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Andre Agassi's Battle With Back Pain

After fighting painful, chronic back pain for years, tennis great Andre Agassi retires from the court and prepares to serve up the next chapter of his life.

Playing Through Pain

By the time of his last Grand Slam victory -- the 2003 Australian Open -- Agassi's back had been hurting for months.

"I thought it was my hip," says Agassi, who says his only mistake in caring for his back was not getting it diagnosed sooner.

Would an earlier diagnosis have made any difference? Probably not, says Alan S. Hilibrand, MD, associate professor of orthopaedic surgery and neurosurgery and director of orthopaedic medical education at Jefferson Medical College and the Rothman Institute in Philadelphia.

"From age 20 on, all people experience a process of drying out of the discs in the spine. In other words, everyone has degenerative disc disease," says Hilibrand, who is also a spokesman for the American Academy of Orthopaedic Surgeons.

Those discs act as cushions between vertebrae, helping to hold them in place. As they dry out, they begin to lose this ability, and the likelihood of one of the vertebrae slipping increases. When that starts to happen, the resulting condition is known as degenerative spondylolisthesis.

Lower back pain is the most obvious symptom, though many people have no symptoms at all. The drying out of the discs, says Hilibrand, can lead to painful tears in the fiber that surrounds them. How severe the pain is varies from person to person. "Some people, for genetic reasons, are very susceptible to that pain," he says.

Athletes have an advantage over couch potatoes when it comes to preventing back pain. Why? Because their strong trunk muscles are better able to support the spine, Hilibrand explains. They can also withstand a lot of suffering.

"Agassi obviously has very strong trunk muscles, but I don't think he would have gotten where he did without a great tolerance for pain."

This type of back pain is very familiar to Justin Gimelstob, a 27-year-old professional tennis player and friend of Agassi's. He underwent emergency back surgery in early September and at the U.S. Open suddenly found himself with two herniated or slipped discs after eight or nine years of back pain.

"The sport is tough on the back," says Gimelstob, who has commiserated with Agassi over their suffering. What frustrates athletes like Gimelstob is that the pain often strikes without warning, throwing off his rhythm. It was the same for Agassi, he says: "That's what Andre was feeling -- that inability to be properly prepared when you don't know what's going to happen."

Agassi’s New Routine

Agassi doesn't anticipate needing surgery, especially now that he is out of the game. So, what is he preparing for now? In addition to his continued work with his foundation, he's bound to keep competing, if not on the court then in his new business ventures. He and Graf are working on an international chain of resort communities. They also unveiled plans for a luxury hotel, the Fairmont Tamarack, in Idaho.

"It's a lane change, not an exit," Agassi says of his new projects.

No matter how strenuous his new work may be, it won't require the superhuman physical conditioning demanded of him by tennis. And that's just fine with Agassi. For now, he's quite happy to miss a workout or two -- or three.

"To go to the gym and train now would feel more empty than focused," he says. "[Physical training] will always be a part of my life, but right now there would be too much nostalgia."

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