- Title
- The aetiology of low back pain in elite hiking class sailors
- Creator
- Schultz, Adrian
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2017
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Introduction: Low back pain (LBP) is the most commonly reported injury in Olympic class sailing. In Laser Radial, Laser, Finn and 470 class sailors, LBP may be due to repetitive sustained hiking, when the sailor leans out over the water to counter-balance the heeling force exerted by the wind. Despite the propensity for LBP in sailors, there is limited published research regarding the nature of this injury. Therefore, the primary aim of this thesis was to determine the prevalence and key factors associated with LBP in elite Olympic class sailors. Participants were recruited from the current Australian Sailing Team and Australian Sailing Squad, and included the entire population eligible for inclusion in this research. Additionally, a member of the Singapore Sailing Team was recruited for Study 4. Four studies were conducted, and are reported in separate manuscripts. Study 1: This study examined the point prevalence of LBP and the value of current musculoskeletal screening protocols to determine risk of seasonal injury. Twenty-two athletes aged 22 ± 3.7 years (mean ± SD) participated in the research, comprising 15 male (68%) and 7 female (32%) participants. Pre-season musculoskeletal screening and 12-month seasonal injury data were analysed for predictive relationships. The results revealed that injury to the lumbar spine was the most commonly reported injury, and the second most common injury resulting in disability (modified or lost participation). Only left-sided single-leg decline squat performance was associated with injury status, while increasing age was significantly associated with thoracic and lumbar spine injury. Current screening protocols did not adequately assess the risk of seasonal injury. Due to the increased risk of spinal injury and disability in older sailors, injury prevention activities should be individualised and age appropriate. Study 2: This study investigated the association between MRI-detected abnormalities of the lumbar spine region and LBP status in elite Olympic class sailors. Fifteen athletes aged 22.2 ± 2.7 years were recruited for this study, and comprised 11 male (73%) and 4 female (27%) participants. Pathoanatomical findings were identified in 80% of the study cohort, with current LBP reported by 53% of participants. Facet joint arthropathy were the most common finding, followed by intervertebral disc defects. Estimated attributable risk of LBP in participants with bilateral facet joint arthropathy was 100%. All athletes reported unrestricted participation in training and competition. Although lumbar spine abnormalities are common in high-performing Olympic class sailors, MRI-detectable abnormalities associate poorly with LBP status. However, bilateral facet joint abnormalities at one or more levels may contribute to current LBP. Study 3: This study investigated spinal posture using wearable sensor technology and muscle size, symmetry and spatial activation patterns of lumbar trunk musculature using mfMRI, following a sustained hiking condition. Fifteen athletes aged 22.2 ± 2.7 years were recruited for this study, and comprised 11 male (73%) and 4 female (27%) participants. At the time of scanning 53% of participants reported current LBP. LBP status accounted for: 1) baseline posture differences (covariates age/gender); 2) differences in erector spinae and total combined muscle size; 3) mean hiking performance relative to body mass and mean lateral and peak left-lateral lumbar flexion during sustained maximal hiking; and 4) activation differences for right multifidus, absolute activation asymmetry for quadratus lumborum and multifidus, relative activation asymmetry for multifidus and total muscle activation (covariates sailing class/height/weight) following sustained maximal hiking. Olympic class sailors with current LBP demonstrate significant muscle activation asymmetries, altered muscle metabolism and posture changes that may have long-term implications for spinal health and LBP prevalence in this population. Study 4: This study investigated the inter-relationships between isometric muscle strength and segmental spine motion during hiking and risk of seasonal low back pain. Ten athletes aged 23.5 ± 3.6 years were recruited for this study, and comprised 8 male (80%) and 2 female (20%) participants. Participants completed screening for current LBP and underwent strength assessment and subsequent biomechanical analysis of hiking performance for three hiking conditions. Hiking performance, at increasing relative intensity, was primarily a function of the athlete’s anthropometry and absolute isometric muscle strength, followed by measures of relative isometric strength and spinal, pelvis and hip joint motion. Hip flexion and trunk extension strength were significantly related to injury status, but did not predict risk of seasonal LBP. Biomechanical assessment of hiking performance has poor predictive value in determining the risk of seasonal LBP, but may be associated with current LBP. Conclusion: Collectively, this thesis reveals a high prevalence of LBP in elite Olympic class sailors and provides important information regarding the aetiology of this type of injury that will help to inform the development of injury prevention strategies in this population. As a result of this research, the Australian Sailing Team became early adoptors of the national Athlete Monitoring System recently implemented by the Australian Institute of Sport, revised and refined current injury screening protocols, contextualised the value of imaging in managing athletes with LBP and gained a deeper understanding of the value of strength development and postural control in hiking performance of Olympic class sailors.
- Subject
- sports injury; low back pain; sailing; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1343113
- Identifier
- uon:29096
- Rights
- Copyright 2017 Adrian Schultz
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 22 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 592 KB | Adobe Acrobat PDF | View Details Download |