Sagittal Integral Morphotype of Competitive Amateur Athletes and Its Potential Relation with Recurrent Low Back Pain

Abstract

Athletes have higher thoracic and lumbar curvature in standing than the reference values of the non-athletic population. The sagittal integral morphotype method (SIM) assessment has not previously been applied to competitive amateur athletes (CAA). The propose of the present study was to determine the SIM of CAA treated at a sports-medicine center and to identify spinal misalignments associated with recurrent low back pain (LBP). An observational analysis was developed to describe the SIM in 94 CAA. The thoracic and lumbar curvatures of the CAA were measured in standing, sitting, and trunk forward flexion. Association analysis (Pearson’s chi-square and Cramér’s V tests) was then performed to identify the SIM misalignments associated with LBP. Effect size was analyzed based on Hedges’ g. The most common thoracic SIMs in CAA were total hyperkyphosis (male = 59.02%; female = 42.42%) and static hyperkyphosis (male = 11.48%; female = 6.06%). Hyperlordotic attitude (female = 30.30%; male = 4.92%), static-functional hyperkyphosis (male = 16.39%; female = 3.03%), and structured hyperlordosis (female = 21.21%; male = 1.64%) were the most common lumbar SIMs. Hyperlordotic attitude, static functional lumbar hyperkyphosis, and structured hyperlordosis were associated with LBP in male and female athletes.

The Sagittal Integral Morphotype in Male and Female Rowers

“…Lumbar curvatures in the slump sitting and trunk forward bending positions, together with height, have been recently found as predicting factors of sciatica history in female classical ballet dancers [ 32 ]. Recurrent lower back pain has been related to the lumbar curve during trunk flexion, as well as reduced hamstring extensibility [ 33 , 59 ]. Hamstring length and demands are factors to consider in future analyses of rowers.…”

“…At present, thoracic and lumbar kyphosis during rowing technique have not been related to the impact of a standardised clinical spine assessment. The specific impact of this sport on spine alignment requires an assessment that allow comparisons with other disciplines [ 1 , 3 , 4 , 10 , 12 , 13 , 30 , 31 , 32 , 33 ].…”

“…Lower back dysfunction due to fatigue [ 20 , 27 ] and stress on the intervertebral joints and discs [ 21 ] described in rowers may have an impact on the basal positioning of the spine in the sagittal plane. Sagittal spinal curvatures play an important role in health, and therefore, both clinical assessment and research in this topic seems to be relevant, as in other sports [ 1 , 3 , 4 , 5 , 6 , 7 , 10 , 13 , 30 , 31 , 32 , 33 ].…”

“…The integrated spinal assessment of the sagittal morphotype has proven to be useful in the assessment of the normal status of the spine of different sportsmen [ 1 , 3 , 4 , 10 , 12 , 13 , 30 , 31 , 32 , 33 , 35 ], as well as scholars [ 35 , 36 , 39 , 40 , 41 ] and adolescents [ 42 ]. The advantage of this standardised assessment is the possible comparison of the spinal adaptations among different sport techniques.…”