskeletal system; unfortunately, this theory has not held true. Instead, it appears that triathletes tend to train more hours per week than any other group of single-sport athletes, leading to a higher incidence of injury.3,13 The results of a study conducted after the 1986 Hawaii Ironman Triathlon competition demonstrated that 91% of participating athletes had suffered at least one softtissue overuse injury during the previous year’s training; spinal injuries were most common, with 72% of athletes reporting low-back pain or sciatica.19 In an evaluation of Japanese triathletes, there was a 59% lifetime (64% of men, 41% of women) and 32% yearly (33% of men, 29% of women) incidence of low-back pain.15 In addition to the focus on overuse or traumatic injuries including back pain,5,19 equally important is gaining an understanding of the longterm consequences and predictors of pain and injury in this unique population,3 so as to improve treatment and outcome.4,22 Although neck pain and overuse injuries in cyclists are quite common and appear to occur more frequently than back pain,1 these issues have not been well-studied in triathletes. Of the 11 articles that we could locate in which overuse injuries were assessed,3–5,8,11–13,15,19,25 only two studies included an assessment of cervical problems,11,15 and none looked specifically at pain or its quantification. In recreational cyclists, 50% or more23,24 reported pain related to neck overuse injuries; this appears to be the most common overuse injury encountered.1,23,24 Most amateur triathletes spend between 10 and 20 hours training per week, with approximately 50% of this time being on the Neck pain in multisport athletes