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Wasser JG, Bruner ML, Chen C, Vincent HK. Identifying Risk Factors for Preexisting or Developing Low Back Pain in Youth, High School, and Collegiate Lacrosse Players Using 3-Dimensional Motion Analysis. Orthop J Sports Med 2024; 12:23259671241231958. [PMID: 38496334 PMCID: PMC10943740 DOI: 10.1177/23259671241231958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 03/19/2024] Open
Abstract
Background Low back pain (LBP) is a common condition that can affect athletes of all ages. The risk factors for LBP onset and worsening associated with the lacrosse shooting motion are not yet known. Purpose To identify training and biomechanical factors associated with preexisting LBP and development of LBP over 6 months in youth, high school, and collegiate lacrosse players. Study Design Case-control study; Level of evidence, 3. Methods A total of 128 lacrosse players were enrolled in this study between January 2016 and January 2019. Player characteristics, lacrosse experience, and participation in other sports were self-reported. At baseline and 2-, 4-, and 6-month follow-ups, the players self-rated the presence and severity of LBP using a numeric pain rating scale (0-10 points). Participants were grouped according to LBP symptoms: no LBP at any time point (n = 102), preexisting LBP (n = 17), or developed LBP within the 6-month period (n = 9). The lacrosse shooting motion was captured via 3-dimensional motion analysis, and kinematic and kinetic variables were recorded. A Low Back Stress Index was used to estimate lumbar stress as a function of pelvic acceleration at the time of maximum lateral trunk lean during the shot. Univariate analyses of covariance and logistic regression models were used to address study aims. Results Compared with the no-LBP group, the preexisting LBP group demonstrated 13.9% to 22.9% lower maximum angular velocities at the pelvis, trunk, and shoulders in the transverse plane (P < .05), 19.3% less collective pelvis-shoulder rotation in the transverse plane (P = .015), and 4.5% more knee flexion excursion (P = .063). The developed-LBP group produced 2.3% to 11.1% higher angular velocities in the pelvis, trunk, and shoulder and generated maximum pelvic acceleration values 36% to 42% higher than the remaining groups (P < .05 for both). Mean Low Back Stress Index values were not statistically significant among the groups (no LBP: 12,504 ± 13,076 deg2/s2; preexisting LBP: 8808 ± 10,174 deg2/s2; developed LBP: 19,389 ± 13,590 deg2/s2; P = .157). Conclusion Preexisting LBP was associated with significantly restricted motion of the pelvis, trunk, and shoulders during a lacrosse shot. Excessive pelvic acceleration may be related to the development of LBP in lacrosse players.
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Affiliation(s)
- Joseph G. Wasser
- Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, Florida, USA
| | - Michelle L. Bruner
- Department of Orthopaedics, University of Florida, Gainesville, Florida, USA
| | - Cong Chen
- Department of Orthopaedics, University of Florida, Gainesville, Florida, USA
| | - Heather K. Vincent
- Department of Physical Medicine & Rehabilitation, University of Florida, Gainesville, Florida, USA
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Kato K, Otoshi K, Tominaga R, Kaga T, Igari T, Sato R, Kaneko Y, Konno SI. Age-Related Differences in the Limited Range of Motion of the Lower Extremity and Their Relation to Low Back Pain in Young Baseball Players: A Cross-Sectional Study of 1215 Players. SPORTS MEDICINE - OPEN 2023; 9:26. [PMID: 37138150 PMCID: PMC10156885 DOI: 10.1186/s40798-023-00572-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Age-related differences in the limited range of motion of the lower extremities and their relationship with low back pain in juvenile athletes have not been well assessed. This study investigated the relationship between low back pain and limited range of motion of the hip and knee in young baseball players during the baseball season. RESULTS Participants comprised 1215 baseball players (216 pitchers, 999 fielders) aged 6-16 years who underwent medical checkups (self-completed questionnaire and physical examination). Of the 1215 players, 255 (21.0%) experienced seasonal low back pain requiring rest during the previous year. The prevalence of low back pain and a positive Thomas test, straight-leg-raising test, and heel-to-buttock test increased with age. Univariate analysis revealed that a positive heel-to-buttock test in both the throwing and non-throwing arm sides in the 11-12 age group and a positive Thomas test in the throwing arm side in the 13-14 age group were associated with seasonal low back pain (P = 0.0051, P = 0.021, and P = 0.048, respectively). Multivariate analysis, adjusted for factors associated with low back pain, showed significant associations between the positive heel-to-buttock test (odds ratio 1.75, 95% confidence interval 1.11-2.79; P = 0.016) and low back pain in players aged 11-14 years. CONCLUSIONS A positive heel-to-buttock test is potentially associated with low back pain among juvenile baseball players. Particular attention should be paid to the limited range of motion of the knee joint and tightness of the quadriceps femoris muscle among baseball players with low back pain aged 11-14 years.
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Affiliation(s)
- Kinshi Kato
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan.
- Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan.
| | - Kenichi Otoshi
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
- Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Ryoji Tominaga
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
| | - Takahiro Kaga
- Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Takahiro Igari
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
| | - Ryohei Sato
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
| | - Yota Kaneko
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
| | - Shin-Ichi Konno
- Department of Orthopedic Surgery, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan
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Tanaka K, Funasaki H, Kubota D, Murayama Y, Saito M, Iguchi Y. Quadratus lumborum muscle strain in a youth soccer player: a case report. Radiol Case Rep 2023; 18:499-502. [DOI: 10.1016/j.radcr.2022.10.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 10/23/2022] [Indexed: 11/25/2022] Open
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Wall J, Meehan WP, Trompeter K, Gissane C, Mockler D, van Dyk N, Wilson F. Incidence, prevalence and risk factors for low back pain in adolescent athletes: a systematic review and meta-analysis. Br J Sports Med 2022; 56:1299-1306. [PMID: 36150752 DOI: 10.1136/bjsports-2021-104749] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the incidence, prevalence, risk factors and morphological presentations of low back pain (LBP) in adolescent athletes. DESIGN Systematic review with meta-analysis. DATA SOURCES Medline, Embase, CINAHL via EBSCO, Web of Science, Scopus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies evaluating the incidence and/or prevalence of LBP in adolescent athletes across all sports. RESULTS There were 80 studies included. The pooled incidence estimate of LBP in adolescent athletes was 11% (95% CI 8% to 13%, I2=0%) for 2 years, 36.0% (95% CI 4% to 68%, I2=99.3%) for 12 months and 14% (95% CI 7% to 22%, I2=76%) for 6 months incidence estimates. The pooled prevalence estimate of LBP in adolescent athletes was 42% (95% CI 29% to 55%, I2=96.6%) for last 12 months, 46% (95% CI 41.0% to 52%, I2=56%) for last 3 months and 16% (95% CI 9% to 23%, I2=98.3%) for point prevalence. Potential risk factors were sport participation, sport volume/intensity, concurrent lower extremity pain, overweight/high body mass index, older adolescent age, female sex and family history of LBP. The most common morphology reported was spondylolysis. Methodological quality was deemed high in 73% of cross-sectional studies and in 30% of cohort studies. Common reasons for downgrading at quality assessment were use of non-validated survey instruments and imprecision or absence of LBP definition. SUMMARY/CONCLUSION LBP is common among adolescent athletes, although incidence and prevalence vary considerably due to differences in study methodology, definitions of LBP and data collection. PROSPERO REGISTRATION NUMBER CRD42020157206.
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Affiliation(s)
- Julia Wall
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - William P Meehan
- The Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Boston Children's Hospital, Waltham, Massachusetts, USA
| | - Katharina Trompeter
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit Bochum, Bochum, Nordrhein-Westfalen, Germany.,Department of Sports Medicine and Sports Nutrition, Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Conor Gissane
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
| | - David Mockler
- John Stearne Medical Library, Trinity College Dublin, Dublin, Ireland
| | - Nicol van Dyk
- High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College, Dublin, Ireland
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Li N, Amarasinghe S, Boudreaux K, Fakhre W, Sherman W, Kaye A. Spondylolysis. Orthop Rev (Pavia) 2022; 14:37470. [PMID: 36045696 DOI: 10.52965/001c.37470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Spondylolysis is a bony defect of the pars interarticularis and most often results from repetitive stress. Although spondylolysis is usually asymptomatic, symptomatic spondylolysis is the most common cause of identifiable back pain in children and adolescent athletes. A thorough history and physical exam, as well as appropriate imaging studies are helpful in diagnosis. General first-ine therapy for spondylolysis is conservative and consists of rest from sports, core strengthening, as well as spinal bracing. Patients who have failed conservative therapy may consider surgical repair. This article aims to review the epidemiology, pathophysiology, presentation, and treatment options of spondylolysis.
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Affiliation(s)
| | - Sam Amarasinghe
- Louisiana State University Health Sciences Center - Shreveport
| | - Kyle Boudreaux
- Louisiana State University Health Sciences Center - Shreveport
| | - Waddih Fakhre
- Louisiana State University Health Sciences Center - Shreveport
| | | | - Alan Kaye
- Louisiana State University Shreveport
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6
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Watanabe Y, Kato K, Otoshi K, Tominaga R, Kaga T, Igari T, Sato R, Oi N, Konno SI. Associations between core stability and low back pain in high school baseball players: A cross-sectional study. J Orthop Sci 2022; 27:965-970. [PMID: 34167867 DOI: 10.1016/j.jos.2021.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/22/2021] [Accepted: 05/24/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Reduced core stability is a potential risk factor for low back pain in athletes. However, the association between core stability and low back pain in high school baseball players has not been thoroughly studied. The purpose of this study was to investigate the relationship between core stability and low back pain and its clinical characteristics in high school baseball players. METHODS Participants comprised 812 high school baseball players who had undergone annual medical evaluations, comprising a self-completed questionnaire and a physical examination. We investigated the relationships between low back pain during the season and on the day of medical evaluations and core stability using a cross-sectional study design. Core stability was assessed using the Sahrmann core stability test. RESULTS Reduced core stability was confirmed in 358 (44.1%) of all players, 98 (49.5%) pitchers, and 260 (42.3%) fielders. In total, 352 players (43.3%) reported incidents of seasonal low back pain during the previous year. Thirty-five pitchers (17.7%) and 153 fielders (24.9%) reported low back pain on the day of the medical evaluations. No significant associations were seen between low back pain throughout the season and reduced core stability. After adjusting for confounding factors (total amount of practice per week, hamstring tightness and quadriceps tightness) using logistic regression modeling, a significant association between presence of low back pain during lumbar extension movement and reduced core stability was found (odds ratio, 2.57; 95% confidence interval, 1.08-6.62; P = 0.033) in pitchers. CONCLUSIONS High school baseball pitchers with reduced core stability showed a higher probability of reporting low back pain during lumbar extension movement. Evaluation of core stability should be considered in high school baseball players, especially in pitchers.
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Affiliation(s)
- Yuki Watanabe
- Department of Rehabilitation Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kinshi Kato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan.
| | - Kenichi Otoshi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Ryoji Tominaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takahiro Kaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan; Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Takahiro Igari
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Ryohei Sato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Naoyuki Oi
- Department of Rehabilitation Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan
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Mayes M, Salesky M, Lansdown DA. Throwing Injury Prevention Strategies with a Whole Kinetic Chain-Focused Approach. Curr Rev Musculoskelet Med 2022; 15:53-64. [PMID: 35389192 PMCID: PMC9076771 DOI: 10.1007/s12178-022-09744-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2021] [Indexed: 12/14/2022]
Abstract
Purpose of Review This review examines the relationship between the baseball pitching motion and the kinetic chain. The goal was to determine the underlying causes of a deficiency in throwing mechanics throughout a throwing motion, and to provide an evidence-based approach on how to prevent injuries caused by a lack of proper mechanics. In doing so, we sought to provide a warm-up strategy that can be added to every baseball player’s daily on-field routine that is tailored to each phase of the throwing motion. Recent Findings To help minimize the risk of injury to overhead throwing athletes, a thorough understanding of the throwing motion is critical. Throwing a ball places extreme stress on the body, notably the shoulder and elbow joints. With a clear understanding of the biomechanics of throwing, we can develop an injury prevention routine to minimize unnecessary stresses throughout the kinetic chain. Summary The throwing cycle is a complex motion that places various stresses throughout the thrower’s body, from the ankle to the core, and from the back to the shoulder and elbow. A thorough understanding of the mechanics of this motion, along with specific exercises to target the specific actions of each phase, may allow for throwers, regardless of their age and experience, to minimize injury risk.
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Affiliation(s)
- Michael Mayes
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA
| | - Madeleine Salesky
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA
| | - Drew A Lansdown
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA.
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Kato K, Otoshi KI, Tominaga R, Kaga T, Igari T, Sato R, Konno SI. The prevalence and clinical characteristics of sacroiliac joint dysfunction in adolescent baseball players. J Orthop Sci 2022; 27:335-341. [PMID: 33750607 DOI: 10.1016/j.jos.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/22/2020] [Accepted: 01/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sacroiliac joint (SIJ) dysfunction is a potential source of low back pain (LBP) in baseball players, who are more likely to be affected by loading of the SIJ in the throwing motion. However, the prevalence and characteristics of this condition have not been studied thoroughly. This study aimed to investigate the prevalence and clinical characteristics of SIJ dysfunction among high school baseball players. METHODS Participants comprised 891 high school baseball players who had undergone annual medical evaluations (a self-completed questionnaire and physical examination). The prevalence of SIJ dysfunction and associations with the measurements of the flexibility of the spine and lower extremities such as finger-floor-distance, straight-leg-raising angle, heel-buttock-distance, Thomas test, and passive range of motion of the hip were investigated. RESULTS Twenty-two of 891 subjects (2.5%) met our criteria for SIJ dysfunction. Twelve subjects (55%) exhibited throwing arm side symptoms more commonly than in the non-throwing arm side (n = 3, 15%) or bilateral side (n = 7, 32%). Previous episodes of LBP were experienced significantly more frequently among subjects with SIJ dysfunction (n = 19, 86.4%) than among those without (n = 501, 57.7%; P = 0.015). The prevalence of present LBP that interfered with play was significantly higher among subjects with SIJ dysfunction (n = 9, 42.9%) than among those without (n = 118, 21.2%; P = 0.038). The prevalence of SIJ dysfunction as a source of LBP was estimated at 7.1% (9 of 127 subjects). After adjustment for associated factors using a logistic regression model, we observed a significant association between a limitation in hip internal rotation on the throwing arm side and SIJ dysfunction (odds ratio 3.11 [1.30-7.71]; P = 0.0109). CONCLUSIONS According to our criteria, the estimated prevalence of SIJ dysfunction among high school baseball players is 2.5%. There was a significant association between a limitation in hip internal rotation on the throwing arm side and SIJ dysfunction.
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Affiliation(s)
- Kinshi Kato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan.
| | - Ken-Ichi Otoshi
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan; Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Ryoji Tominaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Takahiro Kaga
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan; Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan
| | - Takahiro Igari
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Ryohei Sato
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
| | - Shin-Ichi Konno
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan
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Wang Z, Sato K, Nawrin SS, Widatalla NS, Kimura Y, Nagatomi R. Low Back Pain Exacerbation Is Predictable Through Motif Identification in Center of Pressure Time Series Recorded During Dynamic Sitting. Front Physiol 2021; 12:696077. [PMID: 34594234 PMCID: PMC8476954 DOI: 10.3389/fphys.2021.696077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 08/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Low back pain (LBP) is a common health problem - sitting on a chair for a prolonged time is considered a significant risk factor. Furthermore, the level of LBP may vary at different times of the day. However, the role of the time-sequence property of sitting behavior in relation to LBP has not been considered. During the dynamic sitting, small changes, such as slight or big sways, have been identified. Therefore, it is possible to identify the motif consisting of such changes, which may be associated with the incidence, exacerbation, or improvement of LBP. Method: Office chairs installed with pressure sensors were provided to a total of 22 office workers (age = 43.4 ± 8.3 years) in Japan. Pressure sensors data were collected during working days and hours (from morning to evening). The participants were asked to answer subjective levels of pain including LBP. Center of pressure (COP) was calculated from the load level, the changes in COP were analyzed by applying the Toeplitz inverse covariance-based clustering (TICC) analysis, COP changes were categorized into several states. Based on the states, common motifs were identified as a recurring sitting behavior pattern combination of different states by motif-aware state assignment (MASA). Finally, the identified motif was tested as a feature to infer the changing levels of LBP within a day. Changes in the levels of LBP from morning to evening were categorized as exacerbated, did not change, or improved based on the survey questions. Here, we present a novel approach based on social spider algorithm (SSA) and probabilistic neural network (PNN) for the prediction of LBP. The specificity and sensitivity of the LBP inference were compared among ten different models, including SSA-PNN. Result: There exists a common motif, consisting of stable sitting and slight sway. When LBP level improved toward the evening, the frequency of motif appearance was higher than when LBP was exacerbated (p < 0.05) or the level did not change. The performance of the SSA-PNN optimization was better than that of the other algorithms. Accuracy, precision, recall, and F1-score were 59.20, 72.46, 40.94, and 63.24%, respectively. Conclusion: A lower frequency of a common motif of the COP dynamic changes characterized by stable sitting and slight sway was found to be associated with the exacerbation of LBP in the evening. LBP exacerbation is predictable by AI-based analysis of COP changes during the sitting behavior of the office workers.
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Affiliation(s)
- Ziheng Wang
- Department of Medicine and Science in Sports and Exercise, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Keizo Sato
- Division of Biomedical Engineering for Health and Welfare, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Saida Salima Nawrin
- Division of Biomedical Engineering for Health and Welfare, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Namareq Salah Widatalla
- Next Generation Biological Information Technology, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| | - Yoshitaka Kimura
- Next Generation Biological Information Technology, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
- Artificial Intelligence (AI) in Obstetrics and Gynecology Medical Care, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Graduate School of Medicine, Tohoku University, Sendai, Japan
- Division of Biomedical Engineering for Health and Welfare, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
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Maselli F, Rossettini G, Storari L, Barbari V, Viceconti A, Geri T, Testa M. Knowledge and management of low back pain as running-related injuries among Italian physical therapists: findings from a national survey. PHYSICIAN SPORTSMED 2021; 49:278-288. [PMID: 32997551 DOI: 10.1080/00913847.2020.1816124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the beliefs, knowledge, attitudes, behavior, and the clinical management procedures of the Italian physical therapists specialized in orthopedic manipulative physical therapy (OMPT) toward running and its correlation with low back pain (LBP).Design: A cross-sectional online survey was conducted in 2019, according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.Setting: Italy.Participants: One thousand two hundred and eighteen Italian OMPTs. METHODS Survey Monkey software was used to administer the survey. The questionnaire was self-reported and included 26 questions. Descriptive statistics were used and related to the effective respondents for each question. RESULTS One thousand two hundred and eighteen questionnaires (60.9%) were included in the analysis. A considerable cohort of OMPTs working in private practice clinical settings (n = 845; 69.4%; 95% CI 66.7-71.9) has indicated running not to be a relevant risk factor for the onset of LBP (n = 806; 66.2%; 95% CI 63.4-68.8). Moreover, most of the participants (n = 679; 55.7%; 95% CI 52.9-58.5) adopted a combination of manual therapy techniques and therapeutic exercise for the management of runners with LBP. CONCLUSIONS Widespread knowledge of clinical and theoretical management of LBP in runners-patients has emerged among Italian OMPTs. The OMPTs' academic background agrees with the recent literature and therefore highlights the paucity of studies related to LBP as running-related injuries.
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Affiliation(s)
- Filippo Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy
| | - Giacomo Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Lorenzo Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Valerio Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Antonello Viceconti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Tommaso Geri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy.,Private Practice, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Savona, Italy
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The Management of Acute Lumbar Stress Reactions of the Pedicle and Pars in Professional Athletes Playing Collision Sports. Clin Spine Surg 2021; 34:247-259. [PMID: 32991362 DOI: 10.1097/bsd.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/19/2020] [Indexed: 11/26/2022]
Abstract
Acute stress reactions in the lumbar spine most commonly occur in athletes at the pars interarticularis followed by the pedicle. These reactions occur as a result of repetitive microtrauma from supraphysiological loads applied to the lumbar spine. Characteristic motions such as trunk extension and twisting are also thought to play a role and may be sport-specific. Other risk factors include increased lumbar lordosis, hamstring and thoracolumbar fascia tightness, and abdominal weakness. On physical examination, pain is typically reproduced with lumbar hyperextension. Currently, magnetic resonance imaging or nuclear imaging remain the most sensitive imaging modalities for identifying acute lesions. In the elite athlete, management of these conditions can be challenging, particularly in those playing collision sports such as American football, hockey, or rugby. Nonoperative treatment is the treatment of choice with rehabilitation programs focused on pain-free positioning and progressive strengthening. Operative treatment is rare, but may be warranted for patients symptomatic for >12 months. Specialized diagnosis protocols as well as treatment and return to play guidelines from 4 physicians treating elite athletes playing collision sports are presented and reviewed.
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Nakase K, Shitara H, Tajika T, Kuboi T, Ichinose T, Sasaki T, Hamano N, Endo F, Kamiyama M, Miyamoto R, Yamamoto A, Kobayashi T, Takagishi K, Chikuda H. An analysis of pre-season risk factors for low back injury in high-school baseball pitchers: a prospective study. Sci Rep 2021; 11:11415. [PMID: 34075129 PMCID: PMC8169826 DOI: 10.1038/s41598-021-90988-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 05/20/2021] [Indexed: 11/09/2022] Open
Abstract
Pitching motion requires whole-body coordination; therefore, poor control of the lower extremities, pelvis and trunk may cause shoulder and elbow injuries. However, few studies have described the relationship between the shoulder joint function and low back injury in high-school baseball pitchers. A total of 128 healthy high school pitchers underwent pre-season medical checkups, where their shoulder range of motion and shoulder strength were measured. The participants completed a self-recorded daily questionnaire regarding the presence of low back pain. Pitchers were divided into injured and non-injured groups. Low back injury was observed in 13 participants (13.4%). In the injured group, horizontal adduction on the dominant shoulder was significantly less than in the non-injured group. A logistic regression analysis showed that horizontal adduction on the dominant side was a significant independent risk factor for low back injury during the season. It is important to recognize that restriction of the shoulder function not only causes shoulder and elbow injuries but can also risk low back injury.
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Affiliation(s)
- Kurumi Nakase
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan.
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Tsuyoshi Ichinose
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Noritaka Hamano
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Fumitaka Endo
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Masataka Kamiyama
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Ryosuke Miyamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Atsushi Yamamoto
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Tsutomu Kobayashi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Kenji Takagishi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma, 371-8511, Japan
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Maselli F, Esculier JF, Storari L, Mourad F, Rossettini G, Barbari V, Pennella D, Cataldi F, Viceconti A, Geri T, Testa M. Low back pain among Italian runners: A cross-sectional survey. Phys Ther Sport 2021; 48:136-145. [PMID: 33434869 DOI: 10.1016/j.ptsp.2020.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Low Back Pain (LBP) is commonly reported as a very frequent disorder in sports, but its prevalence in runners remains unclear. OBJECTIVES To determine the prevalence of LBP in a wide sample of Italian runners. DESIGN A cross-sectional online survey. SETTING A national survey, according to the CHERRIES and STROBE guidelines, was performed in 2019. PARTICIPANTS 2539 Italian runners. METHODS A sample of Italian runners registered with national running associations was recruited. The survey was conducted using an online survey development platform. The questionnaire was self-reported and included 38 questions. MAIN OUTCOME MEASURES Descriptive statistics and frequencies were used to analyze results. Relationships between demographics, daily habits and running characteristics and the responses given was calculated with Cramer's V. Only correlation values higher >0.60 were deemed of interest. RESULTS 2539 questionnaires (63.5%) were valid for analysis. In total, 22.6% of runners reported having experienced LBP in the past year. Most participants (77.0%) reporting episodes of LBP believed it was not caused by running. No significant correlations (Cramer's V < 0.60) were found between LBP and demographics, training characteristics or lifestyle habits. CONCLUSION The prevalence of LBP among Italian runners was 22,57%. LBP was not associated with training, equipment or lifestyle.
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Affiliation(s)
- F Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy; Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy.
| | - J F Esculier
- The Running Clinic, Lac Beauport, QC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - L Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - F Mourad
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - G Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - V Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - D Pennella
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise C/da Tappino c/o Cardarelli Hospital, Campobasso, Italy
| | - F Cataldi
- Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - A Viceconti
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - T Geri
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
| | - M Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genoa, Campus of Savona, Savona, Italy
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Inspiratory Muscle Training in Rehabilitation of Low Back Pain: A Randomized Controlled Trial. J Sport Rehabil 2020; 29:1151-1158. [PMID: 31910393 DOI: 10.1123/jsr.2019-0231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 10/20/2019] [Accepted: 11/06/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT People with chronic low back pain (CLBP) suffer from weaknesses in their core muscle activity and dysfunctional breathing. Inspiratory muscle training (IMT) was recently developed to treat this condition. OBJECTIVES The present study was conducted to investigate the effect of IMT on core muscle activity, pulmonary parameters, and pain intensity in athletes with CLBP. DESIGN This study was designed as a single-blind, randomized, controlled trial. SETTING Clinical rehabilitation laboratory. PARTICIPANTS A total of 23 male and 24 female athletes with CLBP were randomly divided into the experimental and control groups. MAIN OUTCOME MEASURES The experimental group performed IMT for 8 weeks, 7 days per week and twice daily, using POWERbreathe KH1, beginning at 50% of maximum inspiratory pressure with a progressively increasing training load. The surface electromyography muscle activity of the erector spinae, multifidus, transverse abdominis and rectus abdominis, respiratory function and Visual Analogue Scale score were also measured before and after the intervention in both groups. The repeated-measures analysis of variance and 1-way analysis of covariance were further used to compare the intragroup and intergroup results following the intervention. RESULTS The findings of the study revealed that multifidus and transverse abdominis activity, as well as respiratory function, increased significantly in the IMT group (P < .05). Moreover, a descending trend was observed in the Visual Analogue Scale score in the experimental group (P < .05). CONCLUSION The results showed that IMT can improve respiratory function, increase core muscle activity, and, consequently, reduce pain intensity in athletes with CLBP.
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Kamada M, Manabe H, Yamashita K, Sakai T, Maeda T, Sairyo K. Full-endoscopic Decompression of Foraminal Stenosis Caused by Facet Hypertrophy Contralateral to the Dominant Hand in a Baseball Pitcher: A Case Report. NMC Case Rep J 2020; 7:173-177. [PMID: 33062564 PMCID: PMC7538464 DOI: 10.2176/nmccrj.cr.2019-0075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 02/12/2020] [Indexed: 01/14/2023] Open
Abstract
Back pain and lower extremity pain have various causes and occasionally occur simultaneously, creating diagnostic difficulties. In addition, athletes require special consideration in terms of treatment. Here, we report a case of foraminal stenosis as a result of lumbar disc prolapse combined with facet hypertrophy contralateral to the dominant hand in a baseball pitcher that was successfully treated by minimally invasive full-endoscopic surgery. A 31-year-old left-handed male baseball pitcher presented with complaints of low back pain and right buttock pain while pitching. A diagnosis of foraminal stenosis caused by a disc bulge combined with facet hypertrophy contralateral to the dominant hand was made on the basis of physical and radiological findings. His symptoms improved immediately after transforaminal full-endoscopic lumbar discectomy and foraminoplasty under local anesthesia. He returned to play 3 months after surgery. Foraminal stenosis due to facet hypertrophy may occur in the side contralateral to the throwing arm in pitchers. Minimally invasive decompression using a full-endoscopic procedure is required for high-level athletes at this position.
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Affiliation(s)
- Mitsuhiro Kamada
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan
| | - Hiroaki Manabe
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan
| | - Kazuta Yamashita
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan
| | - Toshinori Sakai
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan
| | - Toru Maeda
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Tokushima, Japan
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Maselli F, Storari L, Barbari V, Colombi A, Turolla A, Gianola S, Rossettini G, Testa M. Prevalence and incidence of low back pain among runners: a systematic review. BMC Musculoskelet Disord 2020; 21:343. [PMID: 32493481 PMCID: PMC7271446 DOI: 10.1186/s12891-020-03357-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
Background Running is one of the most popular sports worldwide. Despite low back pain (LBP) represents the most common musculoskeletal disorder in population and in sports, there is currently sparse evidence about prevalence, incidence and risk factors for LBP among runners. The aims of this systematic review were to investigate among runners: prevalence and incidence of LBP and specific risk factors for the onset of LBP. Methods A systematic review has been conducted according to the guidelines of the PRISMA statement. The research was conducted in the following databases from their inception to 31st of July 2019: PubMed; CINAHL; Google Scholar; Ovid; PsycINFO; PSYNDEX; Embase; SPORTDiscus; Scientific Electronic Library Online; Cochrane Library and Web of Science. The checklists of The Joanna Briggs Institute Critical Appraisal tools were used to investigate the risk of bias of the included studies. Results Nineteen studies were included and the interrater agreement for full-text selection was good (K = 0.78; 0.61–0.80 IC 95%). Overall, low values of prevalence (0.7–20.2%) and incidence (0.3–22%) of LBP among runners were reported. Most reported risk factors were: running for more than 6 years; body mass index > 24; higher physical height; not performing traditional aerobics activity weekly; restricted range of motion of hip flexion; difference between leg-length; poor hamstrings and back flexibility. Conclusions: Prevalence and incidence of LBP among runners are low compared to the others running related injuries and to general, or specific population of athletes. View the low level of incidence and prevalence of LBP, running could be interpreted as a protective factor against the onset of LBP. Systematic review registration PROSPERO CRD42018102001.
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Affiliation(s)
- Filippo Maselli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy. .,Sovrintendenza Sanitaria Regionale Puglia INAIL, Bari, Italy.
| | - Lorenzo Storari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Valerio Barbari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Andrea Colombi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Andrea Turolla
- IRCCS, San Camillo, Laboratory of Rehabilitation Technologies, Rehabilitation Research Unit, Venice, Italy
| | - Silvia Gianola
- IRCCS, Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milano, Italy
| | - Giacomo Rossettini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetic and Maternal Infantile Sciences (DINOGMI), University of Genova - Campus of Savona, Savona, Italy
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Donado C, Spagnuolo GM, Lobo K, Berde C, Dinakar P. Effect of lumbar medial branch blocks on extension-related axial chronic low back pain in a pediatric population: a retrospective chart review and prospective follow-up. Reg Anesth Pain Med 2020; 45:1019-1020. [PMID: 32393524 DOI: 10.1136/rapm-2019-101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/14/2020] [Accepted: 04/17/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Carolina Donado
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Genevieve M Spagnuolo
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Kimberly Lobo
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Charles Berde
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Pradeep Dinakar
- Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA .,Department of Anesthesiology, Perioperative & Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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18
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Perceptions of low back pain in elite gymnastics: A multi-disciplinary qualitative focus group study. Phys Ther Sport 2020; 44:33-40. [PMID: 32375075 DOI: 10.1016/j.ptsp.2020.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To explore the multidisciplinary team experience of Low Back Pain (LBP) in elite gymnastics. DESIGN A qualitative focus group. SETTING British Gymnastics. PARTICIPANTS Ten coaching, sports science and medicine multidisciplinary team members working with British gymnasts. MAIN OUTCOME MEASURES A topic guide informed by literature/expert opinion enabled discussion that was recorded/transcribed verbatim. Initial inductive analytic process developed theoretical insights. Manual coding using constant comparative methods categorised meaningful themes and sub-themes. RESULTS Two key aspects were identified. Emerging themes for LBP presentation included: early identification LBP and influence of multidisciplinary team members on outcomes; factors influencing LBP reporting e.g. coach-athlete relationship; frequent presentations of LBP and accepted norms; athlete history and physical examination e.g. training load. Emerging themes for causation of LBP included: intrinsic risk factors e.g. growth and maturation; extrinsic risk factors e.g. equipment. CONCLUSIONS Individual responses of a gymnast to experiencing LBP were important across all themes. Some LBP was perceived as normal. The coach-athlete relationship and support team are crucial decision-makers around training load and adaptation. Early detection will help minimise time loss from training/performance to expedite healing.
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Abstract
STUDY DESIGN Literature review. OBJECTIVE To conduct a literature review of studies reporting the incidence of pars interarticularis defects in athletes of specific sports, in order to allow more targeted prevention and treatment strategies to be implemented for the groups at highest risk. METHODS Electronic searches were performed using PubMed, Ovid Medline, EMBASE, Google Scholar, Cochrane Database of Systematic Reviews, and Cochrane Database of Controlled Trials from their dates of inception to September 2017, with the following keywords: "spondylolysis," "sports," "low back pain," and "pars defects." RESULTS A total of 509 total articles were retrieved, of which 114 were used in the final review. The incidence of pars interarticularis defects was found to be highest in diving (35.38%), cricket (31.97%), baseball/softball (26.91%), rugby (22.22%), weightlifting (19.49%), sailing (17.18%), table tennis (15.63%), and wrestling (14.74%). Only 5 studies reported the management instituted for their participants, and these were all case reports. Of 74 players with spondylolysis in these studies, 70 (94.59%) underwent conservative treatment and 4 (5.41%) underwent surgical treatment. 61 (82.43%) returned to their previous level of play, 6 (8.11%) retired, and the disposition of the final 7 was not reported. CONCLUSION The current medical literature provides good evidence that the incidence of pars interarticularis defects is higher in the athletic population, with the highest incidence in diving. There remains no gold standard protocol for the management of pars interarticularis defects. Further research is required to compare conservative therapy to surgical therapy and to compare the various surgical techniques to each other.
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Affiliation(s)
- Samuel Tawfik
- University of New South Wales, Sydney, New South Wales, Australia,St George Hospital, Sydney, New South Wales, Australia,Samuel Tawfik, St George Hospital, Sydney, New South Wales, Australia 2217.
| | - Kevin Phan
- University of New South Wales, Sydney, New South Wales, Australia,Neurospine Surgery Research Group, Sydney, New South Wales, Australia
| | - Ralph J. Mobbs
- Neurospine Surgery Research Group, Sydney, New South Wales, Australia,Prince of Wales Private Hospital, Sydney, New South Wales, Australia
| | - Prashanth J. Rao
- Neurospine Surgery Research Group, Sydney, New South Wales, Australia,University of Sydney, Sydney, New South Wales, Australia,Westmead Hospital, Sydney, New South Wales, Australia
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20
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Abstract
With increasing pediatric participation in organized sport and the early specialization of children in single sports, the number of injuries seen in the pediatric and adolescent athletic population continues to increase. Children experience acute traumatic injuries during practice and competition as well as chronic overuse injuries secondary to the repetitive stress on their developing bodies. The unique nature of the pediatric patient often requires a different diagnostic, prognostic, and treatment approach to sports injuries compared with their adult counterparts.
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21
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The Effectiveness of the Mézières Method in Elite Rhythmic Gymnastics Athletes With Low Back Pain: A Randomized Controlled Trial. J Sport Rehabil 2019; 29:913-919. [PMID: 31711041 DOI: 10.1123/jsr.2019-0204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/24/2019] [Accepted: 08/18/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT One of the main reasons why athletes with a high physical condition suffer from low back pain disease is because they often participate in sports that involve disc compression movements during flexion, lifting loads, or torsion movement. OBJECTIVES This study aims to examine the effectiveness of the postural treatment of the Mézières method on elite rhythmic gymnastics athletes with low back pain. DESIGN Double-blind, randomized, controlled trial. SETTING The sports hall of "Puente Tocinos," Murcia, Spain. PARTICIPANTS Ninety gymnastics athletes were randomized into 2 parallel groups (intervention: n = 39; control: n = 51), of whom 98.9% were women (women = 89; man = 1). INTERVENTION The Mézières method postural therapy was implemented. It lasted about 60 minutes in repeated sessions of 2 to 3 meetings per week by counting in overall 60 sessions during a 24-week period. MAIN OUTCOME MEASURES Visual analog scale of pain, sit and reach flexibility test, Runtastic (pedometer performance android application), Roland-Morris Questionnaire for the physical disability, and the Health Status Questionnaire were used. RESULTS The univariate analysis of variance and independent sample t test revealed a significant improvement in the intervention group concerning the visual analog scale pain assessment scale (P < .05, ηp2=.625), and, also, the between-groups effect size was high during the 24 sessions of treatment (d > 0.8) compared with the control one. The same situation persists even for Roland-Morris Questionnaire (P < .05, ηp2=.802), physical score (P < .05, ηp2=.613), mental score (P < .05, ηp2=.736), sit and reach flexibility test (P < .05, ηp2=.666), and Runtastic performance (P < .05, ηp2=.790), where the between-groups effect size was high during the 24 sessions of treatment (d > 0.8). CONCLUSION The Mézières method treatment performed on athletes with low back pain has caused positive effects on all the outcomes analyzed compared with the ones of control group.
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22
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Kemmochi M, Sasaki S, Ichimura S. Association between reduced trunk flexibility in children and lumbar stress fractures. J Orthop 2018; 15:122-127. [PMID: 29657454 DOI: 10.1016/j.jor.2018.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022] Open
Abstract
Background We noticed that most of active sports children with low back pain (LBP) have muscle tightness around the pelvis and reduced trunk flexibility. Abnormalities in short-time inversion recovery (STIR) images on magnetic resonance imaging (MRI) can show stress fracture. Therefore, we investigated the associations among LBP, trunk flexibility, and lumbar stress fractures. Methods A total of 130 patients under the age of 18 years complained of LBP were investigated in STIR MRI images. Among these 130 patients, 65 cases of lumbar stress fracture were diagnosed and 65 cases were not diagnosed as a lumbar stress fracture. We compared between a group suspected of stress fracture (suspected group) and a group of stress fracture(stress fracture group)about their trunk flexibility. These groups were investigated about their initial trunk flexibility about below items; Finger floor distance (FFD), Heel to buttock distance (HBD), straight leg raising (SLR). Results Significant differences were observed between suspected group and stress fracture group about every items; SLR (P < 0.001), FFD (P < 0.01), HBD (P < 0.002). Most cases of stress fracture group had reduced trunk flexibility, and low flexibility in pelvic area muscles was observed in 93.8% (61/65) of cases at the initial examination. Otherwise, that of suspected group was 73.8%(48/65). Conclusions Most patients of lumbar stress fracture had reduced trunk flexibility, and their reduced trunk flexibility might not be caused by LBP. In the early diagnosis of lumbar stress fractures using STIR MRI images, there were indicated that reduced trunk flexibility was one of helpful item for lumbar stress fracture.
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Affiliation(s)
- Masahiko Kemmochi
- Kenmochi Orthopedic Surgery Sports Clinic, KOSSMOS Medical Corporation, 42-1 Higashi-honcho Ota City, Gunma, 373-0026, Japan
| | - Shigeru Sasaki
- Department of Orthopaedic Surgery, Kyorin University, 5-4-1 Mitaka, Shimorenjaku, 181-8612, Tokyo, Japan.,Japan Community Health Care Organization, Yamanashi Hospital, 3 Chome-11-16 Asahi, Kofu, Yamanashi Prefecture, 400-0025, Japan
| | - Shoichi Ichimura
- Department of Orthopaedic Surgery, Kyorin University, 5-4-1 Mitaka, Shimorenjaku, 181-8612, Tokyo, Japan
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23
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Ng L, Rosalie SM, Sherry D, Loh WB, Sjurseth AM, Iyengar S, Wild CY. A biomechanical comparison in the lower limb and lumbar spine between a hit and drag flick in field hockey. J Sports Sci 2018; 36:2210-2216. [PMID: 29493427 DOI: 10.1080/02640414.2018.1445440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Research has revealed that field hockey drag flickers have greater odds of hip and lumbar injuries compared to non-drag flickers (DF). This study aimed to compare the biomechanics of a field hockey hit and a specialised field hockey drag flick. Eighteen male and seven female specialised hockey DF performed a hit and a drag flick in a motion analysis laboratory with an 18-camera three-dimensional motion analysis system and a calibrated multichannel force platform to examine differences in lower limb and lumbar kinematics and kinetics. Results revealed that drag flicks were performed with more of a forward lunge on the left lower limb resulting in significantly greater left ankle dorsiflexion, knee, hip and lumbar flexion (Ps<0.001) compared to a hit. Drag flicks were also performed with significantly greater lateral flexion (P < 0.002) and rotation of the lumbar spine (P < 0.006) compared to a hit. Differences in kinematics lead to greater shear, compression and tensile forces in multiple left lower limb and lumbar joints in the drag flick compared to the hit (P < 0.05). The biomechanical differences in drag flicks compared to a hit may have ramifications with respect to injury in field hockey drag flickers.
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Affiliation(s)
- Leo Ng
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia
| | - Simon M Rosalie
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia.,b Dipartimento di Ingegneria Industriale , Università degli Studi di Firenze , Firenze , Italy
| | - Dorianne Sherry
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia.,c Territory Sportsmedicine , Darwin , Australia
| | - Wei Bing Loh
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia.,d Tan Tock Seng Hospital , Singapore
| | - Andreas M Sjurseth
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia.,e Stadion Fysikalske Institutt , Oslo , Norway
| | - Shrikant Iyengar
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia.,f ProHealthAsia , New Delhi , India
| | - Catherine Y Wild
- a School of Physiotherapy and Exercise Sciences , Curtin University , Perth , Australia
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Abstract
Lower back pain in young athletes is a common problem. The prevalence of back pain from different causes in adolescent age group is between 20% and 30%. However, the incidence of low back pain in young athletes varies widely in different sports. Overuse injuries are the most common cause of low back pain in young athletes. In case of overuse injuries, the cause and effect relationship between back pain and specific condition is often difficult to establish. In adolescent athletes, the most common underlying identified cause of low back pain is lumbar spondylolysis. During adolescent growth spurt, the severity of the pain generally correlates with adolescent growth spurt. Participation in sports starting at an early age and for a longer duration tends to increase the risk for back pain. Numerous conditions cause low back pain in athletes. These include acute trauma, chronic overuse or repetitive trauma, and referred pain. Our focus in here will be on selected conditions that cause recurrent or chronic low back pain.
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Affiliation(s)
- Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Elizabeth Kinsella
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
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Abstract
Lumbar disk herniation, degenerative disk disease, and spondylolysis are the most prevalent lumbar conditions that result in missed playing time. Lumbar disk herniation has a good prognosis. After recovery from injury, professional athletes return to play 82% of the time. Surgical management of lumbar disk herniation has been shown to be a viable option in athletes in whom nonsurgical measures have failed. Degenerative disk disease is predominately genetic but may be accelerated in athletes secondary to increased physiologic loading. Nonsurgical management is the standard of care for lumbar degenerative disk disease in the elite athlete. Spondylolysis is more common in adolescent athletes with back pain than in adult athletes. Nonsurgical management of spondylolysis is typically successful. However, if surgery is required, fusion or direct pars repair can allow the patient to return to sports.
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Wasser JG, Zaremski JL, Herman DC, Vincent HK. Assessment and rehabilitation of chronic low back pain in baseball: part II. Res Sports Med 2017; 25:231-243. [PMID: 28128000 DOI: 10.1080/15438627.2017.1282362] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Repetitive throwing and hitting motions in baseball place mechanical stresses to the lumbar spine which may cause low back pain (LBP). Pain may be due to vertebral stress reactions or insufficiency fractures, intervertebral disc degeneration or intervertebral disc herniation. Untreated chronic conditions have high potential to lead to a more significant injury such as spondylolysis. Chronic LBP increases the risk for missed playing time, early career termination and lower quality of life after retirement. Proper clinical assessment and prevention/rehabilitation of LBP in this population is thus important for performance, play time and overall long-term quality of life. This narrative review synopsizes the available evidence for assessment and rehabilitation of baseball players with LBP, including the structured rehabilitative techniques and programmes which should be administered to affected players. The state of the evidence suggests that there are deficits in identifying the optimal prevention and rehabilitation prescription components for the variety of LBP-inducing injuries in this athletic population.
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Affiliation(s)
- Joseph G Wasser
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , USA
| | - Jason L Zaremski
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , USA
| | - Daniel C Herman
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , USA
| | - Heather K Vincent
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , USA
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Wasser JG, Zaremski JL, Herman DC, Vincent HK. Prevalence and proposed mechanisms of chronic low back pain in baseball: part i. Res Sports Med 2017; 25:219-230. [PMID: 28128007 DOI: 10.1080/15438627.2017.1282361] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The prevalence of low back pain (LBP) among active baseball players ranges between 3 and 15%. The execution of baseball-specific manoeuvres, such as pitching or batting, may be related to the onset of LBP. These baseball motions are complex and require appropriate activation of the core musculature to produce a well-timed motion with forces minimized at the extremities. The spine, core and back musculature are involved with acceleration and deceleration of rotational motions. This narrative review synopsizes the available evidence of the prevalence of and mechanical factors underlying LBP in the baseball population. Possible mechanical mechanisms linking baseball play to LBP include aberrant motion, improper timing, high lumbar stress due to mechanical loading and lumbopelvic strength deficits. Potential clinical implications relating to these possible mechanical mechanisms will also be highlighted. The state of the evidence suggests that there are deficits in understanding the role of baseball motion and playing history in the development of spine conditions.
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Affiliation(s)
- Joseph G Wasser
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , United States of America
| | - Jason L Zaremski
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , United States of America
| | - Daniel C Herman
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , United States of America
| | - Heather K Vincent
- a Department of Orthopaedics and Rehabilitation, Division of Research; Interdisciplinary Center for Musculoskeletal Training and Research , University of Florida , Gainesville , FL , United States of America
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Shurley JP, Newman JK. Spondylolysis in American Football Players: Etiology, Symptoms, and Implications for Strength and Conditioning Specialists. Strength Cond J 2016. [DOI: 10.1519/ssc.0000000000000244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Spencer S, Wolf A, Rushton A. Spinal-Exercise Prescription in Sport: Classifying Physical Training and Rehabilitation by Intention and Outcome. J Athl Train 2016; 51:613-628. [PMID: 27661792 DOI: 10.4085/1062-6050-51.10.03] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Identification of strategies to prevent spinal injury, optimize rehabilitation, and enhance performance is a priority for practitioners. Different exercises produce different effects on neuromuscular performance. Clarity of the purpose of a prescribed exercise is central to a successful outcome. Spinal exercises need to be classified according to the objective of the exercise and planned physical outcome. OBJECTIVE To define the modifiable spinal abilities that underpin optimal function during skilled athletic performance, clarify the effect of spinal pain and pathologic conditions, and classify spinal exercises according to the objective of the exercise and intended physical outcomes to inform training and rehabilitation. DESIGN Qualitative study. DATA COLLECTION AND ANALYSIS We conducted a qualitative consensus method of 4 iterative phases. An exploratory panel carried out an extended review of the English-language literature using CINAHL, EMBASE, MEDLINE, and PubMed to identify key themes and subthemes to inform the definitions of exercise categories, physical abilities, and physical outcomes. An expert project group reviewed panel findings. A draft classification was discussed with physiotherapists (n = 49) and international experts. Lead physiotherapy and strength and conditioning teams (n = 17) reviewed a revised classification. Consensus was defined as unanimous agreement. RESULTS After the literature review and subsequent analysis, we defined spinal abilities in 4 categories: mobility, motor control, work capacity, and strength. Exercises were subclassified by functionality as nonfunctional or functional and by spinal displacement as either static (neutral spinal posture with no segmental displacement) or dynamic (dynamic segmental movement). The proposed terminology and classification support commonality of language for practitioners. CONCLUSIONS The spinal-exercise classification will support clinical reasoning through a framework of spinal-exercise objectives that clearly define the nature of the exercise prescription required to deliver intended physical outcomes.
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Affiliation(s)
- Simon Spencer
- The English Institute of Sport, The Manchester Institute of Health and Performance, Manchester, United Kingdom
| | - Alex Wolf
- The English Institute of Sport, The Manchester Institute of Health and Performance, Manchester, United Kingdom.,Department of Surgery and Cancer, Imperial College, London, Charing Cross Hospital, United Kingdom
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Bittencourt NFN, Santos TRT, Gonçalves GGP, Coelho AP, Gomes BGBDM, Mendonça LDM, Fonseca ST. Reference values of hip abductor torque among youth athletes: Influence of age, sex and sports. Phys Ther Sport 2016; 21:1-6. [DOI: 10.1016/j.ptsp.2015.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 12/10/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
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Appiah-Dwomoh EK, Müller S, Hadzic M, Mayer F. Star Excursion Balance Test in Young Athletes with Back Pain. Sports (Basel) 2016; 4:sports4030044. [PMID: 29910292 PMCID: PMC5968879 DOI: 10.3390/sports4030044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 08/09/2016] [Accepted: 08/16/2016] [Indexed: 12/26/2022] Open
Abstract
The Star Excursion Balance Test (SEBT) is effective in measuring dynamic postural control (DPC). This research aimed to determine whether DPC measured by the SEBT in young athletes (YA) with back pain (BP) is different from those without BP (NBP). 53 BP YA and 53 NBP YA matched for age, height, weight, training years, training sessions/week and training minutes/session were studied. Participants performed 4 practice trials after which 3 measurements in the anterior, posteromedial and posterolateral SEBT reach directions were recorded. Normalized reach distance was analyzed using the mean of all 3 measurements. There was no statistical significant difference (p > 0.05) between the reach distance of BP (87.2 ± 5.3, 82.4 ± 8.2, 78.7 ± 8.1) and NBP (87.8 ± 5.6, 82.4 ± 8.0, 80.0 ± 8.8) in the anterior, posteromedial and posterolateral directions respectively. DPC in YA with BP, as assessed by the SEBT, was not different from NBP YA.
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Affiliation(s)
- Edem Korkor Appiah-Dwomoh
- Clinical Exercise Science, Faculty of Health Science, University Outpatient Clinic, Potsdam 14469, Brandenburg, Germany.
| | - Steffen Müller
- Clinical Exercise Science, Faculty of Health Science, University Outpatient Clinic, Potsdam 14469, Brandenburg, Germany.
| | - Miralem Hadzic
- Clinical Exercise Science, Faculty of Health Science, University Outpatient Clinic, Potsdam 14469, Brandenburg, Germany.
| | - Frank Mayer
- Clinical Exercise Science, Faculty of Health Science, University Outpatient Clinic, Potsdam 14469, Brandenburg, Germany.
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Low Back Pain in Athletes Is Associated with General and Sport Specific Risk Factors: A Comprehensive Review of Longitudinal Studies. Rehabil Res Pract 2015; 2015:850184. [PMID: 26783465 PMCID: PMC4691487 DOI: 10.1155/2015/850184] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 11/24/2015] [Indexed: 02/02/2023] Open
Abstract
We aimed to examine systematically the available evidence on risk factors of low back pain (LBP) in athletes. We performed search without language restriction in PubMed, Ovid, Google Scholar, Scopus, and CINAHL. Longitudinal studies that examined possible risk factors of LBP in athletes were included in this systematic review. Based on methodological quality of studies, a best-evidence synthesis was conducted. Seven longitudinal studies were included, four of which had high methodological quality. Results showed that previous LBP, decreased lumbar flexion, and decreased lumbar extension are positively associated with LBP. There was moderate evidence for hip flexor tightness and high body weight as a risk factor. We found insufficient evidence for association between forward bending, previous injury, and amount of training per week, active years, age, and sex with LBP. In conclusion this study would provide a list of risk factors for LBP in athletes, though it showed a strong evidence for only a few including decrease lumbar flexion or extension, previous LBP, and high body weight. This review indicated a high heterogeneity of study characteristics including assessed risk factors and statistical techniques might limit the quality of evidence.
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Naghdi S, Ansari NN, Yazdanpanah M, Feise RJ, Fakhari Z. The validity and reliability of the functional rating index for evaluating low back pain in athletes. Scand J Med Sci Sports 2015; 25:840-5. [PMID: 25809588 DOI: 10.1111/sms.12447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 02/05/2023]
Abstract
The purpose of the present study was to determine the reliability and validity of the Functional Rating Index (FRI) for athletes with low back pain (LBP). In this cross-sectional and prospective cohort study, the validated Persian FRI (PFRI) was tested in 100 athletes with LBP and 50 healthy athletes. From the athletes with LBP, data were recollected among 50 athletes with a 7-day interval to examine test-retest reliability. The content validity was excellent, and the athletes with LBP responded to all items with no floor or ceiling effects. The discriminative validity was supported by a statistically significant difference in PFRI total scores between the athletes with LBP and healthy athletes. The concurrent criterion validity was good (rho = 0.72). The construct, convergent validity was good (r = 0.83). The internal consistency reliability estimate was high (Cronbach's α = 0.90). Factor analysis demonstrated a single-factor structure with an explained variance of 52.22%. The test-retest reliability was excellent, indicated by an ICC(agreement) of 0.97, and the agreement observed in the Bland and Altman plot demonstrated no systematic bias. It is concluded that the PFRI has excellent psychometric properties for assessing athletes with LBP.
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Affiliation(s)
- S Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - N Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - M Yazdanpanah
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - R J Feise
- Institute of Evidence-Based Chiropractic, Scottsdale, Arizona, USA
| | - Z Fakhari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Dizdarevic I, Bishop M, Sgromolo N, Hammoud S, Atanda A. Approach to the pediatric athlete with back pain: more than just the pars. PHYSICIAN SPORTSMED 2015; 43:421-31. [PMID: 26513167 DOI: 10.1080/00913847.2015.1093668] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Back pain in a pediatric patient can present a worrisome and challenging diagnostic dilemma for any physician. Although most back pain can be attributed to muscle strains and poor mechanics, it is necessary to appreciate the full differential of etiologies causing back pain in the pediatric population. The physician must recognize areas of mechanical weakness in the skeletally immature spine and the sport specific forces that can predispose a patient to injury. A comprehensive history involves determining the onset, chronicity, and location of the pain. A focused physical exam includes a neurological exam as well as provocative testing. The combination of a thorough history and focused physical exam should guide appropriate imaging. Radiographic tests are instrumental in narrowing the differential, making a diagnosis, and uncovering associated pathology. Treatment modalities such as activity modification, heat/cold compresses, and NSAIDs can provide pain relief and allow for effective physical therapy. In most cases nonoperative methods are successful in providing a safe and quick return to activities. Failure of conservative measures requires referral to an orthopedic surgeon, as surgical intervention may be warranted.
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Affiliation(s)
| | - Meghan Bishop
- b 2 Thomas Jefferson University , Philadelphia, PA, USA
| | | | - Sommer Hammoud
- d 4 Department of Orthopaedic Surgery, Thomas Jefferson University , Philadelphia, PA, USA
| | - Alfred Atanda
- e 5 Department of Orthopedic Surgery, Nemours/Alfred I. duPont Hospital for Children , Wilmington, DE, USA
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35
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Abstract
CONTEXT Low Back Pain (LBP) in athletes is common and has a broad spectrum of differential diagnoses that must be taken in to account when a clinician approaches the patient with LBP. The physicians should take into account spinal and extra spinal causes of low back pain in athletes. EVIDENCE ACQUISTION A literature review was performed for the years 1951 through 2013. Keywords used were Low Back Pain and Athletes. We searched MEDLINE, EMBASE, OVID, PUBMED, the Cochrane Library, ELSEVIER, and the references of reviewed articles, for English-language of Low Back Pain in Athletes. RESULTS The two most common causes of LBP arising from spine in athletes are degenerative disc disease and spondylolysis with or without listhesis. Although most athletes, respond well to conservative treatment, surgical treatment is indicated when conservative treatment failes. CONCLUSIONS The major concern in athletes with LBP is return to play and previous level of their activity after treatment. There is insufficient evidence regarding this issue in literature to define the optimal time of return to play following treatment.
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Affiliation(s)
- Javad Mortazavi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Jayran Zebardast
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Babak Mirzashahi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
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Triki M, Koubaa A, Masmoudi L, Fellmann N, Tabka Z. Prevalence and risk factors of low back pain among undergraduate students of a sports and physical education institute in Tunisia. Libyan J Med 2015; 10:26802. [PMID: 25758252 PMCID: PMC4355506 DOI: 10.3402/ljm.v10.26802] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/11/2015] [Accepted: 02/14/2015] [Indexed: 11/14/2022] Open
Abstract
Introduction : For obvious reasons, athletes are at greater risk of sustaining a lumber (lower) spine injury due to physical activity. To our knowledge, no previous studies have examined the prevalence of low back pain (LBP) in a Tunisian sports and physical education institute. Aim : To assess the prevalence of LBP in different sports among students studying in a sports and physical education institute in Tunisia, to determine the causes of the injuries, and to propose solutions. Methods : A total of 3,379 boys and 2,579 girls were studied. A retrospective cross-sectional survey was conducted on a group of students aged 18.5-24.5 years at the Higher Institute of Sport and Physical Education of Sfax to estimate the prevalence of LBP and its relation to the type of sports. Data on age, weight, height, smoking, and the sport in which the student was injured in the low back were collected from the institute health service records from 2005 until 2013. Results : LBP was reported by 879 of the 5,958 study participants (14.8%). The prevalence of LBP was significantly higher (p<0.001) in females (17.6%) than in males (12.5%). LBP prevalence did not differ by body mass index or smoking habit (p>0.05). The sports associated with the higher rates of LBP were gymnastics, judo, handball, and volleyball, followed by basketball and athletics. Conclusion : LBP is frequent among undergraduate students of a sports and physical education institute in Tunisia. It is strongly associated with fatigue after the long periods of training in different sports. Gymnastics, judo, handball, and volleyball were identified as high-risk sports for causing LBP.
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Affiliation(s)
- Moez Triki
- Laboratory of Cardio-Circulatory, Respiratory, and Hormonal Adaptations to Muscular Exercise, Faculty of Medicine Ibn El Jazzar, University of Sousse, Sousse, Tunisia;
| | - Abdessalem Koubaa
- Higher Institute of Sports and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Laboratory of Pharmacology, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Liwa Masmoudi
- Higher Institute of Sports and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicole Fellmann
- Laboratoire de Physiologie-biologie du Sport, Faculté de Médecine, Université d'Auvergne, Clermont-Ferrand, France
- Service de Médecine du Sport et des Explorations Fonctionnelles, CHU G, Clermont-Ferrand, France
| | - Zouhair Tabka
- Laboratory of Cardio-Circulatory, Respiratory, and Hormonal Adaptations to Muscular Exercise, Faculty of Medicine Ibn El Jazzar, University of Sousse, Sousse, Tunisia
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Burgmeier RJ, Hsu WK. Spine surgery in athletes with low back pain-considerations for management and treatment. Asian J Sports Med 2014; 5:e24284. [PMID: 25741419 PMCID: PMC4335480 DOI: 10.5812/asjsm.24284] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 04/09/2014] [Indexed: 11/16/2022] Open
Abstract
While degenerative lumbar spine conditions are common in the general population, there are unique considerations when diagnosed in high-level athletes. Genetic factors have been identified as a more significant contributor to the development of degenerative disc disease than occupational risks, however, some have postulated that the incessant training of young, competitive athletes may put them at a greater risk for accelerated disease. The evidence-based literature regarding lumbar disc herniation in elite athletes suggests that it is reasonable to expect excellent clinical outcomes and successful return-to-sport after either operative or non-operative treatment regardless of sport played. However, those athletes who require repetitive torque on their lumbar spines may have poorer long-term outcomes if surgical treatment is required for this condition. Painful spondylolysis in the athlete can often be treated successfully with non-operative treatment, however, if surgery is required, pars repair techniques provides a motion-sparing alternative that may lead to successful return to sport.
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Affiliation(s)
- Robert J. Burgmeier
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, United States
- Corresponding author: Robert J. Burgmeier, Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, United States. Tel: +1-3129264444, E-mail:
| | - Wellington K. Hsu
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, United States
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, United States
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Early intervertebral disc degeneration changes in asymptomatic weightlifters assessed by t1ρ-magnetic resonance imaging. Spine (Phila Pa 1976) 2014; 39:1881-6. [PMID: 25099319 PMCID: PMC5585866 DOI: 10.1097/brs.0000000000000554] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Case-control study. OBJECTIVE To evaluate early intervertebral disc degeneration quantified by T1ρ- and T2-weighted magnetic resonance imaging (MRI) in asymptomatic weightlifters compared with a healthy control group matched for sex and age. SUMMARY OF BACKGROUND DATA Athletes consistently recruit or transfer high levels of repetitive forces through the spine, and MRI has documented a higher rate of intervertebral disc degeneration in athletes compared with matched controls. This study aims to analyze the potential role of T1ρ-MRI in the assessment of early degenerative changes occurring in intervertebral discs of young asymptomatic weightlifters compared with healthy controls. METHODS Twenty-six asymptomatic young male weightlifters versus a sedentary control group matched for age and sex, both having no lower back pain nor any spinal symptoms, underwent MRI (1.5 T). Degenerative grade was assessed using T2-weighted images, according to the Pfirrmann scale. T1ρ mapping and values in the nucleus pulposus (n=130) were obtained. Differences in T1ρ value between among the groups and linear regression analyses with degenerative grade were determined. RESULTS Pfirrmann degenerative grade did not show significant differences among groups. Instead, T1ρ values were significantly lower in the lumbar spine of weightlifters compared with controls (P<0.05). T1ρ values decreased linearly with degenerative grade. CONCLUSION T1ρ values were significantly lower in athletes compared with a sedentary matched control group showing differences in intervertebral disc degeneration onset among individuals with lifestyle and environmental factors leading to back pain. T1ρ can be potentially used as a valid clinical tool to identify early changes in intervertebral disc on the verge of new emerging intervertebral discs regenerative strategies and treatments. LEVEL OF EVIDENCE 4.
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Abstract
Clinicians must have knowledge of the growth and development of the adolescent spine and the subsequent injury patterns and other spinal conditions common in the adolescent athlete. The management and treatment of spinal injuries in adolescent athletes require a coordinated effort between the clinician, patients, parents/guardians, coaches, therapists, and athletic trainers. Treatment should not only help alleviate the current symptoms but also address flexibility and muscle imbalances to prevent future injuries by recognizing and addressing risk factors. Return to sport should be a gradual process once the pain has resolved and the athlete has regained full strength.
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Affiliation(s)
- Arthur Jason De Luigi
- Department of Rehabilitation Medicine, Georgetown University School of Medicine, 3800 Reservoir Road, Washington, DC 20007, USA.
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40
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Abstract
BACKGROUND Spondylolysis is a common cause of low back pain and significant loss of play in the young athlete. Its incidence in hockey players has not been reported. This study reviewed the incidence and potential causative factors of low back pain and spondylolysis in an elite junior-level ice hockey program over a 15-year period. HYPOTHESIS Because of the repetitive movements of the lower spine required by the sport, spondylolysis was expected to be a frequent cause of low back pain in hockey players. STUDY DESIGN Retrospective case review. LEVEL OF EVIDENCE Level 4. METHODS The medical and athletic trainer records of male ice hockey players, ages 15 to 18 years, who presented with the complaint of low back pain were reviewed. This elite program consisted of 2 rosters. There were approximately 44 players total per year representing these 2 teams. For players diagnosed with spondylolysis, the following factors were reviewed: year in the program, age at presentation, symptoms and duration, studies performed, level of spondylolysis, presence of spondylolisthesis, affected side to shooting side, player position, treatment, and current level of play. RESULTS Over 9 hockey seasons, 25 players presented to medical staff with low back pain. Of those, 44% were confirmed to have lumbar spondylolysis. The majority of these cases presented in the first year of the program without clear history of trauma but rather vague pain with weight lifting or hockey. Less than half of spondylolysis cases were diagnosed on plain films. There were no cases of spondylolisthesis. Spondylolysis occurred on the shooting side in 73% of players. Sixty-four percent of players with spondylolysis were forwards. The treatment for most included rest from lifting and hockey and physical therapy. Average return to play was 8 weeks. Ninety-six percent of players continued to play at an elite level. CONCLUSION Spondylolysis should be strongly considered in the differential of low back pain in ice hockey players with consideration for advanced imaging. Considerable loss of play occurs with spondylolysis, but with proper treatment, excellent outcomes occur. CLINICAL RELEVANCE This study brings to light the prevalence of spondylolysis in ice hockey players. With an increased index of suspicion, the condition can be diagnosed and properly treated to allow full return to play.
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Affiliation(s)
- Laurie D Donaldson
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
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41
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Koehler SM, Rosario-Quinones F, Mayer J, McAnany S, Schiller AL, Qureshi S, Hecht AC. Understanding acute apophyseal spinous process avulsion injuries. Orthopedics 2014; 37:e317-21. [PMID: 24762163 DOI: 10.3928/01477447-20140225-68] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 09/26/2013] [Indexed: 02/03/2023]
Abstract
Apophyseal spinous process avulsion injury was first described in 1941. Since then, there have been sparse additional reports in the literature. The authors report their second case, involving an elite adolescent tennis player. The patient underwent surgical excision of the avulsed spinous process 12 weeks after initial presentation and experienced complete resolution of back pain. The authors provide the first reported histopathological analysis of the avulsion fracture site in the literature for both of their cases. The avulsion injury of the interspinous ligament was characterized by hypercellular fibrocartilage tissue, similar to that seen in severe Osgood-Schlatter's disease. The key physical examination finding in patients with avulsion spinous process fractures is acute tenderness directly over the fracture site that worsens with flexion rather than extension (unlike in spondylolysis). Patients should have routine radiographs, including dynamic flexion-extension views, magnetic resonance imaging, and computed tomography. The authors conclude that after 6 months of nonsurgical management for an athlete, surgical excision should be offered as an alternative. In both of their cases, nonsurgical management failed. Surgical excision offers definitive and simple treatment, as well as early return to athletic activities. Both patients were allowed to return to their competitive level of performance 6 weeks after surgery.
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Abstract
Back pain in the pediatric population is a common complaint presenting to sports medicine clinics. There is a wide differential that should be considered, including mechanical, infectious, neoplastic, inflammatory, and amplified musculoskeletal pain. The history, pain quality, and examination are key components to help distinguish the etiologies of the pain and direct further evaluation. Laboratory investigations, including blood counts and inflammatory markers, can provide insight into the diagnosis. The HLA-B27 antigen can be helpful if a spondyloarthropathy is suspected. Imaging as clinically indicated typically begins with radiographs, and the use of MRI, CT, or bone scan can provide additional information. Proper diagnosis of back pain is important because prognosis and treatments are significantly different. We review the pertinent evaluation, differential diagnoses, and treatment of low back pain in the pediatric population.
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Affiliation(s)
- Alysha J. Taxter
- Division of Rheumatology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Nancy A. Chauvin
- Division of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Pamela F. Weiss
- Division of Rheumatology, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Center for Pediatric Clinical Effectiveness, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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43
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Abstract
Primary musculoskeletal etiologies, such as stress fractures, strains, facet arthropathy, and sacroiliac joint dysfunction, are more common causes of pediatric pain than systemic diseases, both in the office setting and the emergency room. Systemic features, young age, and atypical pain should clue physicians to causes other than a primary musculoskeletal cause and prompt an intensive search for other conditions.
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44
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Jagadish A, Nandyala SV, Marquez-Lara A, Singh K, Lee YP. Spinal Interventions—The Role in the Athlete. OPER TECHN SPORT MED 2013. [DOI: 10.1053/j.otsm.2013.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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45
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Weifen W, Muheremu A, Chaohui C, MD LW, Lei S. Effectiveness of Tai Chi Practice for Non-Specific Chronic Low Back Pain on Retired Athletes: A Randomized Controlled Study. ACTA ACUST UNITED AC 2013. [DOI: 10.3109/10582452.2013.763394] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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46
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Kobayashi A, Kobayashi T, Kato K, Higuchi H, Takagishi K. Diagnosis of radiographically occult lumbar spondylolysis in young athletes by magnetic resonance imaging. Am J Sports Med 2013; 41:169-76. [PMID: 23136176 DOI: 10.1177/0363546512464946] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The early stages of spondylolysis are extremely difficult to diagnose on plain radiography. Although several studies have examined changes in active spondylolysis on magnetic resonance imaging (MRI), no studies to date have determined the onset frequency of active spondylolysis detectable on MRI but occult on plain radiography. Moreover, the clinical features of active spondylolysis described in the literature do not facilitate the differentiation of this condition from other causes of low back pain. PURPOSE This study aimed to evaluate the usefulness of MRI in diagnosing active spondylolysis early and in determining the prevalence of active spondylolysis in cases where findings were not detected on plain radiography. In addition, specific clinical features to aid in the early detection of active spondylolysis were evaluated. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Patients were 200 consecutive young athletes (144 boys and 56 girls; mean age, 14.1 ± 1.5 y) with low back pain. All patients were examined by plain radiography (188 with negative findings and 12 with unclear findings of spondylolysis) and MRI. Computed tomography (CT) was performed only for patients with high intensity changes of the pedicle observed on MRI. The presence or absence of low back pain was examined during lumbar spine extension and flexion. The Kemp test on the right and left sides and percussion of the vertebral spinous process were also performed. RESULTS Ninety-seven (48.5%) patients showed evidence of active spondylolysis on MRI, findings that had been missed by plain radiography. These pars defects were organized into the following categories based on CT findings: nonlysis stage, 52; very early stage, 37; late early stage, 22; progressive stage, 10; and terminal stage, 0. No significant physical examination factors were identified that could assist in the early detection of active spondylolysis. CONCLUSION The MRI results suggest a high rate of active spondylolysis in young athletes with low back pain who test negative for spondylolysis on plain radiography. Magnetic resonance imaging appears to be useful in the early diagnosis of active spondylolysis, especially as we found no significant physical examination factors that could assist in early detection.
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47
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Abstract
Context Low back pain in young athletes is a common complaint and should be taken seriously. It frequently results from a structural injury that requires a high degree of suspicion to diagnose and treat appropriately. Evidence Acquisition A Medline search was conducted from 1996 to May 2008 using the search terms “low back pain in children” and “low back pain in athletes.” Known texts on injuries in young athletes were also reviewed. References in retrieved articles were additionally searched for relevant articles. Sources were included if they contained information regarding diagnosis and treatment of causes of low back pain in children. Results Low back pain is associated with sports involving repetitive extension, flexion, and rotation, such as gymnastics, dance, and soccer. Both acute and overuse injuries occur, although overuse injuries are more common. Young athletes who present with low back pain have a high incidence of structural injuries such as spondylolysis and other injuries to the posterior elements of the spine. Disc-related pathology is much less common. Simple muscle strains are much less likely in this population and should be a diagnosis of exclusion only. Conclusion Young athletes who present with low back pain are more likely to have structural injuries and therefore should be investigated fully. Muscle strain should be a diagnosis of exclusion. Treatment should address flexibility and muscle imbalances. Injuries can be prevented by recognizing and addressing risk factors. Return to sport should be a gradual process once the pain has resolved and the athlete has regained full strength.
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Affiliation(s)
- Laura Purcell
- London Health Sciences Centre, London, Ontario, Canada
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48
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Puentedura EJ, Louw A. A neuroscience approach to managing athletes with low back pain. Phys Ther Sport 2012; 13:123-33. [DOI: 10.1016/j.ptsp.2011.12.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 12/01/2011] [Accepted: 12/01/2011] [Indexed: 01/27/2023]
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49
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Sport-Specific Biomechanics of Spinal Injuries in Aesthetic Athletes (Dancers, Gymnasts, and Figure Skaters). Clin Sports Med 2012; 31:397-408. [DOI: 10.1016/j.csm.2012.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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50
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Abstract
Clinicians taking care of athletes are likely to see many young patients complaining of back pain. The young athlete places significant repetitive stresses across the growing thoracolumbar spine, which can cause acute and overuse injuries that are unique to this age and patient population. Fortunately, by using a careful and systematic approach, with a sport-specific history, careful physical exam, and proper imaging, most problems can be properly identified. Although it is important to always remember that rare and more serious problems such as a neoplasm or infection maybe a source of pain in the athletic patient, most problems are benign and can be treated conservatively. Accurate diagnosis and management of back pain not only can prevent long-term deformity and disability, but it can also allow young athletes to return to doing what they love to do most: play sports.
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Affiliation(s)
- Brian M Haus
- Division of Sports Medicine, Department of Orthopaedic Surgery, Children's Hospital Boston, Boston, MA 02115, USA
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