Low Back Injury Research Articles

Hatha yoga, integrating the segmental stabilization exercise model, can improve trunk muscle endurance in healthy adults.

Low back pain is a very common symptom worldwide and an increasingly important public health problem. Exercises to stabilize the lumbar spine and pelvis have been shown to be effective in preventing or reducing the risk of low back pain. Hatha yoga practice is now increasingly appearing in prevention research and has the potential to improve trunk muscle endurance. The prevention research on endurance training of trunk muscle lacks evidence. The aim of this study was to investigate the effectiveness of a professional and scientifically based exercise program to improve and balance trunk muscle endurance in healthy adults. A non-randomized control study was conducted. Participants were healthy adults without low back pain or injury who had not performed exercises to improve trunk muscle endurance prior to participation in the study. An analysis of the proposed exercise program's effectiveness was conducted. The participants were divided into two groups: the exercise group (EG) performed a three-month hatha yoga exercise program (60 min twice a week) that included the spinal and pelvic segmental stabilization exercise model, or the control group (CG), in which participants were asked to maintain their previous lifestyle during the study period. Trunk muscle endurance was measured at baseline (PRE) and after completion of the exercise program (POST) in both groups. The changes in the measured variables were analyzed (PRE-POST analysis, EG-CG comparison). Seventy-two subjects (nEG = 36, age 32.2 ± 6.8 years; nCG = 36, age 29.9 ± 7.8 years) participated in the study. After the exercise program, the EG participants had significantly better results in endurance in three of the four trunk muscle groups (p < 0.05), but not in any of the endurance ratios. Hatha yoga when integrating the segmental stabilization exercise model can significantly improve the endurance of at least three of the four major trunk muscle groups. For clinical relevance, the long-term effects of the proposed exercise program should be investigated in individuals with low back pain.

Technical pace bowling coaching of adolescent cricketers: A survey on practices and barriers

In cricket pace bowling, research has determined kinematic correlates to ball release speed and lumbar bone stress injury. Coaches have an important role in guiding the development of the bowling action of adolescent pace bowlers; however, it is not clear whether their knowledge and practices align with improving ball release speed and reducing lower back injury risk. This study had three aims: 1) to describe the technical coaching practices of adolescent pace bowlers, 2) to identify the barriers that coaches face in the implementation of such practices, and 3) to determine the relationship between coaches’ demographic characteristics and the frequency of technical coaching. This study used a cross-sectional survey study design combined with a purposive sampling approach. Participants were cricket coaches (n = 130) in Australia aged over 18 years, who coached adolescent cricket teams (10–19 years old). Only 11.3% of coaches “occasionally” engaged in technical bowling coaching in the off-season, which increased to 37.1% during the in-season. When technical bowling coaching was undertaken, it was most common for it to last “15–30 min/session” (34.5% of coaches in the off-season and 38.2% in the in-season). The most common barrier to technical bowling coaching during the off-season was limited access to players, while barriers during the in-season were minimal and varied. Younger coaches and older players were associated with more frequent technical coaching in the off-season. Future coaching educational programmes could help coaches to work around the player-access barrier by encouraging them to prescribe training drills in the off-season.

Relationship between training volume and overuse injuries in female volleyball players

Problems and Purpose. Overuse injuries are a result of repetitive stress without sufficient recovery, and female volleyball players are known to have high risk of overuse injuries due to the cumulative impact of these repetitive actions. Overuse injuries can occur due to high training volume, which is important for skill development. This raises the potential for overuse injuries. For this reason, the study was conducted to evaluate the correlation between training volume and the incidence of overuse injuries in female volleyball players. Materials and methods. This study used a cohort research design to evaluate the correlation between training volume and the incidence of overuse injuries in female volleyball players, using a questionnaire to collect demographic data such as age, weight, height, exercise history, and previous injury history and OSTRC to collect data regarding the incidence, severity, and impact of overuse injuries on sport participation and daily activities. The sample consisted of 48 female volleyball players of Yusso Yogyakarta club. Results. Out of 48 respondents, 42 athletes had experienced injuries. Based on the OSTRC measurement there were 22 athletes had no injuries on their knees, while 12 athletes had mild injuries to their knees, 8 athletes had moderate injuries to their knees, 6 people had severe injuries to their knees and none. For lower back injuries, 12 athletes did not suffer any, 30 experienced mild injuries, 6 experienced moderate injuries, 6 experienced severe injuries, and 2 experienced very severe injuries. And for the shoulder area, there were 18 athletes were not injuried, 12 athletes had mild injuries, 14 athletes had moderate injuries, 2 athletes had severe injuries, and 2 others had suffered very severe injuries. The correlation between training volume and the incidence of overuse injuries in female volleyball players was tested using the Spearman test. It was found that the amount of training per week influence knee overuse injury with a significant value of 0.001. The amount of exercise per week also correlates with the incidents of low back overuse injury (significance value of 0.043) and overuse injuries in the shoulder area (significance value of 0.034). Conclusion. This study found that high volume training increases the risk of injury excess in female volleyball players, such as shoulder, knee and wrist injuries. Therefore, It is important to develop a balanced excercise program that includes rest periods and recovery to prevent injury.

Relationship of Physical Factors to the Occurrence of Injuries in Young Gymnasts.

There is a large population of young athletes who participate in gymnastics, and the prevention of injury in junior athletes is considered important. However, few studies have prospectively investigated the relationship between physical factors and the occurrence of injury. To investigate the physical characteristics that are factors in the injury occurrence in elementary and junior high school gymnasts. Prospective observational study. A total of 36 healthy young gymnasts (at national competition level) were enrolled in the study. Once a week for 23 weeks, injuries were prospectively investigated using self-report questionnaires under the supervision of a research staff. Joint range of motion (hip, ankle, shoulder, and wrist), tightness (Thomas test, Ely test, straight leg raise [SLR], triceps surae, combined abduction test [CAT], horizontal flexion test [HFT]), and muscle elasticity (multifidus) were assessed to compare differences in physical function between injured and non-injured participants. Injuries occurred most commonly in the wrist (42.1%), lower back (30.2%), and foot (9.5%) among males, whereas heel (22.2%), knee (16.0%), and lower back (12.8%) were the most common injury sites among females. Wrist injuries in male athletes showed decreased shoulder joint range of motion, and lower back injuries showed decreased hip and shoulder joint range of motion. Lower back injuries in female athletes showed decreased hip extension mobility. Heel and knee joint injuries in females also showed increased range of motion and decreased tightness. The results of this study indicate that the factors related to flexibility differ according to injury location. Further studies are required to clarify the physical factors that influence injury occurrence by examining the effects of the gymnasts' muscle strength, age, individual factors, and left-right differences. 3.

Characterizing the Compressive Force at L5/S1 During Patient Transfer From Bed to Wheelchair.

The peak compressive forces at L5/S1 during patient transfers have been estimated. However, no study has considered the actual patient body weight that caregivers had to handle during transfers. We developed a simple kinematic model of lifting to address this limitation. Fifteen prospective health care providers transferred a 70-kg individual who mimicked a patient ("patient") from bed to wheelchair. Trials were acquired with the patient donning (weighted) and doffing (unweighted) a 5-kg weight belt. Trials were also acquired with and without knee assistance and a mechanical lift. During trials, kinematics and kinetics of transfers were recorded to estimate the peak compressive force at L5/S1 using static equilibrium equations. The peak compressive force was associated with the transfer method (P < .0005), and the compressive force was 68% lower in lift-assisted than manual transfer (2230 [SD = 433]N vs 6875 [SD = 2307]N). However, the peak compressive force was not associated with knee assistance, nor with a change in the patient body weight. Our results inform that mechanical loading exceeding the National Institute for Occupational Safety and Health safety criterion occurs during patient transfers, confirming a high risk of lower back injuries in caregivers. However, the risk can be mitigated with the use of a mechanical lift.

A versatile knee exoskeleton mitigates quadriceps fatigue in lifting, lowering, and carrying tasks.

The quadriceps are particularly susceptible to fatigue during repetitive lifting, lowering, and carrying (LLC), affecting worker performance, posture, and ultimately lower-back injury risk. Although robotic exoskeletons have been developed and optimized for specific use cases like lifting-lowering, their controllers lack the versatility or customizability to target critical muscles across many fatiguing tasks. Here, we present a task-adaptive knee exoskeleton controller that automatically modulates virtual springs, dampers, and gravity and inertia compensation to assist squatting, level walking, and ramp and stairs ascent/descent. Unlike end-to-end neural networks, the controller is composed of predictable, bounded components with interpretable parameters that are amenable to data-driven optimization for biomimetic assistance and subsequent application-specific tuning, for example, maximizing quadriceps assistance over multiterrain LLC. When deployed on a backdrivable knee exoskeleton, the assistance torques holistically reduced quadriceps effort across multiterrain LLC tasks (significantly except for level walking) in 10 human users without user-specific calibration. The exoskeleton also significantly improved fatigue-induced deficits in time-based performance and posture during repetitive lifting-lowering. Last, the system facilitated seamless task transitions and garnered a high effectiveness rating postfatigue over a multiterrain circuit. These findings indicate that this versatile control framework can target critical muscles across multiple tasks, specifically mitigating quadriceps fatigue and its deleterious effects.

Low back pain or injury before collegiate athletics, a potential risk factor for non-contact athletic injuries.

Majority of research surrounding the predictive value of clinical measurements and assessments for future athletic injury does not differentiate between contact and non-contact injuries. We assessed the association between clinical measures and questionnaire data collected prior to sport participation and the incidence of non-contact lower extremity (LE) injuries among Division III collegiate athletes. Prospective cohort study. University setting, NCAA Division III. 488 Division III freshmen athletes were recruited to participate in the study during their preseason physical examinations. 10,983 public schools. Prospective incidence of non-contact Lower extremity Injury. Athletes completed questionnaires to collect demographics and musculoskeletal pain history. Clinical tests, performed by trained examiners, included hip provocative tests, visual appraisal of a single leg squat to identify dynamic knee valgus, and hip range of motion (ROM). Injury surveillance for each athlete's collegiate career was performed. The athletic training department documented each athlete-reported, new onset injury and documented the injury location, type, and outcome (days lost, surgery performed). Univariable Generalized Estimating Equations (GEE) models were used to analyze the relationship between each clinical measure and the first occurrence of non-contact LE injury. An exchangeable correlation structure was used to account for repeated measurements within athletes (right and left limbs). Of the 488 athletes, 369 athletes (75%) were included in the final analysis. 69 non-contact LE injuries were reported. Responding "Yes" to "Have you ever had pain or an injury to your low back" was associated with an increased risk of non-contact LE, odds ratio = 1.59 (95%CI 1.03- 2.45, p=.04). No other clinical measures were associated with increased injury risk. A history of prior low back pain or injury was associated with an increased risk of sustaining a non-contact LE injury while participating in NCAA Division III athletics.

Predicting Perceived Back Fatigue During Exoskeleton Supported Trunk Bending Tasks using Machine Learning

Repetitive trunk flexion tasks performed over long durations can increase low-back injury risk, where Back Support Industrial Exoskeletons (BSIEs) can be beneficial. While BSIEs have shown effectiveness in lab assessments, real-world outcomes have shown variation based on task complexity, necessitating monitoring of physical demands. Fourteen participants performed repetitive trunk BSIE-assisted forward bending and return, without fatigue and then at medium-high fatigue. We recorded muscle activity in low-back and thigh muscles using Electromyography (EMG) and whole-body stability using force plates. Classification algorithms, namely, Support Vector Machine (SVM), Random Forest (RF), and XGBoost (XGB) were utilized to predict perceived medium-high back fatigue using sensor data. Highest performance was observed with XGB algorithm using data from a single low-back EMG sensor (Accuracy: 86.1%, Recall: 86%), and force plate (93.5, 94.1%). Outcomes of our study can be helpful in developing novel fatigue detection products, benefiting ergonomists in properly implementing BSIEs in industrial scenarios.

Hang up your cleats and hope for the best? A cross-sectional study of five health domains in retired elite female rugby players

ObjectivesTo investigate retired elite female rugby players’ health outcomes (and their relationships) in five key areas (musculoskeletal, cognitive, mental, reproductive/endocrinological and cardiovascular) and how those compare with the general population.MethodsFemale...

Lower Back &amp; Comfortability Analysis of Driving Posture to Mitigate Musculoskeletal Disorders: An Ergonomics Study using Digital Human Modelling in JACK Software

In this paper, the crucial aspect of driver comfort was explored by investigating the prevailing driving postures among individuals, aiming to discern their ergonomic implications and ascertain whether the commonly adopted postures are conducive to musculoskeletal health or pose potential risks. From the last decade vehicle like cars have become one of the common modes of personal transport. Car has high relevance in day-to-day activities like commuting, economic activities and sports etc. The continuous driving of vehicle can lead the driver prone to musculoskeletal disorders such as back pain, spine injury and posture issues. This study is conducted to address the ergonomic aspects of posture of the driver to highlight the risk of Musculoskeletal disorders (MSDs) and to optimize the driving posture. Lower Back Analysis (LBA) and Comfortability Analysis is performed in JACK Software to analyze the driving posture. A DHM (Digital Human Model) is created in JACK Simulation Software according to the collected anthropometric data of an average Pakistani man. A virtual Environment is created in JACK Simulation Software. The posture of the subject is analyzed by taking measurements of the subject’s angle of joints when they are sitting in a driving posture. For Ergonomic Analysis the Driving Posture is evaluated on JACK software to Mitigate Musculoskeletal Disorders. Results show that the subject is having low back compression force of 672 which is below the NIOSH Back Compression Action Limit of 3400N representing a nominal risk of low back injury.

Combination of deep tissue massage and stretching: Does it affect the healing of low back pain injuries?

Background and Study Aim. Low Back Pain (LBP) is an abnormal condition in the lower back which is accompanied by a painful sensation so that it will experience limitations in moving. Therefore, the need for special treatment in dealing with Low Back Pain (LBP) in order to reduce pain. Material and Methods. This research is a pre-experimental research using the approach one group pretest and posttest design. In this study, the results of the initial test data (pretest) were measured in the form of low back pain results with VAS, Modified Schober Test, Fingertip to Floor, and ODI, then giving treatment by combining deep tissue massage with stretching. Therapy is given to patients 3 times a week for 3 weeks, then the final data measurement (Posttest) is carried out. The subjects of this study were patients at the LKP Rumah Sehat Mandiri clinic for the last 5 months who had experienced low back pain injuries. Sampling in this study used purposive sampling so that there were 20 people with an age range of 20-60 years. The analysis in this study uses the SPSS Version 26 application. Results. The results showed that the indicators of pain, flexion, extension, right flexion, left flexion and function had a significant effect using a combination of deep tissue massage and stretching with a significant value si showing 0.000 &lt; 0.05. In the left flexion indicator, a significance value of 0.001 &lt; 0.05 was obtained, so it can be concluded that there is a significant difference in the deep tissue massage combination of stretching treatment. Conclusions. The results of this study provide evidence that the combination of deep tissue massage and stretching provides a significant reduction in the healing of low back pain injuries in patients. That way a combination of deep tissue massage and stretching can be applied to treat low back pain injury healing.

Musculoskeletal injuries in bodybuilders: A brief review with an emphasis on injury mechanisms

In this article we reviewed the literature on injuries and their mechanisms in bodybuilders. Bodybuilding is a weightlifting sport where the main goal is to increase muscle mass while maitaining body symmetry. From a biomechanical point of view, it is important to analyse technical performance of exercises to improve sports technique. Compound exercises based on the development of muscle hypertrophy must be included. The training is different before and during season, in pre-season it is based on reduction of body fat to a low level and a high volume of aerobic exercise. Adequate nutrition, use of supplements and banned substances are widespread in the sport. In that case athletes should be very careful for banned substances in accordance with WADA Code. The most commonly performed exercises where injuries happen are the squat, deadlift and benchpress. The majority of injuries (60 %) are acute, with 93 % shoulder joint injuries, 85 % lower back injuries and 80 % knee injuries. The incidence of injuries is low compared to other sports, between 0.24/1000 hours of training or 0.12 injuries per lifter per year. The most common type of injury is muscle strain, followed by tendinitis and cartilage wear. So it is therefore important to identify risk factors to allow the development of appropriate prevention programs. Muscle ruptures are common with high eccentric loads, with pectoralis major tendon being the most vulnerable to be injured. Than followed by a rupture of biceps femoris during the deadlift exercise, during sudden flexion of the hip joint while the knee is extended. Eccentric contraction and rupture also occurs in the quadriceps muscle, which lifters try to avoid by performing low-bar squat. Uncontrolled abdominal pressure during high-weight exercises causes discus hernias, which lifter can prevent by breathing correctly and using strong muscle stabilizers. The most well-known injury of all is elbow burzitis or »Bodybuilders elbow« due to repetitive flexion and extension movements of elbow joint. To prevent this injuries we have to include preventive measures such as medical check-ups, education of athletes, ensuring safety in competitions, appropriate training and load distribution, treating the body as a whole and regular equipment check-ups.

Epidemiology of musculoskeletal injury in professional and amateur golfers: a systematic review and meta-analysis

ObjectiveTo determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with increased injury frequency.DesignSystematic epidemiological review and...

Simulation analysis of low back forces in Snatch and Clean & Jerk movements via digital human modelling.

Weightlifting is an Olympic sport for dynamic strength and power, and requires the execution of different lifting techniques It is important to analyze the forces subjected to the lower back during weightlifting movements to prevent injuries. Digital Human Modeling (DHM) is a powerful tool that can be used to analyze and optimize the performance of humans while doing their work or activities. The purpose of this study is to present a simulation analysis of the lower back forces during the execution of two weightlifting techniques: Snatch (SN) and Clean & Jerk (CJ), with different loads and for both genders. Digital Human modelling through JACK simulation package was used analyze the forces exerted on the lumbosacral area (L5-S1) of the lower back in order to determine the risk for low back injuries. The level of compression and shear forces recommended by the literature have been set as thresholds. The simulaitons were performed in male and female models, with loads from 20-100kg. The results show that any weight higher than 60 kg in both movements poses risk for the weightlifters in terms of compression and shear forces. It has been observed that weightlifters can lift greater loads in the CJ technique compared to the SN technique. Furthermore, females are able to lift higher loads with lower risk of injuries. Weightlifting is a high-risk activity due to the high levels of shear and compression forces that the body is exposed to during the lifting techniques. Digital Human Modeling holds significant value due to their ability to facilitate the exploration of diverse conditions within a safe environment, devoid of any potential harm to human subjects.

Lateral Pelvis and Lumbar Motion in Seated and Standing Office Work and Their Association With Transient Low Back Pain.

To assess frontal plane motion of the pelvis and lumbar spine during 2 h of seated and standing office work and evaluate associations with transient low back pain. Although bending and twisting motions are cited as risk factors for low back injuries in occupational tasks, few studies have assessed frontal plane motion during sedentary exposures. Twenty-one participants completed 2 h of seated and standing office work while pelvic obliquity, lumbar lateral bending angles, and ratings of perceived low back pain were recorded. Mean absolute angles were compared across 15-min blocks, amplitude probability distribution functions were calculated, and associations between lateral postures and low back pain were evaluated. Mean pelvic obliquity (sit = 4.0 ± 2.8°, stand = 3.5 ± 1.7°) and lumbar lateral bending (sit = 4.5 ± 2.5°, stand = 4.1 ± 1.6°) were consistently asymmetrical. Pelvic obliquity range of motion was 4.7° larger in standing (13.6 ± 7.5°) than sitting (8.9 ± 8.7°). In sitting, 52% (pelvis) and 71% (lumbar) of participants, and in standing, 71% (pelvis and lumbar) of participants, were considered asymmetric for >90% of the protocol. Lateral postures displayed weak to low correlations with peak low back pain (R ≤ 0.388). The majority of participants displayed lateral asymmetries for the pelvis and lumbar spine within 5° of their upright standing posture. In short-term sedentary exposures, associations between lateral postures and pain indicated that as the range in lateral postures increases there may be an increased possibility of pain.

Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study

ObjectivesThe increase in gabapentinoid prescribing is paralleling the increase in serious harms. To describe the low back pain workers compensation population whose management included a gabapentinoid between 2010 and 2017,...

Can the combination of deep tissue massage and stretching influence the recovery process of lower back pain injuries?

Lower Back Pain (LBP) presents as discomfort in the lumbar region, leading to movement limitations. Addressing LBP requires specialized treatment to alleviate pain. The aim of this study was to demonstrate the effectiveness of combining deep tissue massage and stretching in healing low back pain injuries. This study adopted a pre-experimental design, employing a one-group pretest and posttest approach. The initial assessments (pretests) gauged LBP severity using VAS, Modified Schober Test, Fingertip to Floor, and ODI. Subsequently, a combination therapy of deep tissue massage and stretching is administered three times weekly over three weeks. Final assessments (posttest) are conducted. Participants, recruited from the LKP Rumah Sehat Mandiri clinic over the past five months, consisted of 20 individuals aged 20-60 years, sampled purposively. The study revealed significant improvements in pain, flexion, extension, right flexion, left flexion, and functional indicators following the combination therapy, with a significance value of 0.000, indicating a profound effect (p &lt; 0.05). Notably, left flexion demonstrated a significance value of 0.001, further affirming the treatment's efficacy. The findings support the effectiveness of combining deep tissue massage and stretching in reducing LBP severity and promoting healing. Thus, this combined approach holds promise for managing LBP injuries effectively.

Implementing an accelerometer-based pelvis segment for low back kinetic analyses during dynamic movement tasks

An accelerometer-based pelvis has been employed to study segment and joint kinematics during scenarios involving close human-object interface and/or line-of-sight obstructions. However, its accuracy for examining low back kinetic outcomes is unknown. This study compared reaction moments and contact forces of the L5S1 joint calculated with an accelerometer-based and optically tracked pelvis segment. An approach to correct the global pelvis position as a function of thigh angle was developed. One participant performed four dynamic tasks: forward bend, squat, sit-to-stand-to-sit, and forward lunge. A standard bottom-up inverse dynamics approach was used and the root mean square error (RMSE) and coefficient of determination (R2) were calculated to examine kinetic differences between the optical and accelerometer approaches. The RMSE observed for L5S1 reaction flexion-extension moments ranged from 1.32 Nm to 2.20 Nm (R2 ≥ 0.98). The RMSE for net shear and compression reaction forces ranged from 2.13 to 10.45 N and 0.63 – 4.96 N, respectively. Similarly, the RMSE for L5S1 joint contact shear and compression ranged from 13.45 N to 19.51 N (R2 ≥ 0.85) and 31.18 N – 55.97 N (R2 ≥ 0.97), respectively. In conclusion, the accelerometer-based pelvis together with the approach to correct the global pelvis position is a feasible approach for computing low back kinetics with a single equivalent muscle model. The observed error in joint contact forces represents less than 5 % of the NIOSH recommended action limits and is unlikely to alter the interpretation of low back injury risk.

Lightweight active back exosuit reduces muscular effort during an hour-long order picking task

Occupational back exoskeletons and exosuits aim to reduce low back injuries in the workplace. For these technologies to be adopted, it is important that they provide biomechanical benefits to the wearer and do not disrupt job performance. To address this challenge, here we developed a lightweight, soft, active back exosuit that can autonomously control virtual impedance to apply differing assistance during lowering and lifting. In usability tests, participants rated the exosuit as easy to learn and use and reported feeling confident while wearing it. In an experiment involving an hour-long order picking task we demonstrated that the exosuit reduced peak and median muscle activations in the back by 18% and 20%, respectively. Despite the complexity of the movements required, such as walking, bending, and navigating around obstacles while lifting boxes from under a rack, our controller demonstrated impressive robustness with only 14 mistriggers out of 9600 lifts (0.1%). The results of this research suggest that active exosuit technology has the potential to be a highly usable solution to aid warehouse workers in real-world settings.

Does Overhead Squat Performance Affect the Swing Kinematics and Lumbar Spine Loads during the Golf Downswing?

The performance of the overhead squat may affect the golf swing mechanics associated with golf-related low back pain. This study investigates the difference in lumbar kinematics and joint loads during the golf downswing between golfers with different overhead squat abilities. Based on the performance of the overhead squat test, 21 golfers aged 18 to 30 years were divided into the highest-scoring group (HS, N = 10, 1.61 ± 0.05 cm, and 68.06 ± 13.67 kg) and lowest-scoring group (LS, N = 11, 1.68 ± 0.10 cm, and 75.00 ± 14.37 kg). For data collection, a motion analysis system, two force plates, and TrackMan were used. OpenSim 4.3 software was used to simulate the joint loads for each lumbar joint. An independent t-test was used for statistical analysis. Compared to golfers demonstrating limitations in the overhead squat test, golfers with better performance in the overhead squat test demonstrated significantly greater angular extension displacement on the sagittal plane, smaller lumbar extension angular velocity, and smaller L4-S1 joint shear force. Consequently, the overhead squat test is a useful index to reflect lumbar kinematics and joint loading patterns during the downswing and provides a good training guide reference for reducing the risk of a golf-related lower back injury.