BokSmart: Preventive rehabilitation for rugby injuries to the lower back and core

Abstract

Background. The low back is an integral part of the entire movement chain as it functions as part of a complex network of the skeletal, muscular and nervous system. Eighty to 90% of acute low back pain episodes dissipate within 8 -12 weeks regardless of any intervention, but 5 -10% regress into chronic low back pain. As a result of its undistinguished aetiology, the treatment for low back pain remains controversial. Treatment options for low back pain include the following: analgesics, muscle relaxants, antidepressants, nonsteroidal anti-inflammatory drugs, epidural steroid injections, manipulation, back schools, electromyographic biofeedback, traction, orthoses, behaviour therapy, transcutaneous electrical nerve stimulation, acupuncture, and exercise therapy.Results. Therapeutic exercises for low back pain have been shown in 6 different randomised controlled trials to be beneficial in reducing pain by up to 60% and improving functional ability by up to 47%. Furthermore, a Cochrane review on low back pain found strong evidence that exercise therapy is an effective intervention in the treatment of low back pain. When prescribing exercises for an individual with low back pain the following goals need to be considered: (i) improve performance in endurance activities; (ii) improve muscular strength around the spine; (iii) eliminate any impairments in spinal flexibility; (iv) reduce the intensity of the pain being experienced by the individual; and (v) reduce back pain-related disability. A rugby player will have increased core stability/strength and a reduced risk of injury if the internal support mechanisms of the spine have been conditioned to resist distortion or injury from external forces. Not only will improved core