Low Back Pain in Athletes

Mortazavi, Seyed Mohammad Javad; Zebardast, Jayran; Mirzashahi, Babak

doi:10.5812/asjsm.6(2)2015.24718

Cited by 54 publications

(53 citation statements)

References 98 publications

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“…Large complex loads have been shown to cause tissue remodeling and increase the risk of micro‐damage and failure . Moreover, there is a higher prevalence of lower back pain in people that experience large daily loads with rotation, including factory workers, athletes, and military service personnel . While extensive research has been performed to understand changes in compressive mechanics with degeneration, there have been few studies investigating disc torsion mechanics with degeneration.…”

mentioning

confidence: 99%

Contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics

Bezci

Eleswarapu

Klineberg

et al. 2018

Journal Orthopaedic Research

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Stresses applied to the spinal column are distributed between the intervertebral disc and facet joints. Structural and compositional changes alter stress distributions within the disc and between the disc and facet joints. These changes influence the mechanical properties of the disc joint, including its stiffness, range of motion, and energy absorption under quasi-static and dynamic loads. There have been few studies evaluating the role of facet joints in torsion. Furthermore, the relationship between biochemical composition and torsion mechanics is not well understood. Therefore, the first objective of this study was to investigate the role of facet joints in torsion mechanics of healthy and degenerated human lumbar discs under a wide range of compressive preloads. To achieve this, each disc was tested under four different compressive preloads (300-1200 N) with and without facet joints. The second objective was to develop a quantitative structure-function relationship between tissue composition and torsion mechanics. Facet joints have a significant contribution to disc torsional stiffness (∼60%) and viscoelasticity, regardless of the magnitude of axial compression. The findings from this study demonstrate that annulus fibrosus GAG content plays an important role in disc torsion mechanics. A decrease in GAG content with degeneration reduced torsion mechanics by more than an order of magnitude, while collagen content did not significantly influence disc torsion mechanics. The biochemical-mechanical and compression-torsion relationships reported in this study allow for better comparison between studies that use discs of varying levels of degeneration or testing protocols and provide important design criteria for biological repair strategies. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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mentioning

confidence: 99%

Contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics

Bezci

Eleswarapu

Klineberg

et al. 2018

Journal Orthopaedic Research

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“…45 The literature reviews included in the present study reported that not very many acupuncture clinical trials and literature reviews with adequate designs are available, and that it is difficult to obtain high quality evidence through the articles published. [28][29][30][31][32][33] The two Dimitrios revisions, with their non-formatted design, did not clearly describe which studies were included, how many publications were analyzed, or how many patients were included the sum of these publications. 28,29 Cochrane literature reviews have shown that acupuncture therapy is an effective treatment for fibromyalgia, neck pain and chronic low back pain [40][41][42] , but reviews of the same platform have not found significant evidence or have not obtained sufficient information to conclude how effective its use really is in the treatment of osteoarthritis, shoulder pain and elbow pain [49][50][51] .…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that the level of evidence for the use of acupuncture to treat low back pain in athletes is C (consensus, small studies, usual practice, expert opinion or reports and case series -uncontrolled clinical studies). 30 Dong et al have published a meta-analysis of 33 studies on various treatments for shoulder impact syndrome, concluding that exercise and other exercise-based therapies are the most important treatment options for this syndrome. The meta-analysis also concluded that in the early stages, exercise combined with other therapies is recommended as a non-surgical treatment, especially acupuncture and kinesiotaping (with statistical relevance).…”

Section: Literature Reviewmentioning

confidence: 99%

Treatment of Sport Injuries With Acupuncture: A Literature Review

Gentil¹

2018

Rev Bras Med Esporte

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As acupuncture is growing in popularity in Brazil and worldwide, it is necessary to study the benefits and possibilities of this type of treatment more in depth, especially as it is believed to produce fast results with few side effects and does not involve substances banned in sports. Thus, it seems like a good option to be considered as main or adjuvant therapy in sports-related injuries. In order to gain more knowledge about this subject, this article is an integrative review analyzing the publications of the period between January 2012 and January 2017 on the Cochrane and Pubmed platforms that analyzed acupuncture in the treatment of sports injuries. We found 49 articles, 11 of which fulfilled the inclusion criteria: two case reports, three clinical trials and six literature reviews. Although all the articles analyzed produced favorable results with the use of the therapeutic technique in question, flaws in the designs of the studies and the difficulty of creating a placebo control group in acupuncture hinder the qualification of the articles on evidence rating scales. Therefore, it is suggested to the researchers that further studies be published with experimental animal models and observational studies, and that STRICTA recommendations be followed to improve the level of evidence of acupuncture research. Level of Evidence II; Systematic review of level II studies. RESUMOCom a popularização da prática de acupuntura no Brasil e no mundo, faz-se necessário estudar mais profundamente os benefícios e as possibilidades dessa modalidade de tratamento, especialmente porque a mesma é considerada rápida, com poucos efeitos colaterais e isenta de substâncias ilegais na prática esportiva. Dessa forma, parece uma boa opção a ser considerada como tratamento principal ou adjuvante em lesões relacionadas ao esporte. Com o objetivo de ampliar os conhecimentos acerca desse assunto, o presente artigo é uma revisão integrativa, que analisa as publicações no período entre janeiro 2012 e janeiro de 2017, nas plataformas Cochrane e Pubmed, que analisaram acupuntura no tratamento das lesões esportivas. Foram encontrados 49 artigos, 11 dentre eles preencheram os critérios de inclusão: dois relatos de caso, três ensaios clínicos e seis revisões de literatura. Embora todos os artigos analisados tenham apresentado resultados favoráveis com o uso da técnica terapêutica em questão, falhas nos desenhos dos estudos e a dificuldade de criar um grupo controle placebo em acupuntura prejudicam a qualificação dos artigos em escalas de nível de evidência. Por isso, sugere-se aos pesquisadores que sejam publicados mais estudos com modelos experimentais em animais e estudos observacionais, assim como que sejam seguidas as recomendações STRICTA, para melhorar o nível de evidência das pesquisas em acupuntura. Nível de Evidência; II Revisão sistemática de estudos de nível II.Descritores: Acupuntura; Terapia por acupuntura; Traumatismos em atletas; Medicina esportiva. RESUMENCon la popularización de la práctica de la acupuntura en Brasil y en el mund...

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“…Low back pain is extremely common, with at any point in time, approximately 12% of the global population suffering from significant levels of pain 1. Within the sporting population, low back pain is one of the more common musculoskeletal conditions affecting athletes 2. In a review of national and international guidelines, for the management of non-specific back pain in primary care, 12 out of 15 guidelines included manipulation as a recommendation for the management of non-specific low back pain 3.…”

Section: Introductionmentioning

confidence: 99%

Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial

McCarthy

Potter

Oldham

2019

BMJ Open Sport Exerc Med

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BackgroundSpinal manipulation is commonly used to treat back pain. The application of spinal manipulation has traditionally involved an element of targeting the technique to a level of the spine where the proposed movement dysfunction is sited. We evaluated the effects of a targeted manipulative thrust versus a thrust applied generally to the lumbar region.MethodsA randomised controlled clinical trial in patients with low back pain following CONSORT (Consolidated Standards of Reporting Trials) guidelines. Sixty subjects were randomly allocated to two groups: one group received a targeted manipulative thrust (n=29) and the other a general manipulation thrust (GT) (n=31) to the lumbar spine. Thrust was either localised to a clinician-defined symptomatic spinal level or an equal force was applied through the whole lumbosacral region. We measured pressure-pain thresholds (PPTs) using algometry and muscle activity (magnitude of stretch reflex) via surface electromyography. Numerical ratings of pain and Oswestry Disability Index scores were collected.ResultsRepeated measures of analysis of covariance revealed no between-group differences in self-reported pain or PPT for any of the muscles studied.SummaryA GT procedure—applied without any specific targeting—was as effective in reducing participants’ pain scores as targeted approaches.Trial registration number ISRCTN11994230.

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Low Back Pain in Athletes

Cited by 54 publications

References 98 publications

Contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics

Contribution of facet joints, axial compression, and composition to human lumbar disc torsion mechanics

Treatment of Sport Injuries With Acupuncture: A Literature Review

Comparing targeted thrust manipulation with general thrust manipulation in patients with low back pain. A general approach is as effective as a specific one. A randomised controlled trial

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