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

Zemková Erikaa,b, Amiri Banafsheha, Horníková Henrietac, Zapletalová Ludmilab

Sports Medicine and Health Science ›› 2024, Vol. 6 ›› Issue (2) : 123-138. DOI: 10.1016/j.smhs.2023.12.006

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

  • Zemková Erikaa,b, Amiri Banafsheha, Horníková Henrietac, Zapletalová Ludmilab
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Abstract

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. 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. Keywords Athletic training; Back pain; Biomechanical measures;Physiological loading; Spine injury

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Zemková Erika, Amiri Banafsheh, Horníková Henrieta, Zapletalová Ludmila. Potential neurophysiological and biomechanical risk factors for sport-related back problems: A scoping review. Sports Medicine and Health Science, 2024, 6(2): 123‒138 https://doi.org/10.1016/j.smhs.2023.12.006

References

1
J.W.S. Vlaeyen, C.G. Maher, K. Wiech, et al.. Low back pain. Nat Rev Dis Prim. Low back pain. Nat Rev Dis Prim, 4 (1) (2018), p. 52, 10.1038/s41572-018-0052-1.
2
S. Chen, M. Chen, X. Wu,et al.. Global, regional and national burden of low back pain 1990-2019: a systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat, 32 (2021), pp. 49-58, 10.1016/j.jot.2021.07.005.
3
C. Maher, M. Underwood, R. Buchbinder. Non-specific low back pain. Lancet, 389 (10070) (2017), pp. 736-747, 10.1016/S0140-6736(16)30970-9.
4
A. Wu, L. March, X. Zheng,et al.. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med, 8 (6)(2020), p. 299, 10.21037/atm.2020.02.175.
5
D.M. Roffey, E.K. Wai, P. Bishop, B.K. Kwon, S. Dagenais.Causal assessment of workplace manual handling or assisting patients and low back pain: results of a systematic review. Spine J, 10 (7)(2010), pp. 639-651, 10.1016/j.spinee.2010.04.028.
6
B.P. Graw, S.W. Wiesel.Low back pain in the aging athlete. Sports Med Arthrosc Rev, 16 (1)(2008), pp. 39-46, 10.1053/j.semss.2010.06.009.
7
R. Shiri, K. Falah-Hassani. Does leisure time physical activity protect against low back pain? Systematic review and meta-analysis of 36 prospective cohort studies. Br J Sports Med, 51 (19) (2017), pp. 1410-1418, 10.1136/bjsports-2016-097352.
8
H. Heneweer, L. Vanhees, H.S.J.Picavet. Physical activity and low back pain: a U-shaped relation?. Pain, 143 (2009), pp. 21-25, 10.1016/j.pain.2008.12.033.
9
F. Wilson, C.L. Ardern, J. Hartvigsen, et al.. Prevalence. Prevalence and risk factors for back pain in sports: a systematic review with meta-analysis. Br J Sports Med, 55 (11) (2020), pp. 601-607, 10.1136/bjsports-2020-102537.
10.
G.C. Machado, C.G. Maher, P.H. Ferreira, et al.. Can reccurrence after. Can reccurrence after and acute episode of lower back pain be predicted?. Phys Ther, 97 (9) (2017), pp. 889-895, 10.1093/ptj/pzx067.
11.
D. Fett, K. Trompeter, P. Platen. Back pain in elite sports: a cross-sectional study on 1 114 athletes. PLoS One, 12 (6) (2017), Article e0180130, 10.1371/journal.pone.0180130.
12.
J. Mortazavi, J. Zebardast, B. Mirzashahi. Low back pain in athletes. Asian J Sports Med, 6 (2) (2015), Article 24718, 10.5812/asjsm.6(2)2015.24718.
13.
C. Newlands, D. Reid, P. Parmar. The prevalence, incidence and severity of low back pain among international-level rowers. Br J Sports Med, 49 (14) (2015), pp. 951-956, 10.1136/bjsports-2014-093889.
14.
N. Malliaropoulos, D. Mertyri, P. Tsaklis. Prevalence of injury in ultra trail running. Hum Mov, 16 (2) (2015), pp. 52-59, 10.1515/humo-2015-0026.
15.
F. Maselli, L. Storari, V. Barbari, et al. Prevalence and incidence of low back pain among runners: a systematic review. BMC Muscoskel Disord, 21 (1) (2020), p. 343, 10.1186/s12891-020-03357-4.
16.
J. Van Hilst, N.F. Hilgersom, M.C. Kuilman, P.P.F.M. Kuijer, M.H.W. Frings-Dresen. Low back pain in young elite field hockey players, football players and speed skaters: prevalence and risk factors. J Back Musculoskelet, 28 (1) (2015), pp. 67-73, 10.3233/BMR-140491.
17.
M.R. Golbakhsh, M.A. Hamidi, B. Hassanmirzaei. Pelvic incidence and lumbar spine instability correlations in patients with chronic low back pain. Asian J Sports Med, 3 (4) (2012), pp. 291-296, 10.5812/asjsm.34554.
18.
P. O'Sullivan, L. Twomey, G. Allison. Dysfunction of the neuro-muscular system in thepresence of low back pain - implications for physical therapy management. J Man Manip Ther, 5 (1) (1997), pp. 20-26, 10.1179/jmt.1997.5.1.20.
19.
M.M. Panjabi. Clinical spinal instability and low back pain. J Electromyogr Kinesiol, 13 (4) (2003), pp. 371-379, 10.1016/S1050-6411(03)00044-0.
20.
J. Cholewicki, S.P. Silfies, R.A. Shah, et al. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine, 30 (23) (2005), pp. 2614-2620, 10.1097/01.brs.0000188273.27463.bc.
21.
J.P. Correia, R. Oliveira, J.R. Vaz, L. Silva, P. Pezarat-Correia.Trunk muscle activation, fatigue and low back pain in tennis players. J Sci Med Sport, 19 (4)(2016), pp. 311-316, 10.1016/j.jsams.2015.04.002.
22.
M. Rostami, M. Ansari, P. Noormohammadpour, M.A. Mansournia, R. Kordi. Ultrasound assessment of trunk muscles and back flexibility, strength and endurance in off-road cyclists with and without low back pain. J Back Musculoskelet Rehabil, 28 (4) (2015), pp. 635-644, 10.3233/BMR-140559.
23.
N. Roussel, M. De Kooning, A. Schutt, et al. Motor control and low back pain in dancers. Int J Sports Med, 34 (2) (2013), pp. 138-143, 10.1055/s-0032-1321722.
24.
G.P.L.Almeida, V.L. de Souza, S.S. Sano, M.F. Saccol, M. Cohen. Comparison of hip rotation range of motion in judo athletes with and without history of low back pain. Man Ther, 17 (3)(2012), pp. 231-235, 10.1016/j.math.2012.01.004.
25.
K.J. Stuber, P. Bruno, S. Sajko, J.A. Hayden. Core stability exercises for low back pain in athletes: a systematic review of the literature. Clin J Sport Med, 24 (6) (2014), pp. 448-456, 10.1097/JSM.0000000000000081.
26.
M.E. Raabe, A.M.W.Chaudhari. Biomechanical consequences of running with deep core muscle weakness. J Biomech, 67 (2017), pp. 98-105, 10.1016/j.jbiomech.2017.11.037.
27.
V. Moradi, A.H. Memari, M. ShayestehFar, R. Kordi. 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), Article 850184, 10.1155/2015/850184.
28.
M. Hangai, K. Kaneoka, Y. Okubo, et al. Relationship between low back pain and competitive sports activities during youth. Am J Sports Med, 38 (4) (2010), pp. 791-796, 10.1177/0363546509350297.
29.
F. Dal Farra, F. Arippa, G. Carta, M. Segreto, E. Porcu, M. Monticone. Sport and non-specific low back pain in athletes: a scoping review. BMC Sports Sci Med Rehabil, 14 (2022), p. 216, 10.21203/rs.3.rs-2085257/v1.
30.
J.A. Smith, A. Hawkins, M. Grant-Beuttler, R. Beuttler, S.P. Lee. Risk factors associated with low back pain in golfers: a systematic review and meta-analysis. Sport Health, 10 (6) (2018), pp. 538-546, 10.1177/1941738118795425.
31.
C.T.V.Swain, E.J. Bradshaw, C.L. Ekegren, D.G. Whyte. The epidemiology of low back pain and injury in dance: a systematic review. J Orthop Sports Phys Ther, 49 (4)(2019), pp. 239-252. https://doi.org/10.2519/jospt.2019.8609.
32.
C.Y. Cho, Y.S. Hwang, R.J. Cherng.Musculoskeletal symptoms and aasociated risk factors among office workers with high workload computer use. J Manip Physiol Ther, 35 (7)(2012), pp. 534-540, 10.1016/j.jmpt.2012.07.004.
33.
E. Zemková, Z. Kováčiková, L. Zapletalová.Is there a relationship between workload and occurrence of back pain and back injuries in athletes?. Front Physiol, 11 (2020), p. 894, 10.3389/fphys.2020.00894.
34.
H. Arksey, L. O´Malley. Scoping studies: towards a methodological framework. Int J Soc Res Methodol, 8 (2005), pp. 19-32, 10.1080/1364557032000119616.
35.
D. Levac, H. Colquhoun, K.K. O'Brien. Scoping studies: advancing the methodology. Implement Sci, 5 (2010), p. 69, 10.1186/1748-5908-5-69.
36.
M.J. Downes, M.L. Brennan, H.C. Williams, R.S. Dean. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open, 6 (12) (2016), Article e011458, 10.1136/bmjopen-2016-011458.
37.
N.A. Smart, M. Waldron, H. Ismail, et al. Validation of a new tool for the assessment of study quality and reporting in exercise training studies: TESTEX. Int J Evid Base Healthc, 13 (1) (2015), pp. 9-18, 10.1097/XEB.0000000000000020.
38.
R. Balius, C. Pedret, L. Pacheco, J.A. Gutierrez, J. Vives, J. Escoda. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation. Open Access J Sports Med, 2 (2011), pp. 69-73, 10.2147/OAJSM.S17504.
39.
A. Cejudo, J.M. Centenera-Centenera, F. Santonja-Medina. The potential role of hamstring extensibility on sagittal pelvic tilt, sagittal spinal curves and recurrent low back pain in team sports players: a gender perspective analysis. Int J Environ Res Publ Health, 18 (16) (2021), p. 8654, 10.3390/ijerph18168654.
40.
4. A. Cejudo, A. Ginés-Díaz, O. Rodríguez-Ferrán, F. Santonja-Medina, P. Sainz de Baranda. Trunk lateral flexor endurance and body fat: predictive risk factors for low back pain in child equestrian athletes. Children, 7 (10) (2020), p. 172, 10.3390/children7100172.
41.
4. H. Crewe, B. Elliott, G. Couanis, A. Campbell, J. Alderson. The lumbar spine of the young cricket fast bowler: an MRI study. J Sci Med Sport, 15 (3)(2012), pp. 190-194, 10.1016/j.jsams.2011.11.251.
42.
4. M. Fortin, A. Rizk, S. Frenette, M. Boily, H. Rivaz. Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain. Phys Ther Sport, 37 (2019), pp. 77-85, 10.1016/j.ptsp.2019.03.004.
43.
4. J.A. Hides, W.R. Stanton, M. Freke, S. Wilson, S. McMahon, C. Richardson. MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain. Br J Sports Med, 42 (10)(2008), pp. 809-813, 10.1136/bjsm.2007.044024.
44.
4. K. Koyama, K. Nakazato, S. Min, et al. Radiological abnormalities and low back pain in gymnasts. Int J Sports Med, 34 (3) (2013), pp. 218-222, 10.1055/s-0032-1316366.
45.
4. S. Mueller, J. Stoll, J. Mueller, M. Cassel, F. Mayer. Trunk muscle activity during drop jump performance in adolescents athletes with back pain. Front Physiol, 8 (2017), p. 274, 10.3389/fphys.2017.00274.
46.
4. P. Noormohammadpour, S. Mirzaei, N. Moghadam, M.A. Mansournia, R. Kordi. Comparison of lateral abdominal muscle thickness in young male soccer players with and without low back pain. Int J Sports Phys Ther, 14 (2) (2019), pp. 273-281. View at publisher .
47.
47 C. Ranson, A. Burnett, R. Kerslake. Injuries to the lower back in elite fast bowlers: acute stress changes on MRI predict stress fracture. J Bone Joint Surg Br, 92 (12) (2010), pp. 1664-1668, 10.1302/0301-620X.92B12.24913.
48.
S. Shenoy, H. Balachander, J. Sandhu. Long latency reflex response of superficial trunk musculature in athletes with chronic low back pain. J Back Musculoskelet Rehabil, 26 (4) (2013), pp. 445-450, 10.3233/BMR-130404.
49.
G.B. Wilkerson, J.L. Giles, D.K. Seibel. Prediction of core and lower extremity strains and sprains in collegiate football players: a preliminary study. J Athl Train, 47 (3) (2012), pp. 264-272, 10.4085/1062-6050-47.3.17.
50.
M.H. Cole, P. Grimshaw.Trunk muscle onset and cessation in golfers with and without low back pain. J Biomech, 41 (13)(2008), pp. 2829-2833, 10.1016/j.jbiomech.2008.07.004.
51.
I. Tak, M. Weerink, M. Barendrecht.Judokas with low back pain have lower flexibility of the hip-spine complex: a case-control study. Phys Ther Sport, 45 (2020), pp. 30-37, 10.1016/j.ptsp.2020.06.003.
52.
R. Balius, C. Pedret, P. Galilea, F. Idoate, A. Ruiz-Cotorro. Ultrasound assessment of asymmetric hypertrophy of the rectus abdominis muscle and prevalence of associated injury in professional tennis players. Skeletal Radiol, 41 (12) (2012), pp. 1575-1581, 10.1007/s00256-012-1429-y.
53.
M.H. Cole, P. Grimshaw.Electromyography of the trunk and abdominal muscles in golfers with and without low back pain. J Sci Med Sport, 11 (2)(2008), pp. 174-181, 10.1016/j.jsams.2007.02.006.
54.
J.A. Hides, W.R. Stanton, S. Wilson, M. Freke, S. McMahon, K. Sims. Retraining motor control of abdominal muscles among elite cricketers with low back pain. Scand J Med Sci Sports, 20 (6) (2010), pp. 834-842, 10.1111/j.1600-0838.2009.01019.x.
55.
K. Iwai, K. Koyama, T. Okada, et al. Asymmetrical and smaller size of trunk muscles in combat sports athletes with lumbar intervertebral disc degeneration. SpringerPlus, 5 (1) (2016), pp. 1-8, 10.1186/s40064-016-3155-8.
56.
J. Iwamoto, H. Abe, Y. Tsukimura, K. Wakano. Relationship between radiographic abnormalities of lumbar spine and incidence of low back pain in high school and college football players: a prospective study. Am J Sports Med, 32 (3) (2004), pp. 781-786, 10.1177/0363546503261.
57.
J.W. Myrer, A.W. Johnson, C. Neves, J. Bridges, T. Neves, D. Eggett. Multifidus size in female collegiate volleyball players from preseason to postseason and with back pain. Med Sci Sports Exerc, 46 (2014), p. 803, 10.1249/01.mss.0000495909.06028.d5.
58.
D.M. Lindsay, J.F. Horton. Trunk rotation strength and endurance in healthy normals and elite male golfers with and without low back pain. N Am J Sports Phys Ther, 1 (2) (2006), pp. 80-89.
59.
W. Van Hoof, K. Volkaerts,K. O'Sullivan, S. Verschueren, W. Dankaerts. Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls-field study using a wireless posture monitoring system. Man Ther, 17 (4)(2012), pp. 312-317, 10.1016/j.math.2012.02.012.
60.
R.L. Chimenti, S.A. Scholtes, L.R. Van Dillen. Activity characteristics and movement patterns in people with and people without low back pain who participate in rotation-related sports. J Sport Rehabil, 22 (2013), pp. 161-169, 10.1123/jsr.22.3.161.
61.
M.H. Cole, P.N. Grimshaw.The crunch factor's role in golf-related low back pain. Spine J, 14 (5)(2014), pp. 799-807, 10.1016/j.spinee.2013.09.019.
62.
M. Rozan, V. Rouhollahi, A. Rastogi, D.K. Dureha. Influence of physiological loading on the lumbar spine of national level athletes in different sports. J Hum Kinet, 50 (2016), pp. 115-123, 10.1515/hukin-2015-0148.
63.
B. Senington, R.Y. Lee, J.M. Williams. Biomechanical risk factors of lower back pain in cricket fast bowlers using inertial measurement units: a prospective and retrospective investigation. BMJ Open Sport Exerc Med, 6 (1) (2020), Article e000818, 10.1136/bmjsem-2020-000818.
64.
S. Mueller, J. Mueller, J. Stoll, M. Cassel, A. Hirschmüller, F. Mayer. Back pain in adolescent athletes: results of a biomechanical screening. Sports Med Int Open, 1 (1) (2017), pp. E16-E22, 10.1055/s-0042-122713.
65.
L. Ng, A. Campbell, A. Burnett, A. Smith, P. O'Sullivan. Spinal kinematics of adolescent male rowers with back pain in comparison with matched controls during ergometer rowing. J Appl Biomech, 31 (6) (2015), pp. 459-468, 10.1123/jab.2015-0012.
66.
T. Narita, K. Kaneoka, M. Takemura, Y. Sakata, T. Nomura, S. Miyakawa. Critical factors for the prevention of low back pain in elite junior divers. Br J Sports Med, 48 (11) (2014), pp. 919-923, 10.1136/bjsports-2012-091875.
67.
A. Campbell, L. Straker, P. O'Sullivan, B. Elliott, M. Reid. Lumbar loading in the elite adolescent tennis serve: link to low back pain. Med Sci Sports Exerc, 45 (8) (2013), pp. 1562-1568, 10.1249/mss.0b013e31828bea5e.
68.
A. Campbell, P. O'Sullivan, L. Straker, B. Elliott, M. Reid. Back pain in tennis players: a link with lumbar serve kinematics and range of motion. Med Sci Sports Exerc, 46 (2) (2014), pp. 351-357, 10.1249/mss.0b013e3182a45cca.
69.
M. Tojima, S. Torii.Difference in kick motion of adolescent soccer players in presence and absence of low back pain. Gait Posture, 59 (2018), pp. 89-92, 10.1016/j.gaitpost.2017.10.012.
70.
T. Goto, T. Sakai, K. Sugiura, et al. Dash-associated spondylolysis hypothesis. Spine Surg Relat Res, 3 (2) (2018), pp. 146-150, 10.22603/ssrr.2018-0020.
71.
M. Marsden, M. Schwellnus. Lower back pain in cyclists: a review of epidemiology, pathomechanics and risk factors. Int Sportmed J (ISMJ), 11 (1) (2010), pp. 216-225.
72.
P.M. Parizel, J.L. Gielen, F.M. Vanhoenacker. The spine in sports injuries: cervical spine. F.M. Vanhoenacker, M. Maas, J.L. Gielen (Eds.), Imaging of Orthopedic Sports Injuries, Springer (2007), pp. 377-389. View at publisher .
73.
M.H. Cole, P.N. Grimshaw. The biomechanics of the modern golf swing: implications for lower back injuries. Sports Med, 46 (3) (2016), pp. 339-351, 10.1007/s40279-015-0429-1.
74.
N. Edwards, C. Dickin, H. Wang.Low back pain and golf: a review of biomechanical risk factors. Sports Med Health Sci, 2 (1)(2020), pp. 10-18, 10.1016/j.smhs.2020.03.002.
75.
G.S. Gluck, J.A. Bendo, J.M. Spivak.The lumbar spine and low back pain in golf: a literature review of swing biomechanics and injury prevention. Spine J, 8 (5)(2008), pp. 778-788, 10.1016/j.spinee.2007.07.388.
76.
G.M. Streisfeld, C. Bartoszek, E. Creran, B. Inge, M.D. McShane, T. Johnston. Relationship between body positioning, muscle activity,spinal kinematics in cyclists with and without low back pain: a systematic review. Sport Health, 9 (1) (2017), pp. 75-79, 10.1177/1941738116676260.
77.
D.A. Reid, P.J. McNair. Factors contributing to low back pain in rowers. Br J Sports Med, 34 (2000), pp. 321-325, 10.1177/1941738116676260.
78.
S. Arumugam, P. Ayyadurai, S. Perumal, G. Janani, S. Dhillon, K.A. Thiagarajan. Rowing injuries in elite athletes: a review of incidence with risk factors and the role of biomechanics in its management. Indian J Orthop, 54 (3) (2020), pp. 246-255, 10.1007/s43465-020-00044-3

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