Low back pain incidence in New Zealand rowers and its relationship with functional movement patterns
Newlands, Craig Morgan
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Introduction: Low back pain (LBP) is frequently reported as the most common injury affecting rowers, accounting for 15-40% of all rowing injuries. It is generally believed and promoted within the sports medicine community that screening functional movement patterns is important as an injury prevention strategy and performance strategy. The Movement Competency Screen (MCS) is a tool that consists of five functional movement patterns. It has been shown to be reliable in uninjured subjects but has not been used in injured populations or linked to the injury prevalence and incidence of sporting populations. Purpose: To investigate the incidence of LBP among New Zealand rowers and its relationship with the type and volume of training undertaken, as well as studying the effect LBP has on rowers’ ability to train and compete. A secondary aspect of the study was to investigate the relationship between functional movement patterns as assessed by the MCS and the LBP injury data. Methods: New Zealand representative rowers, 46 males (mean age 22 years, SD 4) and 30 females (mean age 21 years, SD 4) undertook a longitudinal prospective cohort study using a self-reported on-line questionnaire, repeated monthly over a full year, therefore including off-season as well as training and competition phases. The MCS was undertaken at the beginning of the study. Results: 817 (90%) questionnaires were completed, 59 (78%) subjects completed all twelve questionnaires. Injury incidence rate equaled 1.68 per 1000 exposure hours. The cumulative incidence was 95% with 72 new LBP episodes reported. Fifty two percent of subjects experienced at least one new episode of LBP. The point prevalence of LBP was 13.7%. Of these injuries, 45% were incidental, 29% were minor, 18% were moderate and 9% were severe. There was a significantly positive high correlation between new LBP and total training hours per month (r=0.83, p=0.001). A previous history of LBP was found to be the most significant risk factor in developing new LBP (OR 2.03, p=0.01). Age of the subjects was also a risk factor with the likelihood of developing a new low back injury increasing for every year in age (OR 1.07, p=0.04). Subjects who had an MCS score of 16 or more out of 21 were more likely to develop LBP than those with a score of 15 or less out of 21; however this was not a statistically significant finding (OR 1.58, p=0.08). Conclusion: LBP is a common injury among New Zealand representative rowers. There is a strong relationship between training load and the development of LBP. Previous history of injury and subject age are the strongest indicators of risk of LBP. The MCS screening results imply that those subjects who had a better MCS score, and therefore moved better, were more at risk of LBP. Further research is warranted to assess the ability of the MCS to determine risk of any injury in other sports.