Asymmetry and Tightness of Lower Limb Muscles in Equestrian Athletes: Are They Predictors for Back Pain?

Abstract

Athletes may suffer from low back pain (LBP). Some studies have considered restricted range of motion (ROM) as a risk factor for LBP in athletes; however, ROM has not been evaluated in equestrian athletes (EAs) with LBP. The aims of this research in EAs were (I) to analyze the relationship between lower limb ROM (tightness and asymmetry) and LBP and (II) to determine the reference values for lower limb ROM indicating high risk of LBP. Forty-three young (9–18 years old) EAs were voluntarily recruited in technical training camps. The EAs were assessed for 11 passive lower limb ROMs using the ROM-SPORT I Battery. LBP data were taken at the end of a 1-year period through a questionnaire. Binary logistic regression and receiver operating characteristic curves were calculated. Sixty-seven percent of EA had suffered LBP. Hip adduction (OR = 1.347, medium; p = 0.015) and knee flexion (OR = 1.109, small; p = 0.023) were predictors of LBP in EAs. A hip adduction of 26° and knee flexion of 128° were found to be the optimal cutoff values for predictive screening of EAs at high risk of LBP.

Assessment of the Range of Movement of the Lower Limb in Sport: Advantages of the ROM-SPORT I Battery

“…The main movements of the lower limb are hip extension, hip adduction with the hip flexed 90 • , hip flexion with the knee flexed and extended, hip abduction with the hip neutral and hip flexed 90 • , hip external and internal rotation, knee flexion, ankle dorsiflexion with the knee flexed and extended ROMs. These movements have usually been selected in the scientific literature because limited ROM, induced by muscle tightness, increases the sports injury risk [24,83] and decreases athletic physical-technical performance [3,36,38]. In addition, the measurement results of each of these ROMs in ascending order determines the lower, limb flexibility profile in the sport and is based on the specificity of this component of physical fitness to a given sport [7,17,42,45,49,83].…”

“…Several assessment sessions required depends directly on the type of study. Generally, scientific studies perform only one evaluation session; specifically, studies to determine the lower-limb flexibility profile [7,42,45,49,91,92] or to associate/predict athletic physical-technical performance [3,37,39,93] and risk of injury [11,12,24,83,94]. The validity and absolute reliability of scientific studies involved 2-4 assessment sessions to determine the relative or absolute reliability of an assessment battery test [58].…”

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

“…Therefore, prevention of LBP in competitive soccer and basketball players is important to health and sport professionals. Based on assumptions, 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] and lumbar hypolordosis or hypokyphosis-posterior convexity-in trunk forward flexion [22] positions have been associated with LBP.…”

Lower Extremity Flexibility Profile in Basketball Players: Gender Differences and Injury Risk Identification

“…In addition, flexibility has been shown to depend on age [15,16], gender [14,17], lateral dominance due to muscle asymmetry [18,19], player position [20,21], and tier of competition [16,22]. It has been observed that an athlete who has specific ROM values for each technical movement of the sport has an optimal ROM that allows him to improve his physical and technical performance [23,24]. Several studies have observed that physical and technical performance in sports (sprinting, jumping, agility, kicking, balance) decreases when the technical movement is limited by muscle tightness [25,26] or nonoptimal ROM [24].…”

“…Previously published studies have determined the lower extremity flexibility profile by applying the ROM-SPORT battery to handball [30], soccer [15,31], futsal [17,32], and inline hockey players [18,29]. In addition, the ROM-SPORT battery predicted the risk of low back pain using the hip flexion test with the knee extended in basketball and soccer players [33], the external and internal rotation test in inline hockey players [34] and hip adduction and knee flexion in equestrian athletes [23].…”