Influences of limited flexibility of the lower extremities and occurrence of low back pain in adolescent baseball players: A prospective cohort study |
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| Institution: | 1. Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, Japan;2. Department of Sports Medicine, Fukushima Medical University School of Medicine, Koriyama City, Japan;1. Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan;2. Department of Orthopaedic Surgery, Kenpoku Medical Center Takahagi Kyodo Hospital, 1006-9 Agehocho, Kamitetsuna, Takahagi, Ibaraki, 3180004, Japan;1. Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan;2. Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University School of Medicine, 1-12-1, Fukumuro, Miyagino-ku, Sendai, 983-8512, Japan;1. Weill Cornell Medical College, New York, New York, U.S.A.;2. Sports Medicine Institute Hospital for Special Surgery, New York, New York, U.S.A.;3. Cornell University College of Engineering, Ithaca, New York, U.S.A.;4. George Washington University School of Medicine, Washington, DC, U.S.A;1. Hokkaido Orthopedic Memorial Hospital, Sapporo, Japan;2. Department of Orthopedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan;3. Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama, Japan;1. Department of Orthopedic Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan;2. Department of Hand Surgery, Nara Medical University, Kashihara, Nara, 634-8522, Japan;3. Department of Tamai Susumu Memorial Limb Trauma Center, Nara Medical University, Kashihara, Nara, 634-8522, Japan |
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| Abstract: | BackgroundLimited flexibility of the lower extremities, such as hamstring tightness, has long been suggested as a physical risk factor for low back pain among adolescent athletes. However, few prospective cohort studies have examined the direction of causality for this relationship. This prospective cohort study investigated the relationship between limited flexibility of the lower extremities and the occurrence of low back pain among high school baseball players.MethodsParticipants comprised 335 high school baseball players from 43 high school baseball teams who had undergone baseline medical evaluations (a self-completed questionnaire and physical examination). Occurrence of low back pain during a 1-year follow up, and associations with measurements of flexibility of the lower extremities such as straight-leg-raising angle (hamstring tightness), Thomas test (iliopsoas tightness), heel-buttock-distance (quadriceps tightness), and passive range of motion of the hip were investigated.ResultsIn total, 296 players (88.4%) participated in the 1-year follow-up survey, with 147 of the 296 players (49.7%) reporting the occurrence of low back pain during follow-up. The number of players with low back pain during follow-up peaked in November, then decreased and was lowest in June. After adjusting for factors associated with low back pain using logistic regression modeling, a significant association between hamstring tightness on the non-throwing arm side and low back pain (odds ratio 2.86, 95% confidence interval 1.17–6.94; P = 0.018) was found.ConclusionsHamstring tightness on the non-throwing arm side was identified as a potential risk factor for low back pain in high school baseball players. These results may provide guidance in the development of future prevention programs. |
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