The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players

Abstract

Background: The lumbar multifidus muscle (LMM) plays a critical role to stabilize the spine. While low back pain (LBP) is a common complaint in soccer players, few studies have examined LMM characteristics in this athletic population and their possible associations with LBP and lower limb injury. Therefore, the purpose of this study was to 1) investigate LMM characteristics in university soccer players and their potential association with LBP and lower limb injury; 2) examine the relationship between LMM characteristics and body composition measurements; and 3) examine seasonal changes in LMM characteristics. Methods: LMM ultrasound assessments were acquired in 27 soccer players (12 females, 15 males) from Concordia University during the preseason and assessments were repeated in 18 players at the end of the season. LMM crosssectional area (CSA), echo-intensity and thickness at rest and during contraction (e.g. function) were assessed bilaterally in prone and standing positions, at the L5-S1 spinal level. A self-reported questionnaire was used to assess the history of LBP and lower limb injury. Dual-energy x-ray absorptiometry (DEXA) was used to acquire body composition measurements. Results: Side-to-side asymmetry of the LMM was significantly greater in males (p = 0.02). LMM thickness when contracted in the prone position (p = 0.04) and LMM CSA in standing (p = 0.02) were also significantly greater on the left side in male players. The LMM % thickness change during contraction in the prone position was significantly greater in players who reported having LBP in the previous 3-months (p < 0.001). LMM CSA (r = − 0.41, p = 0.01) and echo-intensity (r = 0.69, p < 0.001) were positively correlated to total % body fat. There was a small decrease in LMM thickness at rest in the prone position over the course of the season (p = 0.03). Conclusions: The greater LMM contraction in players with LBP may be a maladaptive strategy to splint and project the spine. LMM morphology measurements were correlated to body composition. The results provide new insights with regards to LMM morphology and activation in soccer players and their associations with injury and body composition measurements.

Investigation of the Relationship Between Sagittal Curvature and Lumbar Extensor Muscle Volume in Patients with Lower Back Pain

“…When volumes of the muscles in the lower lumbar region were examined; the mean right PSOAS muscle volume was found as 885.9 ± 358.7 mm 3 , while the mean left PSOAS muscle volume was found as 890.9 ± 346.1 mm 3 . No statistically signi cant difference was found between the PSOAS angles in both sides (p = 0.790).…”

“…Deterioration of muscle composition may cause the occurrence of prolonged lower back pain and its recurrence (3). Extensor muscles of the lumbar spine are found posterior to the vertebral bodies, and play a critical role in the control of movements and providing mechanical balance (4).…”

Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training

“…Out of the 21 selected studies, fourteen studies (66.7%) [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ] were aimed at investigating the relationship between LBP and the morphology of the lumbar multifidus muscle (LMM), strength, and strength endurance of core muscles in different sports. The remaining seven studies (33.3%) [ 44 , 45 , 46 , 47 , 48 , 49 , 50 ] investigated the effect of different core training programs on the prevention or reduction of LBP in various sports.…”

LUMINOUS database: lumbar multifidus muscle segmentation from ultrasound images

“…The 109 athletes underwent a US procedure to obtain LM images at the L5 level in both the prone and standing positions. The LOGIQ e ultrasound machine (GE Healthcare, Milwaukee, WI) was used with a curvilinear probe with its imaging parameters maintained at the following values for all image acquisitions: frequency: 5 MHz, gain: 60, depth: 8.0 cm [ 39 ]. Only the LM muscle was assessed, as it is the most commonly examined muscle amongst the paraspinal muscle group using US and is the most sensitive to spinal pathology.…”

“…For subjects with larger muscles, the right and left sides were imaged unilaterally. Similarly, LM CSA measurements were obtained in the standing position, where subjects stood in their habitual standing posture [ 39 ]. The images were stored as separate datasets for each subject in *.tif format.…”