Chronic low back pain and disability in Brazilian jiu-jitsu athletes

Examination of Non-Specific Low Back Pain, Pain Perceptions and Disability Between Brazilian Jiu Jitsu, Muay Thai and Boxing Athletes

Background: Non-specific low back pain is the leading cause of years lived with disability worldwide. The present study investigates non-specific low back pain, pain perceptions and disability due to pain among Brazilian Jiu Jitsu, Muay Thai and Boxing athletes. Methods: The study included 90 amateur athletes (aged 18-45 years; M = 28.97, SD = 5.88). The athletes completed the valid and reliable Pain Beliefs Perceptions Inventory (PBPI), the Quebec Pain Disability Scale (QPDS) and the Short-Form McGill Pain Questionnaire (SF-MPQ) which includes the Visual Analogue Scale (10 cm VAS 0-10 rating system) and the Present Pain Intensity index (PPI). Results: The results revealed that the majority of athletes rated their pain as low (SF-MPQ: M = 12.34, SD = 8.91; VAS: M = 1.65, SD = 1.82; PPI: M = 2.10, SD = 1.08) with low disability due to pain (QPDS: M = 18.98, SD = 22.71). Also, the majority of athletes disagreed that their pain was mysterious or persistent with high duration (PBPI: M = 1.43, SD = 2.23). Between the three martial arts, Brazilian Jiu Jitsu athletes showed statistically significantly (a) higher emotional and sensational pain intensity (x2(2) = 15.73; p < 0.001; x2(2) = 19.34; p < 0.001), (b) higher disability due to pain (x2(2)= 25.30; p < 0.001) and (c) more mysterious, more persistent pain with more duration (x2(2)= 9.32; p < 0.05) than Muay Thai and Boxing athletes. Also, a few correlations were found between age and pain perception only in Brazilian Jiu Jitsu and Boxing martial arts athletes. Conclusions: Further research is required to elucidate the biomechanical and psychological factors contributing to these differences between martial arts athletes.

Prevalence and risk factors of chronic low back pain in university athletes: a cross-sectional study

AIM

This study aimed to establish the prevalence of chronic low back pain (CLBP) in university-level athletes and to examine the influence of age, sex, body mass index (BMI), sports discipline, sleep, anxiety, and depression on CLBP. The secondary purpose was to check the association of certain variables in athletes having CLBP with the sports discipline and chronicity of LBP.

METHODS

A total of 340 players (100% response rate) from different sports, aged 18-30 years with at least 1 year of participation in sports at the university level were screened for the present study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their demographic variables, personal and pain-related factors. The study was registered on the clinical trials registry, India (CTRI/2021/09/036675).

RESULTS

The results revealed the sport-wise point prevalence as follows: cricket (18.5%), basketball (15.6%), volleyball (20.0%), football (11.4%), badminton (7.7%) and tennis (7.7%). A higher number of years at university-level participation (>4 years), smoking, anxiety and BMI (>25 kg/m²) are risk factors for CLBP. The type of LBP, the intensity of the pain (current and last week), variation of the pain intensity, disability, intake of oral medications, physiotherapy for CLBP, number of missed days of training and number of missed matches are not significantly related to the chronicity of LBP or the sports discipline. Only the number of missed days of training had a significant association with the chronicity of LBP.

CONCLUSIONS

CLBP is a common complaint in Indian university athletes, and our findings indicate the necessity for a specific prevention program.

Back pain and body posture of non-professional Brazilian Jiu-Jitsu practitioners

Background

The aim of the study was to assess the prevalence of back pain in non-professional Brazilian Jiu-Jitsu practitioners (NP-BJJ practitioners), and to assess the relationship between their back pain and postural disorders.

Methods

The study involved 61 subjects (age: 30.7 ± 4.9 years old; body mass: 79.4 ± 12.9 kg; body height: 179.6 ± 8.4 cm; 8 woman and 53 man), 31 who trained Brazilian Jiu-Jitsu (BJJ) and 30 subjects who had never trained any combat sport. The mean time of training BJJ in the study population was 3.9 ± 4.1 years. Postural assessments were conducted with the use of the photogrammetric method. The assessment of back pain and injuries was conducted with the Oswestry Disability Index (ODI) and with our proprietary questionnaire.

Results

Among both populations, 37 subjects reported back pain. There were no differences in back pain location between the two groups or in functional state on the ODI. Significant differences between the groups in the values of the postural parameters (spinal height, length of kyphosis, length of lordosis, pelvis inclination angle) were observed. Statistically significant differences between the NP-BJJ practitioners with and without back pain in the length of the thoracic kyphosis and the differences in the height of the waist triangles were found.

Conclusions

Both in the study population and in the control group the spinal pain was minimal or moderate on the ODI. BJJ practitioners who reported back pain had characteristic postural changes in some of the analysed postural parameters in comparison to BJJ practitioners who did not report back pain.

Does the Fight Profile Interfere with Orthopedic Injuries in Brazilian Jiu-Jitsu?

Purpose

To evaluate the prevalence and characteristics of orthopedic injuries associated with the technical-tactical profiles of Brazilian Jiu-Jitsu (BJJ) fighters, according to the fighters’ graduation level (beginner and advanced).

Patients and Methods

Cross-sectional study, which included the participation of amateur and professional BJJ athletes, aged between 18 and 60 years and practitioners of the sport for at least six months. All answered a mixed self-reported morbidity questionnaire. Participants were divided into four groups, according to the technical-tactical profile in the fight (keeper and passer) and the fighter’s graduation level (beginner and advanced), and also into four subgroups, divided by joining the groups in pairs above. Descriptive and analytical statistical procedures were used, with a level of statistical significance set at 5% (p < 0.05).

Results

A total of 198 participants were included in the study. There was a higher prevalence of musculoskeletal injuries in advanced fighters (p<0.001), with no significant difference between the profiles of guard and passer fighters. Sprains were the most common type of injury in all studied groups and subgroups. The anatomical segments knee and shoulder, respectively, were the most affected in all groups, and both segments showed significant associations of the athletes in the advanced and guard groups.

Conclusion

The study showed important data for creation of specifics injury prevention protocols, through the higher prevalence of injuries in athletes of the advanced profile and in the segments of the knee and shoulder, with emphasis on the guard fighters.

Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis

OBJECTIVES

We aimed to determine the prevalence of low back pain (LBP) in sport, and what risk factors were associated with LBP in athletes.

DESIGN

Systematic review with meta-analysis.

DATA SOURCES

Literature searches from database inception to June 2019 in Medline, Embase, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus, supplemented by grey literature searching.

ELIGIBILITY CRITERIA

Studies evaluating prevalence of LBP in adult athletes across all sports.

RESULTS

Eighty-six studies were included (30 732, range 20-5958, participants), of which 45 were of 'high' quality. Definitions of LBP varied widely, and in 17 studies, no definition was provided. High-quality studies were pooled and the mean point prevalence across six studies was 42%; range 18%-80% (95% CI 27% to 58%, I2=97%). Lifetime prevalence across 13 studies was 63%; range 36%-88% (95% CI 51% to 74%, I2=99%). Twelve-month LBP prevalence from 22 studies was 51%; range 12%-94% (95% CI 41% to 61%, I2=98%). Comparison across sports was limited by participant numbers, study quality and methodologies, and varying LBP definitions. Risk factors for LBP included history of a previous episode with a pooled OR of 3.5; range 1.6-4.0 (95% CI 1.9 to 6.4). Statistically significant associations were reported for high training volume, periods of load increase and years of exposure to the sport.

CONCLUSION

LBP in sport is common but estimates vary. Current evidence is insufficient to identify which sports are at highest risk. A previous episode of LBP, high training volume, periods of load increase and years of exposure are common risk factors.

The Psychological Burden of Retirement from Sport

Participation in sport is associated with numerous physical and psychological health benefits, but also can have negative consequences, such as career ending injuries, which may have long-term effects on mental health. Recent research suggests that involuntary retirement, due to injury, illness, or being cut from a sport, can be particularly detrimental. As such, this review focuses on the impact athletic retirement has on the psychological well-being of collegiate athletes. We provide an algorithm to inform clinical decision making regarding involuntary retirement, as well as recommendations for the development of support programs and educational resources for athletes struggling with career transition. Our aim is that in developing retirement algorithms, support programs, and educational resources for athletes who are retired from sport, we can intervene early thus reducing the potential long-term psychological burden they may experience.

Is There a Relationship Between Workload and Occurrence of Back Pain and Back Injuries in Athletes?

The back is subjected to a great deal of strain in many sports. Up to 20% of all sports injuries involve an injury to the lower back or neck. Repetitive or high impact loads (e.g., running, gymnastics, skiing) and weight loading (e.g., weightlifting) affect the lower back. Rotation of the torso (e.g., golf, tennis) causes damage to both, the lumbar and thoracic spine. The cervical spine is most commonly injured in contact sports (e.g., boxing, football). One of the factors that increases the odds of injuries in athletes is excessive and rapid increases in training loads. In spite of currently emerging evidence on this issue, little is known about the balance between physiological loading on the spine and athletic performance, versus overloading and back pain and/or injury in athletes. This scoping review aims (i) to map the literature that addresses the association between the training load and the occurrence of back pain and/or injury, especially between the Acute:Chronic Workload Ratio (ACWR) and back problems in athletes of individual and team sports, and (ii) to identify gaps in existing literature and propose future research on this topic. A literature search of six electronic databases (i.e., MEDLINE, PubMed, Web of Science, SCOPUS, SportDiscus, and CINAHL) was conducted. A total of 48 research articles met the inclusion criteria. Findings identified that fatigue of the trunk muscles induced by excessive loading of the spine is one of the sources of back problems in athletes. In particular, high training volume and repetitive motions are responsible for the high prevalence rates. The most influential are biomechanical and physiological variations underlying the spine, though stress-related psychological factors should also be considered. However, limited evidence exists on the relationship between the ACWR and back pain or non-contact back injuries in athletes from individual and team sports. This may be due to insufficiently specified the acute and chronic time window that varies according to sport-specific schedule of competition and training. More research is therefore warranted to elucidate whether ACWR, among other factors, is able to identify workloads that could increase the risk of back problems in athletes.

Brazilian Jiu Jitsu, Judo, and Mixed Martial Arts Injuries Presenting to United States Emergency Departments, 2008-2015

Limited research has systematically examined injuries resulting from Brazilian Jiu Jitsu (BJJ), Judo, and mixed martial arts (MMA), especially when compared to more well-known or -established martial arts. These three combative sports differ substantially regarding their rules and techniques. BJJ emphasizes ground positioning and submission, Judo rewards throwing an opponent on their back with submission ending the match, and MMA emphasizes knocking out or forcing the submission of one's opponent. We examined injuries, among people of any age, experienced from participation in BJJ, Judo, and MMA. We analyzed data from the United States (U.S.) Consumer Product Safety Commission National Electronic Injury Surveillance System to create estimates of injuries presenting to U.S. emergency departments (EDs). We compared injury profiles between sports, including estimated numbers of injuries, their site, type, and mechanism. Participation in BJJ, Judo, and MMA resulted in an estimated 39,181 injuries presenting to U.S. EDs from 2008 through 2015. Strains and sprains were the most common diagnoses for BJJ and Judo participants, whereas abrasions/contusions were the most commonly diagnosed MMA injury. Being struck resulted in the majority of injuries for all three sports. The head was the most injured body region for BJJ and MMA, whereas the leg was the most injured body region for Judo. Finally, the majority of BJJ and Judo injuries occurred during noncompetitive grappling, whereas most MMA injuries occurred during competition. Our study adds to the limited literature examining injuries from BJJ, Judo, and MMA using data from a probability sample and is an initial step towards understanding the national burden of injury from participation in these sports. Given the quantity and severity of injuries sustained by participants, additional research is needed to assess the riskiness of participation and the effectiveness of interventions, such as improved personal protective gear and mats, as a means to prevent commonly occurring injuries.

Injury rate and pattern among Brazilian jiu-jitsu practitioners: A survey study

OBJECTIVE

To determine the 6-month incidence rate and pattern of Brazilian jiu-jitsu (BJJ)-related injuries and characterize associations between injuries and experience level, demographic factors, and training variables.

DESIGN

Descriptive epidemiology study.

SETTING

Online survey.

PARTICIPANTS

1287 adult BJJ practitioners.

OUTCOME MEASURES

6-month BJJ-related injury incidence, anatomical pattern of injuries, and injury-associated demographic and training variable identification.

RESULTS

59.2% of practitioners reported at least one injury over 6 months. The knee was the most common site. Logistic regression analysis demonstrated 6-month injury incidence was negatively associated with years of training and body weight, and positively associated with training days per week and instructor status. More experienced athletes were more likely to report low back injury, while less experienced athletes more frequently reported head, upper extremity, and elbow injuries. None of the following variables were predictive of injury risk: gi preference, instruction on break-falling, and participation in a structured beginner's program.

CONCLUSIONS

The risk factor analysis is applicable to BJJ instructors interested in reducing student injury risk. The widespread pattern of injuries and the distinction between types of injuries sustained at different levels of experience are notable findings that sports medicine practitioners should keep in mind when working with BJJ athletes.

Prevalence of low back pain among athletes: A systematic review

BACKGROUND

The prevalence of low back pain (LBP) in athletes across a variety of time frames and sports is not known.

OBJECTIVES

To systematically collate and appraise studies on the prevalence of LBP in athletes and stratify by point, one year and life-time prevalence.

METHODS

A comprehensive search was conducted in February 2016. The following sources were individually searched: PubMed (1950 to present), Ovid SP Medline (1950 to present), ISI (1982 to present) and Google Scholar; Surveys were included if they aimed to report the prevalence of LBP amongst the athletes. Two reviewers independently evaluated the methodological quality of the studies.

RESULTS

The literature search generated 4379 records. Title and/or abstracts were reviewed by two investigators and full-texts of 201 relevant articles were selected for further evaluation. Studies were included if they reported the prevalence of LBP in an athletic population (any level of participation in sports and any age range) and were written in English. Furthermore, to adequately assess the prevalence rate, studies had to report the number of athletes with LBP as a percentage of the total number of athletes. Studies that did not contain necessary data to calculate prevalence rate including case reports and non-original studies were excluded and 41 studies entered the bias assessment step. A bias assessment was applied to the methodology of 41 studies, and 36 with low to moderate risk for bias were included in this review. LBP in athletes was shown to have a point prevalence ranging from 10% to 67%, a one-year prevalence ranging from 17% to 94%, and a life-time prevalence ranging from 33% to 84%. The highest prevalence of LBP was found among skiers, floorball players and rowers and the lowest were found in shooters, golfers and triathletes.

CONCLUSION

Like general population, LBP is quite prevalent among athletes. There is a lack of sound data on the prevalence and mechanism of LBP in some popular sports such as volleyball, swimming and track and field. The lack of standardization of research methods and outcome measurement tools are significant problems in literature. Researchers need to use standard and internationally acceptable definitions for LBP and related functional disability. Investigators are encouraged to conduct epidemiologic studies, along with search for possible mechanism of LBP, by recruitment of large sample population of the athletes who are selected through randomization of the national population and adopt recent recommendations for a standard definition of LBP.

Reliability and Validity of Athletes Disability Index Questionnaire

OBJECTIVE

The purpose of this study was to evaluate validity and reliability of a new proposed questionnaire for assessment of functional disability in athletes with low back pain (LBP).

DESIGN

Validity and reliability study.

SETTING

Elite athletes participating in different fields of sports.

PARTICIPANTS

Participants were 165 male and female athletes (between 12 and 50 years old) with LBP.

INTERVENTIONS

Athlete Disability Index (ADI) Questionnaire which is developed by the authors for assessing LBP-related disability in athletes, Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ).

MAIN OUTCOME MEASURES

Self-reported responses were collected regarding LBP-related disability through ADI, ODI, and RDQ.

RESULTS

The test-retest reliability was strong, and intraclass correlation value ranged between 0.74 and 0.94. The Cronbach alpha coefficient value of 0.91 (P < 0.001) demonstrated excellent internal consistency of the questionnaire. The correlation coefficient between ADI and ODI was r = 0.918 (P < 0.0001), between ADI and RDQ was r = 0.669 (P < 0.0001), and between ADI and visual analog scale was r = 0.626 (P < 0.001). According to ODI and RDQ, disability levels were mild in the large majority of subjects (91.5% and 86.0%, respectively). Alternatively, disability assessments by the ADI did not cluster at the mild level and ranged more broadly from mild to very high.

CONCLUSION

The ADI is a reliable and valid instrument for assessing disability in athletes with LBP. Compared with the available LBP disability questionnaires used in the general population, ADI can more precisely stratify the disability levels of athletes due to LBP.

Could current factors be associated with retrospective sports injuries in Brazilian jiu-jitsu? A cross-sectional study

BACKGROUND

Brazilian jiu-jitsu is characterized by musculoskeletal disorders and high occurrence of sports injuries. The present study was aimed to analyze some internal factors, as well as to describe occurrence and characteristics of retrospective musculoskeletal injuries in different age groups of Brazilian jiu-jitsu practitioners.

METHODS

One hundred ninety-three Brazilian jiu-jitsu practitioners, which were divided into three age groups: Adolescent, Adult, and Master. Besides anthropometric characterization, standard clinical tests were conducted to analyze the global and segmental joint flexibility, lumbar spine range of motion, and handgrip strength. Sports injury occurrence and total physical activity were obtained from an adapted morbidity survey and International Physical Activity Questionnaire - Short Form (IPAQ-SF), respectively.

RESULTS

A total of 247 cases of retrospective injuries was registered (1.27 injury/ participant). Occurrence of rectus femoral muscle retraction in the right leg was increased within Master. Adult and Master have exhibited higher occurrence of sports injuries than Adolescent group (p < 0.05). Joint injuries were the most common sports-related injuries by all Brazilian jiu-jitsu practitioners. While female gender and exposure time constituted the most predictive variables for sports injury occurrence in Adolescent, graduation level was more associated with sports injuries occurrence in Adult.

CONCLUSIONS

Joint injuries derived from combat demands were the main sports injury in all age categories of Brazilian jiu-jitsu. Master subjects presented a higher occurrence of clinical changes and retrospective musculoskeletal injuries in relation to other age groups. Female gender and exposure time constituted the main predictive factors in adolescent subjects, while graduation category was more directly associated with retrospective injury onset in the Adult group.

Functional Movement Screening Performance of Brazilian Jiu-Jitsu Athletes From Brazil: Differences Considering Practice Time and Combat Style

Boscolo Del Vecchio, F, Foster, D, and Arruda, A. Functional movement screening performance of Brazilian jiu-jitsu athletes from Brazil: differences considering practice time and combat style. J Strength Cond Res 30(8): 2341-2347, 2016-Brazilian jiu-jitsu (BJJ) is a grappling combat sport that athletes, lying (guard fighter) or kneeling (pass fighter) on the mat, attempt to force their opponents to submit. Brazilian jiu-jitsu practices may result in muscular imbalances, which increase the risk of injury. Instead, the Functional Movement Screen (FMS) is an evaluation routine that could be related to injury incidence and seeks to detect muscular imbalance and movement dysfunction. Thus, the aim of the study was to investigate the injury profile and the FMS score and their relationship, with consideration for the BJJ fight style. Sports injuries were recorded in the last 12 months of 33 BJJ athletes, and the statistical analyses were applied to a routine evaluation FMS and a score of 14 points or less was considered low performance in FMS. We used a logistic regression; the effect size (ES) was calculated, and 5% was assumed as the statistical significance level. Pass fighters showed a higher percentage of injuries on the thorax (24.24%) than did guard fighters (6.67%, p = 0.01). Upper limbs were the most injured part of the body (χ = 36.7; p < 0.001), and they were 79% of the injuries that occurred in training sessions (χ = 14.53; p < 0.001). Despite the lack of statistical differences in the FMS performance between guard and pass fighters (t = 1.97; p = 0.05), its magnitude was considered medium (ES = 0.77). There was an association between FMS and presence of injury (χ = 4.95; p = 0.03). Considering the FMS score as a predictor and the presence or absence of injury as the dependent variable, the data met a Wald coefficient of 4.55, p = 0.03 and Exp (B) = 5.71. The study found that almost half of the sample had injuries in the upper limbs and a quarter had injuries in the lower limbs in the last year. A poor FMS score was observed, and lower scores in the FMS were associated with a higher risk of injury in BJJ athletes.