Neuromuscular Function in Athletes Following Recovery From a Recent Acute Low Back Injury

Abstract

Study Design: Observational case control design. Objectives: To examine muscle response to sudden trunk loading in athletes with and without a recent history of acute low back injury (LBI). Background: Impaired neuromuscular function is associated with chronic low back pain. This study examined whether such impairment persists after recovery from an acute LBI. Methods and Measures:Seventeen athletes who had a recent history of acute LBI and 17 matched healthy controls were tested. At the time of testing (mean = 56 days postinjury, range = 7-120 days postinjury), all athletes were symptom free and had returned to regular competition. Subjects performed isometric exertions in trunk flexion, extension, and left and right lateral bending against a trunk restraining cable. Upon reaching the target isometric force, the cable was released to impose sudden loading on the lumbar spine. Surface EMG signals from 12 major trunk muscles were recorded. The shut-off and switch-on latencies and number of muscles responding to sudden loading were compared between the 2 groups. Results: In all 4 testing directions, the athletes with a recent history of acute LBI shut off significantly fewer muscles and did so with delayed latency. On average, the injured subjects shut off 4.0 out of 6.0 (SD = 1.3) muscles compared to 4.6 out of 6.0 (SD = 1.3) muscles in the control group. The average muscle shut-off latency was 71 (SD = 31) milliseconds for the injured and 50 (SD = 21) milliseconds for the control subjects. No differences were found in number or latency of muscles switching on. Conclusions: These objective measures of neuromuscular function indicated an altered muscle response pattern to sudden trunk loading in athletes following their clinical recovery from a recent acute LBI.

The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment

“…Whether the hip joint is the cause of dysfunction or the victim, there has been evidence since 1939 that there exists a chain of adaptive reactions changing movement patterns throughout the system. This can occur from the foot up to the pelvis and from the trunk down to the foot [53][54][55][56][57][58][59]. Bullock-Saxton [60] and Janda [40] demonstrated this further in examining muscle activation patterns in male athletes who had chronic ankle sprains (> four months).…”

Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review

“…The relationship of pain and changes in motor control has been shown in several studies [11][12][13][14][15][16][17] and is seen as a protective reaction of the body to limit provocation of the painful area [9]. This, in the long run, can cause further damage, exacerbate the symptoms through peripheral and central nervous system sensitization (lowering of pain threshold), and promote dysfunctional movement patterns [4,10,18].…”

Core y sistema de control neuro-motor: mecanismos básicos para la estabilidad del raquis lumbar

“…Como estos cambios persisten tras la remisión de los síntomas 18 los déficits en el control de la musculatura abdominal han sido asociadas con la persistencia y cronicidad del dolor lumbar 33 ; -Se ha observado que el entrenamiento para mejorar el control de la musculatura del tronco es efectivo para mejorar la activación muscular durante tareas funcionales [51][52] . Cambios en los mecanismos de control neural de la musculatura del tronco también contribuye al dolor lumbar 53 ;…”