You may have heard the statistic that 80 per cent of all adult experience low back pain at some point in their lives. Well, adults aren’t the only ones with back pain. Studies are now showing that the number of children and teens reporting back pain is on the rise. In this study from Japan, the relationship between sports participation and low back pain is the focus.
Researchers from several different universities in Japan (University of Tsukuba, Kyoto University, Waseda University) participated in this study. They surveyed 4667 incoming freshman at the University of Tsukuba about their sports participation and incidence of back pain. Because every freshman was given the questionnaire to fill out as part of the medical screening process, there was a very high response rate (67.4 per cent).
They showed that students involved in a high level of sports activities were much more likely to have back pain compared with those who either didn’t participate at all or students with low sports involvement. Let’s take a closer look at what questions were asked and how the data was analyzed.
First of all, sports participation was defined as more than three times each week from grade school through high school. Factors investigated included whether the student missed school due to low back pain, presence of leg pain and/or numbness, and whether the student had to quit playing competitively due to low back pain. Additionally, they were asked if anyone had low back pain in the four weeks before filling out the survey.
The authors also collected information on type of sports and length of time the students were involved in each. The most common sports activities were soccer, baseball, basketball, track and field, tennis, kendo, swimming, and volleyball. Kendo is a modern Japanese martial art of sword-fighting. Students who participated in more than one sport or who played five years or more in one type of sport were evaluated a little more closely.
They found that low back pain was just as likely in males as in females, so it didn’t look like sex was a risk factor. Since the students who didn’t play had the fewest cases of low back pain, sports participation itself is a risk factor. And those who played the longest had the highest rates of low back pain so duration of play was also a risk factor.
As for the type of sport most closely linked with low back pain: that was volleyball! Soccer had the lowest association with back pain with baseball, track and field, basketball, swimming, kendo, and tennis in between (in that order).
The authors say it would be easy to conclude from their study that high levels of participation in sports activities is linked with an increased risk of low back pain. But there are some important variables to consider.
First, the freshmen weren’t required to fill out the survey. It was done on a voluntary basis. It’s possible that students who had back pain in the past were more likely to participate in this type of study. Second, it’s well known that sitting for long periods (studying or watching television) is also a risk factor for low back pain. And students (even active sports types) sit as much (if not more) than they play.
The fact that low back pain was greater in those who participated in sports compared with those who don’t may be the most significant finding. It’s likely that the non-sports students sit even more than those who play — but the study didn’t ask for information on number of hours sitting so further study is needed to check this out.
The authors suggest that future studies pay attention to the types of postures and motions and compare these with number and types of injuries for each of the eight sports listed. Based on the results of other studies done, it looks like some injuries (e.g., disc degeneration) are more common in some sports athletes (e.g., swimmers and baseball players in this example).
Why all the fuss about which sport causes the most back pain? Prevention. If it were possible to prevent low back pain in any age group, it would be worth it. Finding the key risk factors might make it easier to keep it from happening in the first place. Setting up guidelines for youth sports that might limit the number of cases and severity of low back pain is the goal.
This study helps move us in that direction by investigating duration of sports activities and type of sports to target. Pointing out areas for future study to further identify preventive and management techniques is an extra benefit of this particular project.