Potential neurophysiological and biomechanical risk factors for sport-related back problems: A scoping review

This scoping review aims (1) to map the literature dealing with neurophysiological and biomechanical aspects of back problems in athletes in order to identify valid risk-factors for their prevention, plus (2) to identify gaps in the existing research and propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar. The main neurophysiological risk factors identified leading to back problems in athletes are neuromuscular imbalance, increased muscle fatigability, muscle dysfunction and impaired motor control, whilst biomechanical risk factors include maladaptive spinal, spinopelvic and lower limb kinematics, side-to-side imbalances in axial strength and hip rotation range of motion, spinal overloading and deficits in movement pattern. However, most studies focused on back pain in the lumbar region, whereas less attention has been paid to thoracic and cervical spine problems. The range of sports where this topic has been studied is relatively small. There is a lack of research in sports in which the core muscles are highly involved in specific movements such as lifting weights or trunk rotations. A limited number of studies include female athletes and master athletes of both genders. In addition to chronic back pain patients, it is equally important to conduct research on healthy athletes with a predisposition to spine problems. Investigators should focus their empirical work on identifying modifiable risk factors, predict which athletes are at risk for back problems, and develop personalized sport-specific assessment tools and targeted prevention strategies for them. This review was registered using the Open Science Framework Registries (https://osf.io/ha5n7).

The importance of core strength for change of direction speed

Change of direction speed (CODS) is determined by several physical aspects, such as linear sprint speed, reactive strength and power of leg muscles. It appears that core strength may also play a role in CODS, however, its relationship to CODS remains unclear. The aim of this narrative review was to analyze the literature addressing a) the relationship between core strength and CODS and b) the effect of core strength training on CODS. This analysis revealed a significant relationship between the parameters of core strength and stability (the pressure of the activated core muscles during lower limb movement and the greatest mean force output of maximum volunteered contraction) and the time in the Agility T-Test. However, this parameter was not significantly related to the strength endurance of core muscles (total time in the plank test). Core training provides a sufficient stimulus for the development of CODS in less-skilled middle-adolescent athletes, while its effectiveness decreases in higher-skilled adult athletes. These findings indicate that core muscle strength contributes significantly to the change of direction speed. Core training is therefore useful for improving CODS.