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Low back pain in young female gymnasts and the effect of specific segmental muscle control exercises of the lumbar spine: a prospective controlled intervention study

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Prospective controlled intervention study. To evaluate a specific segmental muscle training program of the lumbar spine in order to prevent and reduce low back pain in young female teamgym gymnasts. Teamgym is a team sport comprising three events: trampette, tumbling and floor programme. In a recent study, it was found that teamgym gymnasts practice and compete despite suffering from back pain. Specific muscle control exercises of the lumbar spine have shown good results in reducing pain intensity and functional disability levels in patients with low back pain. To our knowledge, this type of training has not been studied in an adolescent athletic population before. Fifty-one gymnasts, with and without LBP, 11–16 years old, from three top-level gymnastics team participated in the study comprising 12 weeks. Every day the gymnasts answered a questionnaire regarding low back pain. After baseline (4 weeks) the intervention group performed a specific segmental muscle training program. Twenty-four gymnasts (47%) reported low back pain during baseline. Nine gymnasts failed to answer the questionnaire every day and the following results are based on 42 gymnasts (intervention group, n = 30, and control group, n = 12). Gymnasts in the intervention group reported significantly less number of days with low back pain at completion compared to baseline (P = 0.02). Gymnasts in the control group showed no difference in terms of days with low back pain or intensity of low back pain between baseline and completion. Eight gymnasts (out of 15) with LBP in the intervention group became pain free. Specific segmental muscle control exercises of the lumbar spine may be of value in preventing and reducing low back pain in young teamgym gymnasts.

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References

  1. Andersson EA, Oddsson LIE, Grundström H, Nilsson J, Thorstensson A (1996) EMG activities of the quadratus lumborum and erector spinae muscles during flexion-relaxation and other motor tasks. Clin Biomech 11:392–400

    Article  Google Scholar 

  2. Arakoski JPA, Kankaanpää M, Valta T et al (1999) Back and hip extensor muscle function during therapeutic exercises. Arch Phys Med Rehabil 80:842–850

    Article  Google Scholar 

  3. Bak K, Kalms SB, Olesen S, Jørgensen U (1994) Epidemiology of injuries in gymnastics. Scand J Med Sci Sports 4:148–154

    Article  Google Scholar 

  4. Baranto A, Ekström L, Hellström M, Lundin O, Holm S, Swärd L (2004) Fracture patterns of adolescent porcine spine: an experimental loading study in bending-compression. Spine 30:75–82

    Google Scholar 

  5. Barr KP, Griggs M, Cadby T (2005) Lumbar stabilization: core concepts and current literature, part 1. Am J Phys Med Rehabil 84:473–480

    Article  PubMed  Google Scholar 

  6. Biering Sörensen F (1983) A prospective study of low back pain in a general population. I. Occurrence, recurrence and aetiology. Scand J Rehabil Med 15:71–79

    PubMed  Google Scholar 

  7. Bono CM (2004) Low-back pain in athletes. Current concepts review. J Bone Joint Surg 86A:382–396

    Google Scholar 

  8. Borg G, Holmgren A, Lindblad I (1981) Quantitative evaluation of chest pain. Acta Med Scand Suppl 644:43–45

    PubMed  CAS  Google Scholar 

  9. Borg G (1998) Borg’s perceived exertion and pain scales. Champaign, III: Human kinetics

  10. Burton AK, Clarke RD, McClune TD, Tillotson KM (1996) The natural history of low back pain in adolescents. Spine 21:2323–2328

    Article  PubMed  CAS  Google Scholar 

  11. Caine D, Cochrane B, Caine C (1989) An epidemiologic investigation of injuries affecting young competitive female gymnasts. Am J Sports Med 17:811–820

    Article  PubMed  CAS  Google Scholar 

  12. Cresswell AG, Grundström H, Thorstensson A (1992) Observations on intra-abdominal pressure and patterns of abdominal intra-muscular activity in man. Acta Physiol Scand 144:409–418

    PubMed  CAS  Google Scholar 

  13. Danneels LA, Vanderstraeten GG, Cambier DC et al (2001) Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. Br J Sports Med 35:186–191

    Article  PubMed  CAS  Google Scholar 

  14. Deyo RA (2002) Diagnostic evaluation of LBP. Reaching a specific diagnosis is often impossible. Arch Intern Med 162:1444–1447

    Article  PubMed  Google Scholar 

  15. Hagins M, Adler K, Cash M, Daugherty J, Mitrani G. (1999) Effects of practice on the ability to perform lumbar stabilization exercises. J Orthop Sports Phys Ther 29:546–555

    PubMed  CAS  Google Scholar 

  16. Harms-Ringdahl K, Carlsson AM, Ekholm J et al (1986) Pain assessment with different intensity scales in response to loading of joint structures. Pain 27:401–411

    Article  PubMed  CAS  Google Scholar 

  17. Harreby M, Nygaard B, Jessen T et al (1999) Risk factors for low back pain in a cohort of 1389 Danish school children: an epidemiologic study. Eur Spine J 8:444–450

    Article  PubMed  CAS  Google Scholar 

  18. Harringe ML, Lindblad S, Werner S (2004) Do team gymnasts compete in spite of symptoms from an injury? Br J Sports Med 38:398–401

    Article  PubMed  CAS  Google Scholar 

  19. Harringe ML, Renström P, Werner S (2007) Injury incidence, mechanism and diagnosis in top level teamgym. A prospective study conducted over one season. Scand J Med Sci Sports 17:115–119

    PubMed  CAS  Google Scholar 

  20. Hides JA, Richardson CA, Jull GA (1996) Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine 21:2763–2769

    Article  PubMed  CAS  Google Scholar 

  21. Hides JA, Jull GA, Richardson CA (2001) Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine 26:E243–E248

    Article  PubMed  CAS  Google Scholar 

  22. Hodges PW, Richardson CA (1996) Inefficient muscular stabilization of the lumbar spine associated with low back pain. A motor control evaluation of transversus abdominis. Spine 21:2640–2650

    Article  PubMed  CAS  Google Scholar 

  23. Hodges PW, Butler JE, McKenzie DK, Gandevia SC (1997) Contraction of the human diaphragm during rapid postural adjustments. J Physiol 505:539–548

    Article  PubMed  CAS  Google Scholar 

  24. Hodges PW, Richardson CA (1998) Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J Spinal Disord 11:46–56

    Article  PubMed  CAS  Google Scholar 

  25. Homer S, Mackintosh S (1992) Injuries in young female elite gymnasts. Physiotherapy 78:804–808

    Article  Google Scholar 

  26. Hutchinson MR (1999) Low back pain in elite rhythmic gymnasts. Med Sci Sports Exerc 31:1686–1688

    Article  PubMed  CAS  Google Scholar 

  27. Indahl A, Kaigle AM, Reikeras O, Holm S (1995) Electromyographic response of the porcine multifidus musculature after nerve stimulation. Spine 20:2652–2658

    Article  PubMed  CAS  Google Scholar 

  28. Indahl A, Kaigle AM, Reikeras O, Holm SH (1997) Interaction between the porcine lumbar intervertebral disc, zygapophysial joints, and paraspinal muscles. Spine 22:2834–2840

    Article  PubMed  CAS  Google Scholar 

  29. Jarvik JG, Deyo RA (2002) Diagnostic evaluation of low back pain with emphasis on Imaging. Am Intern Med 137:586–597

    Google Scholar 

  30. Karlsson L, Lundin O, Ekström L, Hansson T, Swärd L (1998) Injuries in adolescent spine exposed to compressive loads: an experimental cadaveric study. J Spinal Disord 11:501–507

    Article  PubMed  CAS  Google Scholar 

  31. Katz DA, Scerpella TA (2003) Anterior and middle column thoracolumbar spine injuries in young female gymnasts. Report of seven cases and review of the literature. Am J Sports Med 31:611–616

    PubMed  Google Scholar 

  32. Kolt GS, Kirkby RJ (1999) Epidemiology of injury in elite and subelite female gymnasts: a comparison of retrospective and prospective findings. Br J Sports Med 33:312–318

    PubMed  CAS  Google Scholar 

  33. Kujala UM, Salminen JJ, Taimela S, Oksanen A, Jaakkola L (1992) Subject characteristics and low back pain in young athletes and nonathletes. Med Sci Sports Exerc 24:627–632

    PubMed  CAS  Google Scholar 

  34. Kujala UM, Taimela S, Erkintalo M, Salminen JJ, Kaprio J (1996) Low-back pain in adolescent athletes. Med Sci Sports Exerc 28:165–170

    PubMed  CAS  Google Scholar 

  35. Lundin O, Ekström L, Hellström M, Holm S, Swärd L (2000) Exposure of the porcine spine to mechanical compression: differences in injury pattern between adolescents and adults. Eur Spin J 9:466–471

    Article  CAS  Google Scholar 

  36. Merskey H (1994) Logic truth and language concepts of pain. Qual Life Res 3:S69–S76

    Article  PubMed  Google Scholar 

  37. O’Sullivan PB, Twomey LT, Allison GT (1997) Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 22:2959–2967

    Article  PubMed  CAS  Google Scholar 

  38. O’Sullivan PB (2000) Lumbar segmental “instability”: clinical presentation and specific stabilizing exercise management. Man Ther 5:2–12

    Article  PubMed  CAS  Google Scholar 

  39. Papageorgiou AC, Croft PR, Ferry S, Jayson MI, Silman AJ (1995) Estimating the prevalence of low back pain in the general population. Evidence from the south Manchester back pain survey. Spine 20:1889–1894

    Article  PubMed  CAS  Google Scholar 

  40. Panjabi MM (1992) The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 5:383–389

    Article  PubMed  CAS  Google Scholar 

  41. Panjabi MM (2003) Clinical spinal instability and low back pain. J Electromyogr Kinesiol 13:371–379

    Article  PubMed  Google Scholar 

  42. Panjabi MM (2006) A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. Eur Spine J 15:668–676

    Article  PubMed  Google Scholar 

  43. Quint U, Wilke H-J, Shirazi-Adl A, Parnianpour M, Loer F, Claes LE (1998) Importance of the intersegmental trunk muscles for the stability of the lumbar spine. Spine 23:1937–1945

    Article  PubMed  CAS  Google Scholar 

  44. Richardson CA, Jull GA (1995) Muscle control—pain control. What exercises would you prescribe? Man Ther 1:2–10

    Article  PubMed  CAS  Google Scholar 

  45. Salén BA, Spangfort EV, Nygren ÅL, Nordemar R (1994) The disability rating index: an instrument for assessment of disability in clinical settings. J Clin Epidemiol 47:1423–1434

    Article  PubMed  Google Scholar 

  46. Sands WA, Schultz BB, Newman AP (1993) Women’s gymnastics injuries. A 5-year study. Am J Sports Med 21:271–276

    Article  PubMed  CAS  Google Scholar 

  47. Sjolie AN (2004) Associations between activities and low back pain in adolescents. Scand J Med Sci Sports 14:352–359

    Article  PubMed  Google Scholar 

  48. Solomonow M, Zhou B-H, Harris M, Lu Y, Baratta RV (1998) The ligamento-muscular stabilizing system of the spine. Spine 23:2552–2562

    Article  PubMed  CAS  Google Scholar 

  49. Storheim K, Bø K, Pederstad O, Jahnsen R (2002) Intra-tester reproducibility of pressure biofeedback in measurement of transversus abdominis function. Physiother Res Int 7:239–249

    Article  PubMed  Google Scholar 

  50. Swärd L, Hellström M, Jacobsson B, Peterson L (1990) Back pain and radiologic changes in the thoraco-lumbar spine of athletes. Spine 15:124–129

    Article  PubMed  Google Scholar 

  51. Swärd L, Hellström M, Jacobsson B, Nyman R, Peterson L (1991) Disc degeneration and associated abnormalities of the spine in elite gymnasts. A magnetic resonance imaging study. Spine 16:437–443

    Article  PubMed  Google Scholar 

  52. Thornbury JR, Fryback DG, Turski PA, Javid MJ, McDonald JV, Beinlich BR, Gentry LR, Sackett JF, Dasbach EJ, Martin PA (1993) Disk-caused nerve compression in patients with acute low back pain: diagnosis with MR, CT myelography, and plain CT. Radiology 186:731–738

    PubMed  CAS  Google Scholar 

  53. Watson KD, Papageorgiou AC, Jones GT et al (2002) Low back pain in schoolchildren: occurrence and characteristics. Pain 97:87–92

    Article  PubMed  Google Scholar 

  54. Wilke H-J, Wolf S, Claes LE, Arand M, Wiesend A (1995) Stability increase of the lumbar spine with different muscle groups. Spine 20:192–198

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

We would like to thank the coaches and gymnasts who participated in this study. We would also like to thank the Swedish National Centre of Research in Sports (CIF) for economical support.

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Authors and Affiliations

  1. Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Forskningscentrum M3:00, 171 76, Stockholm, Sweden

    M. L. Harringe & S. Werner

  2. Swedish School of Sport and Health Sciences, Stockholm, Sweden

    M. L. Harringe

  3. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden

    J. S. Nordgren, I. Arvidsson & S. Werner

  4. Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden

    M. L. Harringe & S. Werner

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  1. M. L. Harringe
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  2. J. S. Nordgren
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  4. S. Werner
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Correspondence to M. L. Harringe.

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Harringe, M.L., Nordgren, J.S., Arvidsson, I. et al. Low back pain in young female gymnasts and the effect of specific segmental muscle control exercises of the lumbar spine: a prospective controlled intervention study. Knee Surg Sports Traumatol Arthr 15, 1264–1271 (2007). https://doi.org/10.1007/s00167-007-0289-9

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