Context: Previous research has analyzed how the sport influences sagittal spinal curvatures in young athletes and has found that spinal curves may be modified as a consequence of repeated movement patterns and postures of each discipline. Objective: To analyze sagittal spinal alignment by equestrian discipline and its relation to training load, and to describe “sagittal integrative morphotype” in young riders. Design: Observational descriptive study. Setting: Training room. Participants: A total of 23 riders (aged 9–17 y)—13 dressage riders (3 males and 10 females) and 10 show jumping riders (5 males and 5 females)—participated voluntarily. Main Outcome Measures: Mann–Whitney U test was applied to determine differences between riders’ characteristics (gender, discipline, and training load) and spine variables. Results: According to normality ranges for spinal curves, females showed an increase for lumbar curvature in standing position. It was found that show jumping riders manifested an increment in thoracic and lumbar curves while standing and an increase in the thoracic curvature in slump sitting. Statistically significant differences were found when lumbar curvature, “sit and reach” distance, and lumbo-horizontal angle in flexion were analyzed by gender in “sit and reach” test. No statistical significant differences were found when spinal curves in each position were analyzed depending on the training load. With regard to “sagittal integrative morphotype,” all riders presented a hyperkyphotic dorsal morphotype no matter what their discipline. As for the lumbar curve, dressage and show jumping riders presented a functional hyperkyphotic morphotype. Conclusions: It is important to note that many riders presented a sagittal imbalance for the thoracic and lumbar curves. Therefore, as the sagittal spinal misalignments persist and worsen over time, exercise programs to prevent or rehabilitate these imbalances in young riders will be needed. The “sagittal integrative morphotype” assessment is an essential tool in order to identify the spinal misalignment.

Background: Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women.Objective: The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football.Methods: A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sport discus and the Cochrane Library databases. Twenty-one studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model. Results:The overall incidence of injuries in female football players was 6.1 injuries/1000 hours of exposure.Match injury incidence (19.2 injuries/1000 hours of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000 hours of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000 hours of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000 hours of exposure) and joint (non-bone) and ligament (1.5 injuries/1000 hours of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1-3 days of time loss) were the most common. The incidence rate of injuries during matches in the top 5 world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000 hours of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6-1.7) whereby on average players sustained more than one injury per season. Conclusions:Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. In order to markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics in order to make football players more capable of responding to the challenges that they have to deal with during match play.Registration: This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152). Key pointsa) Match injury incidence is almost 6 times higher than the training injury incidence rate.-I b) Lower extremity is the anatomical region more frequently injured and the most common types of injuries are muscle/ tendon strains and joint (non-bone) and ligament. c) Although slight/minimal injuries are the most common, the number of severe injuries is high. d) Match injury incidence rates in the top-5 world ranking leagues was nearly t...

Background Physiological sagittal spinal curvatures play an important role in health and performance in sports. For that reason, several scientific studies have assessed spinal morphology in young athletes. However, to our knowledge, no study has assessed the implications of Inline Hockey (IH) practice on sagittal integrative spinal morphotype in adolescent players. Objectives The aims of the present study were to describe habitual sagittal spinal posture in young federated IH players and its relationship with training load and to determine the sagittal integrative spinal morphotype in these players. Methods An observational analysis was developed to describe the sagittal spinal morphotype in young federated IH players. A total of 74 IH players from the Technification Plan organized by the Skating Federation of the Valencian Community (aged from 8 to 15 years) participated in the study. Thoracic and lumbar curvatures of the spine were measured in a relaxed standing position (SP), in a slump sitting position (SSP) and in maximum flexion of the trunk (MFT) to determine the “Sagittal Integrative Morphotype” of all players. An unilevel inclinometer was used to quantify the sagittal spinal curvatures. The Hip Joint Angle test was used to quantify the Lumbo-Horizontal angle in flexion (L-H fx) of all participants with a goniometer. Results When thoracic curvature was analyzed according to normality references, it was found that 64.9% of IH players had thoracic hyperkyphosis in a SSP, while 60.8% and 74.3% of players were classified as normal in a SP and in MFT, respectively. As for the lumbar curve, 89.2% in a SP and 55.4% in MFT were normal, whereas 68.9% of IH players presented lumbar hyperkyphosis in a SSP. Regarding the “Sagittal Integrative Morphotype,” only 17.6% of players were classified as “Normal” in the three measured positions for the thoracic curve, while 37.8% had “Thoracic Hyperkyphosis” and 41.8% presented “Functional Thoracic Hyperkyphosis.” As for the “Sagittal Integrative Lumbar Morphotype,” only 23% of athletes had a normal curve in the three positions, whereas 66.2% presented “Functional Lumbar Hyperkyphosis.” When the L-H fx was evaluated, the results showed that only 16.2% of the athletes were classified as normal. Conclusions Federative IH practice seems to cause specific adaptations in spinal sagittal morphotype. Taking into account the “Sagittal Integrative Morphotype” only 17.6% IH players presented “Normal Morphotype” with a normal thoracic kyphosis in the three measured positions, while only 23% IH players presented “Normal Morphotype” with a normal lumbar curvature in the three assessed positions. Furthermore, only 16.2% of IH players showed normal pelvic tilt. Exercise programs to prevent or rehabilitate these imbalances in young IH players are needed.

The sagittal spinal morphology presents 4 physiological curvatures that increase endurance to axial compression forces and allow adequate postural balance. These curves must remain within normal ranges to achieve a static and dynamic balance, a correct functioning of the muscles and an adequate distribution of the loads, and thus minimize the injury risk. The purpose of this study was to categorize the sagittal spinal alignment according to the different morphotypes obtained for each curve in standing, slump sitting, and trunk forward bending positions in schoolchildren. It was a cross-sectional study. Sagittal spinal curvatures were assessed in 731 students from 16 elementary schools. In the sagittal standing position assessment, 70.45% and 89.06% of schoolchildren presented a “normal” morphotype for both dorsal and lumbar curves, respectively. After the application of the “Sagittal Integral Morphotype” protocol according to the morphotypes obtained in the three positions assessment (standing, slump sitting, and trunk forward bending), it was observed how the frequency of normal morphotypes for the dorsal and lumbar curve decreased considerably (only 32% and 6.6% of children obtained a “normal sagittal integral morphotype” for the thoracic and lumbar curvatures, respectively). These results show how it is necessary to include the slump sitting and trunk forward bending assessment as part of the protocol to define the “integral” sagittal alignment of the spine and establish a correct diagnosis. The use of the diagnostic classification presented in this study will allow early detection of misalignment not identified with the assessment of standing position.

To explore sagittal spinal alignment and pelvic disposition of schoolchildren in a slump sitting position is needed in order to establish preventive educational postural programs. The purposes of this study were to describe sagittal spinal alignment and pelvic tilt (LSA) in a slump sitting position and to explore the association of sagittal spine and pelvic tilt with back pain (BP) among 8-12-year-old children. It was a cross-sectional study. Sagittal spinal curvatures, BP and pelvic tilt were assessed in 582 students from 14 elementary schools. It was found that 53.44% of children had slight thoracic hyperkyphosis and that 48.80% presented moderate lumbar hyperkyphosis and 38.66% presented slight lumbar hyperkyphosis. Those who did not suffer from BP in any part of the back had a higher lumbar kyphosis (24.64 ± 7.84) or a greater LSA (107.27 ± 5.38) than children who had some type of BP in the previous year or week (lumbar kyphosis: 23.08 ± 8.06; LSA: 105.52 ± 6.00), although with no clinically relevant differences. In fact, neither sufferers nor those who did not have BP presented normal mean values for lumbar kyphosis or LSA according to normality references. This study demonstrates the need to assess sagittal morphotype in childhood since schoolchildren remain incorrectly seated for many hours and it greatly affects their spinal curvatures.

Knowledge on back care is important to prevent back problems. The purpose of this study was to a) describe back pain and knowledge on back care related to physical activity in adolescents and b) determine the association between these two factors. This was a cross-sectional study. A total of 276 students (aged from 12 to 17 years old), from three Spanish public secondary schools, had to complete a survey about back pain and another one about their knowledge on back care related to physical activity. The results showed a mean score of 2.54 ± 1.85 (out of 10), and 90.58% of students failed the knowledge test. Those who suffered from back pain in the week before scored higher (2.91 ± 1.66) than non-sufferers (2.42 ± 1.90), with statistically significant differences (Z = −2.109; p = 0.035; r = 0.127), although with no academically relevant differences. Finally, despite the relationship between a higher mean score in the knowledge test and back pain within the previous week, it has been found that there was not a significant association because most of the students got very low scores in the knowledge test. It also shows an important lack of knowledge about physical activity for back care in adolescents.

BACKGROUND: The child’s spine shows changes in posture and balance of its curvatures during growth and musculoskeletal spinal conditions are likely to develop, such as back pain (BP). OBJECTIVE: The purposes of this study were (a) to describe the sagittal spinal alignment in a relaxed standing position and (b) to analyze its association with BP among 8 to 12-year-old children. METHODS: This was a cross-sectional study. A total of 731 elementary schoolchildren (379 girls and 352 boys), from 16 Spanish schools, participated. An unilevel inclinometer was used to quantify the sagittal spinal curvatures (thoracic and lumbar) in a relaxed standing position. Sagittal spinal morphotype was analyzed by sex, age, weight, height, and BMI. Children’s parents or legal guardians filled in a questionnaire according to the children’s responses about the BP suffered in the previous week and the preceding year. RESULTS: The mean angular value of thoracic kyphosis was 36.08 ± 8.99∘ and significantly higher in males than in females (p= 0.036). In contrast, the mean value of lumbar lordosis was 32.11 ± 7.46∘, being higher in females than in men (p< 0.01). The thoracic curve tends to increase by age (p= 0.003). Children who had low back pain (LBP) in the previous week had a significantly greater lumbar curve (35.88 ± 8.20∘) than those who did not have LBP in the preceding week (32.24 ± 7.30∘). The angle for lumbar curvature was a small predictor of LBP occurrence in the assessed children (OR = 1.082 [small]; 95% CI = 1.009–1.160, p= 0.028). CONCLUSIONS: To conclude, almost 3/4 of the students were classified with normal thoracic kyphosis; however, 27.36% of the students had thoracic hyperkyphosis. Lumbar hyperlordosis was identified in 9.05% of the students, and was 2.5 times more frequent in girls. The lumbar curvature was a small predictor of LBP occurrence in the assessed children and the angle of lumbar curvature that most accurately identified individuals at risk of developing LBP was determined to be 33∘. The results of this study indicate the need to assess sagittal spinal curvatures at school during development ages.

and Sainz de Baranda, Pilar (2021) Reliability of five trunk flexion and extension endurance field-based tests in high school-aged adolescents: ISQUIOS Programme. Journal of Sports Sciences, 39 (16). pp. 1860-1872.