Low Back Pain in Elite and Semi-elite Australian Football Codes

Abstract

No study has investigated the levels and prevalence of low back pain (LBP) occurring in Australian football codes (Australian Rules, soccer, rugby league and rugby union) or at different levels of athletic play (elite and semi-elite). PURPOSE: To document the levels and prevalence of LBP symptoms in Australian male elite and semi-elite level football code players and to compare data with an age-matched non-athletic population. METHODS: Subjects were drawn from clubs playing in the national or international competition for elite players (n=271) and the highest level state competition for semi-elite players (n=360). Age matched controls were drawn from a convenience sample of university students and office workers (n=152). Subjects completed the validated and reliable Quadruple Visual Analogue Scale (VAS) and the McGill Pain Questionnaire (short form), along with a series of specific LBP questions regarding frequency and duration of symptoms, age of first onset LBP and aetiology. Group means were compared using descriptive statistics. RESULTS: There was a significant increased difference between controls and semi-elites and between semi-elites and elites for current VAS, VAS average and VAS at worst (all p<0.01) (controls 1/10 v semi-elites 2/10 v elites 3/10 for current and average VAS, controls 4/10 v seim-elites 5/10 v elites 6/10 for VAS at worst). The average pain profile was also clinically significant between controls and elites (p<0.01). There was a significant difference between controls and combined elite and semi-elites for VAS at best (p<0.01) (controls 0/10 v semi-elites and elites 1/10). There was a significant difference between controls and semi-elites combined compared with elites for levels of overall pain, sensory aspect of pain severity and total pain rating (all p<0.01). There was no difference between the age of first onset of LBP for any group (average age 17). 85% of elites, 65% of semi-elites and 53% of controls said their first ever episode or attack of LBP was due to athletic activities. The point prevalence of LBP was 69% for elites, 57% for semi-elites and 55% for controls. 93% of elites, 75% of semi-elites and 49% of controls said their current episode of LBP was due to athletic activities. 40% of elites, 31 % of semi-elites and 17% of controls experience daily or weekly LBP. CONCLUION: Footballers in Australia compared with age-matched controls have significantly higher levels and prevalence of LBP and this figure escalates significantly with level of play. It appears from this cohort that the mechanism for pain is associated with non-contact athletic activity.