Body mass, nonspecific low back pain, and anatomical changes in the lumbar spine in judo athletes

ESTUDIO COMPARATIVO LESIONAL EN JUDOCAS DE ÉLITE

El Judo es un deporte estático alto y dinánimo bajo, con alto riesgo de colisión corporal y lesional. El objetivo de este trabajo es determinar la incidencia lesional y comparar los distintos factores de riesgo que pudieran estar implicados. Se estudió a un total de 86 judocas del Equipo Nacional de Judo español (ENJE) durante dos períodos olímpicos: Beijing-Río. Se produjeron 2028 lesiones con mayor frecuencia en miembro inferior, sin diferencias significativas por sexo. Se objetivó mayor incidencia lesional cuando el judoca era tori y durante el momento del entrenamiento. No existen trabajos previos que comparen estos parámetros, por lo que este estudio aporta datos que pueden ser utilizados para prevenir los riesgos de lesión en el judo de alta competición.

Strength and Power-Related Measures in Assessing Core Muscle Performance in Sport and Rehabilitation

While force-velocity-power characteristics of resistance exercises, such as bench presses and squats, have been well documented, little attention has been paid to load, force, and power-velocity relationships in exercises engaging core muscles. Given that power produced during lifting tasks or trunk rotations plays an important role in most sport-specific and daily life activities, its measurement should represent an important part of the test battery in both athletes and the general population. The aim of this scoping review was 1) to map the literature related to testing methods assessing core muscle strength and stability in sport and rehabilitation, chiefly studies with particular focus on force-velocity-power characteristics of exercises involving the use of core muscles, 2) and to identify gaps in existing studies and suggest further research in this field. The literature search was conducted on Cochrane Library databases, Scopus, Web of Science, PubMed and MEDLINE, which was completed by SpringerLink, Google Scholar and Elsevier. The inclusion criteria were met in 37 articles. Results revealed that among a variety of studies investigating the core stability and core strength in sport and rehabilitation, only few of them analyzed force-velocity-power characteristics of exercises involving the use of core muscles. Most of them evaluated maximal isometric strength of the core and its endurance. However, there are some studies that assessed muscle power during lifting tasks at different loads performed either with free weights or using the Smith machine. Similarly, power and velocity were assessed during trunk rotations performed with different weights when standing or sitting. Nevertheless, there is still scant research investigating the power-velocity and force-velocity relationship during exercises engaging core muscles in able-bodied and para athletes with different demands on stability and strength of the core. Therefore, more research is needed to address this gap in the literature and aim research at assessing strength and power-related measures within cross-sectional and intervention studies. A better understanding of the power-force-velocity profiles during exercises with high demands on the core musculature has implications for designing sport training and rehabilitation programs for enhancement of athletes' performance and/or decrease their risk of back pain.

Translation and Adaptation of the French Version of the Risk Stratification Index, a Tool for Stratified Care in Chronic Low Back Pain: A Pilot Study

Background and Objectives: Low back pain is a worldwide health problem. An early diagnosis is required to develop personalized treatment strategies. The Risk Stratification Index (RSI) was developed to serve the purpose. The aim of this pilot study is to cross-culturally translate the RSI to a French version (RSI-F) and evaluate the test-retest reliability of RSI-F using a French active population. Materials and Methods: The RSI was translated from German to French (RSI-F) based on the guidelines of cross-cultural adaptation of self-report measures. A total of 42 French recreational athletes (age 18−63 years) with non-specific low back pain were recruited and filled in the RSI-F twice. The test-retest reliability was examined using intraclass correlation coefficient (ICC1,2) and Pearson correlation coefficient. Results: Finally, 33 questionnaires were analyzed (14 males and 19 females, age 31 ± 10 years, 9.5 ± 3.2 h/week of training). The test-retest of RSI-F CPI and DISS were excellent (CPI: ICC1,2 = 0.989, p < 0.001; r = 0.989, p < 0.001; DISS: ICC1,2 = 0.991, p < 0.001; r = 0.991, p < 0.001), as well as Korff pain intensity (ICC1,2 = 0.995, p < 0.001; r = 0.995, p < 0.001) and disability (ICC1,2 = 0.998, p < 0.001; r = 0.998, p < 0.001). Conclusion: The RSI-F is linguistically accurate and reliable for use by a French-speaking active population with non-specific low back pain. The RSI-F is considered a tool to examine the evolution of psychosocial factors and therefore the risk of chronicity and the prognostic of pain. Further evaluations, such as internal, external validity, and responsiveness should be evaluated in a larger population.

The association of lower trunk muscle strength with low back pain in elite lightweight judokas is dependent on lumber spine abnormalities

BACKGROUND: Lumbar radiological abnormalities (LRA) and trunk muscle weakness are major causes of the low back pain (LBP). We reported that the prevalence of LRA was approximately 90% in middle- and heavyweight-judokas, independent to the occurrence of LBP. However, the trunk muscle weakness, especially the rotators, plays a key role in occurrence of LBP in heavyweight judokas. OBJECTIVE: To examine the trunk muscle strength (TMS) and LRA impact on LBP occurrence in lightweight judokas. METHOD: The strength of the trunk extensors, flexors, and rotators was measured in 32 lightweight male judokas. LBP and LRA were identified using a questionnaire, X-ray, and MRI. RESULTS: The occurrence rate of LBP and LRA were 40.6% and 62.5%, respectively, without any significant correlation. Among judokas without LRA, TMS of those with LBP were significantly lower than those without LBP (P< 0.05, the extensor; 60∘/s: ES [d] = 1.38, 90∘/s: ES [d] = 0.78, and 120∘/s: ES [d] = 0.37, flexor; 60∘/s: ES [d] = 1.48, dominant rotator; 60∘/s: ES [d] = 1.66, and 90∘/s: ES [d] = 1.87, non-dominant rotator; 90∘/s: ES [d] = 0.17, and dominant/non-dominant rotator ratio; 90∘/s: ES [d] = 1.55). Moreover, there were significant negative correlations between LBP severity and TMS (P< 0.05, the extensor; 90∘/s: r=-0.63, dominant rotator; 90∘/s: r=-0.648, and dominant/non-dominant rotator ratio; 90∘/s: r=-0.621) in judokas without LRA. RESULTS: The occurrence rate of LBP and LRA were 40.6% and 62.5%, respectively, without any significant correlation. Among judokas without LRA, the extensor (60, 90, and 120∘/s), flexor (60∘/s), dominant rotator (60 and 90∘/s), non-dominant rotator (90∘/s), and dominant/non-dominant rotator ratio (90∘/s) of judokas with LBP were significantly lower than those of the judokas without LBP. Moreover, there were significant negative correlations (P< 0.05) between LBP severity and the extensor (90∘/s; r=-0.63) and dominant rotator (90∘/s; r=-0.648) strength, and dominant/non-dominant rotator ratio (90∘/s; r=-0.621) in judokas without LRA. CONCLUSION: Weak trunk musculature may be a co-factor in the occurrence of LBP in lightweight judokas without LRA.

Nonspecific Low Back Pain among Kyokushin Karate Practitioners

Background and objective: Spinal pain is a common and growing problem, not only in the general population but also among athletes. Lifestyle, occupation, and incorrectly exerted effort have a significant impact on low back pain. To assess the prevalence of low back pain among those practicing Kyokushin karate, we take into account age, body weight, sex, length of karate experience, level of skill, and occupation. Materials and Methods: The study involved 100 people practicing Kyokushin karate, aged 18 to 44. A questionnaire developed for this study and the Oswestry Disability Index (ODI) were used. Results: The research showed the prevalence of low back pain among karate practitioners (55%), depending on age (R = -0.24; p = 0.015), body weight (χ² = 16.7; p = 0.002), occupation (χ² = 18.4; p = 0.0004), and overall length of karate experience (R = -0.28; p = 0.04). A correlation was also found between sex (χ² = 22.3; p = 0.001), occupation (χ² = 51; p = 0.0000), length of experience (R = -0,28; p = 0.04), karate skill level (R = 0.39; p = 0.003), and the intensity of pain defined using the Visual Analogue Scale (VAS). Subjects with low back pain showed minimal (71%) and moderate (29%) disability according to the Oswestry index. Conclusions: Low back pain is common in karate practitioners and depends on age, weight, occupation, and length of karate experience. The intensity of low back pain is influenced by sex, occupation, overall length of training experience, and one's level of karate skill. Lumbar spine ailments reduce functionality and quality of life to a small degree. Karate practitioners seldom seek treatment for spinal pains, and only few use physiotherapy and pharmacology.

Weight Category-dependent Trunk Muscle Strength and its Relation with LBP in Elite Judokas

Trunk muscle strength (TMS), especially rotator, is an important factor for both athletic performance and injury risks in judokas. However, the characteristics of TMS that depend on weight categories are still unclear. Although inadequate TMS might cause low back pain (LBP), the relationship between these two variables is not fully understood. In this study, weight category-dependent TMS and its relationship with LBP was investigated in Japanese judokas. The subjects were 66 male collegiate judokas, who were classified into the lightweight (N=14), middleweight (N=29) or heavyweight (N=23) category. The peak torques of extensor, flexor and rotator muscles were measured. The LBP group and non-LBP group were defined by questionnaire. TMS (normalized by body weight) in the heavier weight category showed a lower tendency in comparison with other categories, except for rotator strength. Significant differences were observed in the extensors (90 and 120 °/s; P<0.05) and flexors (60, 90 and 120 °/s; P<0.05). The LBP group (N=9) only showed significantly lower extensor (60 °/s; P<0.05) and right-rotator (60 °/s; P<0.01) strength in the heavyweight category compared with the non-LBP group (N=14). The relative TMS of judokas decreased in the heavyweight category, except for trunk rotator strength. Notably, low trunk extensor and rotator strengths are risk factors for LBP in heavyweight judokas.

Trunk Lateral Flexor Endurance and Body Fat: Predictive Risk Factors for Low Back Pain in Child Equestrian Athletes

Low back pain (LBP) is the most common overuse musculoskeletal injury suffered by child equestrian athletes (CEA). Despite this, little is known about the risk factors related to LBP in these athletes, and very limited research has been conducted on this topic. This study was designed to investigate predictive risk factors for LBP in CEA. The purposes of this research were to determine whether anthropometric, range of motion (ROM), core endurance and sagittal spinal morphotype measures are risk factors for LBP and to establish a diagnostic cutoff value for those factors associated with LBP. Nineteen CEA between the ages of 12 and 17 years were voluntarily recruited. Potential risk factors evaluated included corporal composition, lower limb ROM, core endurance and sagittal spinal measures. Associations and predictions were calculated between these risk factors and the LBP during the last 12 months. Almost half of the CEA have suffered at least one episode of LBP. Two risk factors and cutoff values were identified as predictors of LBP in CEA: having a high body fat higher than 23% (p = 0.01) and trunk lateral flexor endurance lower to 65 s (p = 0.021), body fat being the strongest predictor.

Martial arts injuries: a longitudinal study about judo, karate and wushu carried out in the Community of Madrid, Spain

BACKGROUND

Martial arts are currently being practiced throughout the world by about 100 million people. Considering that sports injuries account for 20% of all emergencies treated in hospitals, this is an issue that should be further studied. Our objective was to determine the prevalence and type of injuries in wushu, judo, and karate practitioners in Community of Madrid, Spain.

METHODS

A descriptive epidemiology study was carried out. A questionnaire was used to collect data from 457 men and women practicing karate, judo and/or wushu, including injuries from the past five years, type of injury and occurrence during training or competition.

RESULTS

Injuries that disrupted training occurred in 56% of judokas, in 36.7% of karatekas and in 38.9% of wushu practitioners (WP). For judokas, the most common injury site was "shoulder/arm/elbow" (13.43%), for karatekas, it was "lower leg/foot/ankle" (9.95%), and for WP it was "groin/hip/thigh" (9.45%) (P=0.000). The most common injuries in judo and karate were "ankle sprains and joint injuries" (4.98% and 3.98%), while for WP the most common injury were "hamstring strains" (5.47%) (P=0.008). There was no relationship between occurrence of a first injury and sex, age or belt rank.

CONCLUSIONS

Judo is the martial art with the highest percentage of injuries, followed by wushu and then karate.

Judokas with low back pain have lower flexibility of the hip-spine complex: A case-control study

OBJECTIVE

Study whether male adult judokas with and without low back pain (LBP) have different hip-spine flexibility.

DESIGN

Cross-sectional.

SETTING

Judo training centres.

PARTICIPANTS

Judokas with (n = 29) and without (n = 33) LBP.

MAIN OUTCOME MEASURES

Range of motion (ROM) (passive and active rotations) of hips, lumbar spine (flexion-extension) and fingertip-to-floor distance (FTFD).

RESULTS

The non-dominant hips of judokas with LBP had 6.8 ± 1.2° (ES:1.45, p < 0.001) lower passive and 8.0 ± 1.3° (ES:1.55, p < 0.001) lower active internal rotation. Dominant hips of judokas with LBP had 5.1 ± 1.6° (ES: 0.81, p = 0.002) lower active internal rotation and 8.8 ± 2.9° (ES:0.79, p = 0.003) lower active total rotation. The LBP group showed 8.0 ± 2.8° (ES: 0.73, p = 0.006) lower flexion and 6.0 ± 2.2° (ES: 0.69, p = 0.009) lower extension of the lumbar spine. The FTFD in the LBP group was 7.3 ± 2.6 cm (ES: 0.72, p = 0.007) lower. The multi-level regression analyses showed passive (OR 1.54, 95%CI 1.18-2.00, p = 0.001) and active (OR 1.47, 95%CI 1.16-1.87, p = 0.001) hip internal rotation of the non-dominant leg and lumbar spinal flexion (OR 1.11, 95%CI 1.03-1.20, p = 0.006) and extension (OR 1.16, 95%CI 1.01-1.33, p = 0.035) were related to LBP.

CONCLUSION

Lower hip internal rotation of the non-dominant leg (passive and active) and lower lumbar flexibility are significantly related to LBP in male adult judokas.

Prevalence of low back pain among athletes: A systematic review

BACKGROUND

The prevalence of low back pain (LBP) in athletes across a variety of time frames and sports is not known.

OBJECTIVES

To systematically collate and appraise studies on the prevalence of LBP in athletes and stratify by point, one year and life-time prevalence.

METHODS

A comprehensive search was conducted in February 2016. The following sources were individually searched: PubMed (1950 to present), Ovid SP Medline (1950 to present), ISI (1982 to present) and Google Scholar; Surveys were included if they aimed to report the prevalence of LBP amongst the athletes. Two reviewers independently evaluated the methodological quality of the studies.

RESULTS

The literature search generated 4379 records. Title and/or abstracts were reviewed by two investigators and full-texts of 201 relevant articles were selected for further evaluation. Studies were included if they reported the prevalence of LBP in an athletic population (any level of participation in sports and any age range) and were written in English. Furthermore, to adequately assess the prevalence rate, studies had to report the number of athletes with LBP as a percentage of the total number of athletes. Studies that did not contain necessary data to calculate prevalence rate including case reports and non-original studies were excluded and 41 studies entered the bias assessment step. A bias assessment was applied to the methodology of 41 studies, and 36 with low to moderate risk for bias were included in this review. LBP in athletes was shown to have a point prevalence ranging from 10% to 67%, a one-year prevalence ranging from 17% to 94%, and a life-time prevalence ranging from 33% to 84%. The highest prevalence of LBP was found among skiers, floorball players and rowers and the lowest were found in shooters, golfers and triathletes.

CONCLUSION

Like general population, LBP is quite prevalent among athletes. There is a lack of sound data on the prevalence and mechanism of LBP in some popular sports such as volleyball, swimming and track and field. The lack of standardization of research methods and outcome measurement tools are significant problems in literature. Researchers need to use standard and internationally acceptable definitions for LBP and related functional disability. Investigators are encouraged to conduct epidemiologic studies, along with search for possible mechanism of LBP, by recruitment of large sample population of the athletes who are selected through randomization of the national population and adopt recent recommendations for a standard definition of LBP.

Prevalence of Back Pain in Sports: A Systematic Review of the Literature

Background

Back pain is a frequent health problem in the general population. The epidemiology of back pain in the general population is well researched, but detailed data on the prevalence and risk factors of back pain in athletes are rare.

Objective

The primary objective was to review articles about back pain in athletes to provide an overview of its prevalence in different sports and compare its prevalence among various types of sports and the general population.

Data Sources

A comprehensive search of articles published through May 2015 was conducted. Two independent reviewers searched six databases from inception (PubMed^®, Embase, MEDLINE^®, Cochrane Library, PsycINFO and PSYNDEX), using specifically developed search strategies, for relevant epidemiological research on back pain in 14- to 40-year-old athletes of Olympic disciplines. The reviewers independently evaluated the methodological quality of reviewed articles meeting the inclusion criteria to identify potential sources of bias. Relevant data were extracted from each study.

Results

Forty-three articles were judged to meet the inclusion criteria and were included in the assessment of methodological quality. Of these, 25 were assessed to be of high quality. Lifetime prevalence and point prevalence were the most commonly researched episodes and the lower back was the most common localization of pain. In the high-quality studies, lifetime prevalence of low back pain in athletes was 1–94%, (highest prevalence in rowing and cross-country skiing), and point prevalence of low back pain was 18–65% (lowest prevalence in basketball and highest prevalence in rowing).

Conclusion

The methodological heterogeneity of the included studies showed a wide range of prevalence rates and did not enable a detailed comparison of data among different sports, within one discipline, or versus the general population. Based on the results of this review, however, it seems obvious that back pain requires further study in some sports.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0645-3) contains supplementary material, which is available to authorized users.

Association of COL11A1 4603C/T polymorphism with cervical disc degeneration in collegiate wrestlers

BACKGROUND

The authors previously identified that COL11A1 gene polymorphism is not a susceptibility factor for lumbar disc degeneration (LDD) in athletes. However, the relationship between COL11A1 gene polymorphism and cervical disc degeneration (CDD) remains unclear. We hypothesized that significant associations between COL11A1 4603C/T gene polymorphism and CDD, but not LDD, in collegiate wrestlers exist. This study aims to examine the relationship between CDD, LDD, and COL11A1 4603C/T gene polymorphism in collegiate wrestlers.

METHODS

The subjects enrolled in this study were 92 (Study-1) and 123 (Study-2) Japanese collegiate male wrestlers. Study-1 and Study-2 were conducted in 2010-2012 and 2012-2015, respectively.

RESULTS

CDD and LDD prevalence among the wrestlers was 51.1% (47/92) and 43.9% (54/123), respectively. We found that COL11A1 4603C/T was significantly associated with CDD, but not with LDD. Using logistic regression analysis with concomitant confounding factors, we further confirmed that COL11A1 4603C/T was a significant risk factor for CDD (co-dominant genetic model [CC vs. CT+TT]: adjusted odds ratio [OR] 2.28; 95% CI: 1.13-4.59; dominant genetic model [CC+CT vs. TT]: adjusted OR 11.71; 95% CI: 1.36-101.06).

CONCLUSIONS

Results suggest that COL11A1 4603C/T gene polymorphism is associated with an increased risk of CDD, but not LDD, in Japanese collegiate wrestlers.

Asymmetrical and smaller size of trunk muscles in combat sports athletes with lumbar intervertebral disc degeneration

Background

Lumbar intervertebral disc degeneration (LDD) frequently occurs in athletes. Associations between LDD and trunk muscles still remain unclear.

Purpose

This study examined whether there is an association between the prevalence of LDD and the symmetry and size of the cross-sectional areas (CSAs) of the trunk muscles in combat sports athletes.

Methods

Participants in this study were 151 collegiate male combat sports athletes. A total of 755 lumbar intervertebral discs from L1–2 to L5–S1 in 151 athletes were assessed using magnetic resonance imaging (MRI) and a comprehensive grading system of LDD (grades I–V). All 151 athletes were divided into 2 groups: LDD and non-LDD. CSAs of trunk muscles at the L3–4 disc level were measured using MRI.

Results

Sixty-nine athletes had LDD at 1 or more disc levels (45.7 %). The LDD grade for the lower 2 disc levels was significantly higher than that for the other disc levels (p < 0.001). The CSAs of the left and right sides in trunk muscles were significantly asymmetrical, independent of the LDD which was prevalent in the disc levels (obliques: p = 0.040; quadratus lumborum: p < 0.001). The relative CSAs of trunk muscles to their body weight in the LDD group were significantly smaller than those in the non-LDD group (rectus abdominis: p = 0.011; obliques: p = 0.024; quadratus lumborum: p = 0.006; lumbar erector spinae plus multifidus: p = 0.001).

Conclusion

This study suggests that the prevalence of LDD is associated with asymmetrical and relatively smaller CSAs of trunk muscles in combat sports athletes.

Low back pain status of female university students in relation to different sport activities

PURPOSE

To investigate the prevalence of low back pain (LBP) and its absence rate among female university student athletes in different types of sports.

METHODS

A cross-sectional study based on a standard self-reporting questionnaire was performed among 1335 athletes. Participants were female athletes who attended the National Sports Olympiad of Female University Students in basketball, volleyball, futsal, tennis, badminton, swimming, track and field, shooting, and karate.

RESULTS

One thousand and fifty-nine athletes with the mean (SD) age of 23.1 (3.8) years responded to the questionnaire (response rate 79%). The 12-month prevalence of LBP was 39.0%; in addition, lifetime and point prevalence of LBP were 59.7 and 17.8%, respectively. Basketball (47.9 %) and karate (44.0 %) players had reported the highest 12-month prevalence of LBP. Also, LBP prevalences in shooting (29.7 %) and badminton (42.4 %) players were not negligible. Results show that, LBP led to relatively high absence rate from training sessions (27.9%) and matches (13.0%).

CONCLUSION

While most of the existing literatures regarding female athletes' LBP have focused on particular sports with specific low back demands (such as skiing and rowing), many other sports have not been studied very well in this regard. Investigating LBP prevalence and related factors in other types of sports, such as combat sports, badminton and shooting, can help us better understand the prevalence of low back pain and provide us with necessary insight to take effective steps towards its prevention in athletes.

Cartilage Intermediate Layer Protein and Asporin Polymorphisms Are Independent Risk Factors of Lumbar Disc Degeneration in Male Collegiate Athletes

OBJECTIVE

Lumbar disc degeneration (LDDG), recently reported to have strong genetic determinants, is a major cause of discopathy and lower back pain. However, most studies have only evaluated the effects of a single susceptibility polymorphism. Our purpose was to examine the effect of two susceptibility polymorphism for LDDG in Japanese collegiate athletes.

DESIGN

We investigated two susceptibility genes for LDDG-cartilage intermediate layer protein (CILP) and asporin (ASPN)-in 516 collegiate athletes and genotyped the risk allele of CILP (1184T/C) and ASPN (D14). LDDG was evaluated using T2-weighted magnetic resonance imaging.

RESULTS

By using logistic regression analysis, we found that the ASPN D14 allele and CILP genotype were associated with an increased risk of LDDG in male but not female athletes (CILP CT: odds ratios [OR] = 1.77, 95% confidence interval [CI] = 1.07-2.93; CILP CC: OR = 4.38, 95% CI = 1.42-13.54; ASPN D14: OR = 2.17, 95% CI = 1.10-4.28]. We also found that CILP C and ASPN D14 were independent variables. The ORs with more than two risk alleles were largely increased.

CONCLUSIONS

The CILP and ASPN polymorphisms are independent genetic risk factors for LDDG in male but not female Japanese collegiate athletes.

Anterior Limbus Vertebra and Intervertebral Disk Degeneration in Japanese Collegiate Gymnasts

Background:

Magnetic resonance imaging (MRI) studies have shown that gymnasts have a high prevalence of radiological abnormalities, such as intervertebral disk degeneration (IDD) and anterior limbus vertebra (ALV). These 2 abnormalities may coexist at the same spinal level. However, the relationship between IDD and ALV remains unclear.

Hypothesis:

A significant relationship exists between IDD and ALV in Japanese collegiate gymnasts.

Study Design:

Case-control study.

Methods:

A total of 104 Japanese collegiate gymnasts (70 men and 34 women; age, 19.7 ± 1.0 years) with 11.8 ± 3.6 years of sporting experience participated. T1- and T2-weighted MRIs were used to evaluate ALV and IDD.

Results:

The prevalence among the gymnasts of IDD and ALV was 40.4% (42/104) and 20.2% (21/104), respectively. The prevalence of IDD was significantly higher in gymnasts with ALV than those without ALV, as determined using the chi-square test. Logistic regression analysis demonstrated a significant association between IDD and ALV (adjusted odds ratio [OR], 6.60; 95% confidence interval [CI], 2.14-20.35). IDD was further grouped by whether it was present in the upper lumbar region (L1-2, L2-3, and L3-4 disks) or in the lower lumbar region (L4-5 and L5-S1 disks). Upper IDD had a greater association with ALV (adjusted OR, 33.17; 95% CI, 7.09-155.25) than did lower IDD (adjusted OR, 6.71; 95% CI, 1.57-28.73).

Conclusion:

In Japanese collegiate gymnasts, ALV is a predictor of IDD, especially in the upper lumbar region.

Clinical Relevance:

Information regarding ALV is important to prevent IDD in Japanese collegiate gymnasts.

Comparison of hip rotation range of motion in judo athletes with and without history of low back pain

This study compared hip rotation range of motion in judo athletes with and without a history of low back pain. Forty-two athletes (22 males) were divided into two groups: 21 with history of low back pain (HLBP) and 21 without history of low back pain (Control). Internal and external hip rotation range of motion in active and passive movement were measured using computed photogrammetry. The HLBP group exhibited a significant reduction in active internal rotation (27.5 ± 6.5°vs 38.2 ± 6.5°), active total rotation (80.1 ± 9.5°vs 87.4 ± 7.9°) of the non-dominant limb (P < 0.01) and active total rotation (82.6 ± 7.6°vs 87.6 ± 9.8°; P = 0.04) in comparison with the control group. In passive rotation, the HLBP group showed a significant reduction in internal rotation of the dominant (41.9 ± 6.1°vs 46.1 ± 8.4°; P = 0.04) and non-dominant limb (37.1 ± 8.4°vs 47.3 ± 7.6°; P < 0.001), total rotation of the non-dominant limb (96.7 ± 10.2°vs 105.1 ± 11°; P = 0.005) and total rotation (98.5 ± 9.2°vs 105 ± 11.2°; P = 0.02). Within the HLBP group, a significant reduction in both active and passive internal rotation (P < 0.001) and active and passive total rotation (P < 0.01) of the non-dominant limb was detected. The same was not found in the control group. The results demonstrate that judo athletes with a history of low back pain exhibit deficits in hip rotation and greater asymmetry between limbs.

Cartilage intermediate layer protein gene is associated with lumbar disc degeneration in male, but not female, collegiate athletes

BACKGROUND

The authors previously identified a significant association between lumbar disc degeneration (LDDG) and cartilage intermediate layer protein (CILP) single nucleotide polymorphism (SNP) in collegiate male judokas.

HYPOTHESIS

A significant association between LDDG and the CILP SNP is observed in Japanese collegiate athletes.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

The participants were 601 trained collegiate athletes (male, 403; female, 198) from 7 different sports. Lumbar disc degeneration was evaluated using T2-weighted magnetic resonance imaging. Genotyping of the CILP gene (1184T/C) was performed by using DNA sequencing.

RESULTS

Among the 601 collegiate athletes, the odds ratio (OR) for the occurrence of LDDG with the CILP C allele was 1.4 (95% confidence interval [CI], 1.05-1.86). By using logistic regression analysis concomitant with the interaction term and the Wald test, the authors found that weight (OR, 1.04; 95% CI, 1.02-1.06), CILP genotype (CT: OR, 2.0; 95% CI, 1.24-3.15; CC: OR, 2.9; 95% CI, 1.09-7.74), and gender (OR, 2.1; 95% CI, 1.21-3.67) were significant risk factors for LDDG. These analyses also indicated that there was no effect of the CILP genotype on LDDG in female athletes.

CONCLUSION

The CILP SNP 1184T/C is a risk factor for male collegiate athletes. Information regarding the CILP gene polymorphism may be important for preventing and managing lumbar disc diseases, especially in male athletes.

The use of instability to train the core musculature

Training of the trunk or core muscles for enhanced health, rehabilitation, and athletic performance has received renewed emphasis. Instability resistance exercises have become a popular means of training the core and improving balance. Whether instability resistance training is as, more, or less effective than traditional ground-based resistance training is not fully resolved. The purpose of this review is to address the effectiveness of instability resistance training for athletic, nonathletic, and rehabilitation conditioning. The anatomical core is defined as the axial skeleton and all soft tissues with a proximal attachment on the axial skeleton. Spinal stability is an interaction of passive and active muscle and neural subsystems. Training programs must prepare athletes for a wide variety of postures and external forces, and should include exercises with a destabilizing component. While unstable devices have been shown to be effective in decreasing the incidence of low back pain and increasing the sensory efficiency of soft tissues, they are not recommended as the primary exercises for hypertrophy, absolute strength, or power, especially in trained athletes. For athletes, ground-based free-weight exercises with moderate levels of instability should form the foundation of exercises to train the core musculature. Instability resistance exercises can play an important role in periodization and rehabilitation, and as alternative exercises for the recreationally active individual with less interest or access to ground-based free-weight exercises. Based on the relatively high proportion of type I fibers, the core musculature might respond well to multiple sets with high repetitions (e.g., >15 per set); however, a particular sport may necessitate fewer repetitions.