Authors: Meagan Anstruther, Stephanie Valentin, Geoffrey Dover, Maryse Fortin.
Introduction: Low back pain (LBP) is highly prevalent in athletes, with decreased lumbar multifidus (LM) crosssectional area (CSA) reported in athletes with LBP and lower limb injury (LLI) as well as decreased LM thickness in athletes with LLI. Previous research has only investigated connections between LM, LBP, and LLI in small samples of athletes in a single sport at a time. This study aimed to (1) examine LM morphology and function across a general sample of male and female university level varsity athletes; (2) investigate whether LM characteristics were predictors of LBP and LLI.
Methods: Ultrasound images of LM at L5 were acquired in prone and standing. Body composition was assessed with DEXA and a self-reported questionnaire provided demographics and history of injury. Paired t-tests and independent t-tests compared LM measurements between the sides and sex, respectively. Univariate and multivariate logistic regression analyses were used to assess possible LM characteristic predictors of LBP and LLI.
Results: 134 university varsity athletes were evaluated. LM CSA was larger on the non-dominant side in prone. Increased LM thickness was associated with decreased odds of LBP in the previous 4-week (OR=0.49 [0.27, 0.88], p=0.02) and 3-month (OR=0.43 [0.21, 0.89], p=0.02) in the multivariable model, while a greater number of years playing at the university level was associated with increased odds of LBP (OR=1.29 [1.01, 1.65], p=0.04). Greater LM CSA asymmetry (OR=1.14 [1.01, 1.28], p=0.03) and sport (OR=1.44 [1.04, 1.96], p=0.02) were significant predictors of LLI in the previous 12 months.
Conclusion: Leg dominance may play a role in unilateral differences. LM thickness and LM CSA asymmetry were predictors of injury. Preseason screening of LM morphology and function could help identify athletes at risk of LBP and LLI, allowing coaches, medical staff, and training staff to target these individuals and provide specific injury prevention programs.
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