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.

Antonio Cejudo,Fernando Santonja-Medina,Josep María Centenera-Centenera

doi:10.3390/ijerph18168654

Antonio Cejudo, Fernando Santonja-Medina + Show 1 more

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https://doi.org/10.3390/ijerph18168654

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Abstract

It is assumed that mechanical restriction of hamstring tightness disrupts sagittal spine–pelvis–leg alignment and alters the lumbar–pelvic rhythm predisposing to low back pain (LBP) in athletes; however, this association is not clear. A prospective cross-sectional cohort study was conducted to determine the influence of hamstring extensibility (HE) on sagittal pelvic tilt, sagittal spinal curves, and LBP in 94 soccer and basketball players (61 man and 33 woman) with (n = 36) and without recurrent LBP (n = 58). Descriptive analysis displayed significant gender differences for HE, sagittal pelvic tilt, and lumbar curve. Differences were found between the low-HE and high-HE groups in lumbosacral angle in for the maximum trunk forward flexion (LH-MTFP). Low-HE was associated with LH-MTFP, lumbar curve and LBP in male players (p ≤ 0.023). In female players, LH-MTFP and lumbar curve were associated with low-HE (p ≤ 0.020). Low-HE predicted LH-MTFP (p = 0.000; OR = 65.6950) and LBP (p = 0.028; OR = 13.915) in male players. The decision tree analysis showed that 50.8% of the players were classified with restricted LH-MTFP, 77.4% with low-HE among male players. The 100% of male players with recurrent LBP had low-HE. The 65% of female players with low-HE had restricted LH-MTFP. Measurement of HE, lumbar curve, and LH-MTFP are important in making training decisions for to reduce the incidence of recurrent LBP in soccer and basketball players.

Highlights

Low back pain (LBP) is one of the most common health-related complaints in team sport players
Previous systematic reviews have reported that the prevalence of LBP in these athletes ranges from 17% to 94% [1,2]
The variables analyzed obtained a statistical power of ≥0.85 for HF-KE, slump sitting position, LH-maximum trunk forward flexion position, lumbar curve, thoracic curve in slump sitting position, 0.70 for thoracic curve in relaxed standing position, and 0.61 for thoracic curve in MTFP

Summary

Introduction

Low back pain (LBP) is one of the most common health-related complaints in team sport players. Clinical findings, and scientific studies, various risk factors—such as high body mass [1,10], sports experience [1], muscle weakness [11,12], muscle tightness [13,14,15], sagittal lumbo-pelvic misalignments [12,16], and sagittal spinal misalignments [17,18]—have been postulated as potential predictors of LBP in athletes and general population. In this sense, lumbar hyperlordosis in standing [19,20,21]

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