Landing Stiffness Between Individuals With and Without a History of Low Back Pain

Context: Reduced spinal stabilization, delayed onset of muscle activation, and increased knee joint stiffness have been reported in individuals with a history of low back pain (LBP). Biomechanical adaptations resulting from LBP may increase the risk for future injury due to suboptimal loading of the lower-extremity or lumbar spine. Assessing landing mechanics in these individuals could help identify which structures might be susceptible to future injury. Objective: To compare vertical and joint stiffness of the lower-extremity and lumbar spine between individuals with and without a previous history of LBP. Design: Cross-sectional study. Setting: Research laboratory. Participants: There were 45 participants (24 without a previous history of LBP—age 23 [8] y, height 169.0 [8.5] cm, mass 69.8 [13.8] kg; 21 with a previous history of LBP—age 25[9] y, height 170.0 [8.0] cm, mass 70.2 [11.8] kg). Interventions: Single-limb landing trials on the dominant and nondominant limb from a 30-cm box. Main Outcome Measures: Vertical stiffness and joint stiffness of the ankle, knee, hip, and lumbar spine. Results: Individuals with a previous history of LBP had lower vertical stiffness (P = .04), but not joint stiffness measures compared with those without a previous history of LBP (P > .05). Overall females had lower vertical (P = .01), ankle (P = .02), and hip stiffness (P = .04) compared with males among all participants. Males with a previous history of LBP had lower vertical stiffness compared with males without a previous history LBP (P = .01). Among all individuals without a previous history of LBP, females had lower vertical (P < .01) and ankle stiffness measures (P = .04) compared with males. Conclusions: Landing stiffness may differ among males and females and a previous history of LBP. Comparisons between individuals with and without previous LBP should be considered when assessing landing strategies, and future research should focus on how LBP impacts landing mechanics.

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Jogging Kinematics After Lumbar Paraspinal Muscle Fatigue

Journal of Athletic Training ◽

10.4085/1062-6050-44.5.475 ◽

2009 ◽

Vol 44 (5) ◽

pp. 475-481 ◽

Cited By ~ 22

Author(s):

Joseph M. Hart ◽

D. Casey Kerrigan ◽

Julie M. Fritz ◽

Christopher D. Ingersoll

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Lower Extremity ◽

Healthy Controls ◽

Low Back ◽

Trunk Flexion ◽

History Of ◽

Lumbar Extension ◽

Recurrent Low Back Pain

Abstract Context: Isolated lumbar paraspinal muscle fatigue causes lower extremity and postural control deficits. Objective: To describe the change in body position during gait after fatiguing lumbar extension exercises in persons with recurrent episodes of low back pain compared with healthy controls. Design: Case-control study. Setting: Motion analysis laboratory. Patients or Other Participants: Twenty-five recreationally active participants with a history of recurrent episodes of low back pain, matched by sex, height, and mass with 25 healthy controls. Intervention(s): We measured 3-dimensional lower extremity and trunk kinematics before and after fatiguing isometric lumbar paraspinal exercise. Main Outcome Measure(s): Measurements were taken while participants jogged on a custom-built treadmill surrounded by a 10-camera motion analysis system. Results: Group-by-time interactions were observed for lumbar lordosis and trunk angles (P < .05). A reduced lumbar spine extension angle was noted, reflecting a loss of lordosis and an increase in trunk flexion angle, indicating increased forward trunk lean, in healthy controls after fatiguing lumbar extension exercise. In contrast, persons with a history of recurrent low back pain exhibited a slight increase in spine extension, indicating a slightly more lordotic position of the lumbar spine, and a decrease in trunk flexion angles after fatiguing exercise. Regardless of group, participants experienced, on average, greater peak hip extension after lumbar paraspinal fatigue. Conclusions: Small differences in response may represent a necessary adaptation used by persons with recurrent low back pain to preserve gait function by stabilizing the spine and preventing inappropriate trunk and lumbar spine positioning.

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Self-Myofascial Release of the Superficial Back Line Improves Sit-and-Reach Distance

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0306 ◽

2020 ◽

Vol 29 (4) ◽

pp. 400-404 ◽

Cited By ~ 1

Author(s):

Whitney Williams ◽

Noelle M. Selkow

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lower Extremity ◽

Low Back ◽

Myofascial Release ◽

Plantar Surface ◽

The Past ◽

Plantar Aspect ◽

History Of ◽

Hamstring Flexibility

Context: Decreased hamstring flexibility can lead to a plethora of musculoskeletal injuries, including low back pain, hamstring strains, and patellofemoral pain. Lack of flexibility may be the result of myofascial adhesions. The fascia connected to the hamstrings is part of the superficial back line that runs from the cranium to the plantar aspect of the foot. Any disruption along this chain may limit the flexibility of the hamstring. Objective: To investigate if self-myofascial release (SMR) of the plantar surface of the foot in addition to the hamstring group was more effective at improving the flexibility of the hamstrings when compared with either intervention alone. Design: Cross-over study. Setting: Athletic training facility. Participants: Fifteen college students (5 males and 10 females; age: 20.9 [1.4] y, height: 173.1 [10.3] cm, mass: 80.0 [24.9] kg) who were not older than 30, with no history of low back pain or injury within the past 6 months, no history of leg pain or injury within the past 6 months, no current signs or symptoms of cervical or lumbar radicular pain, no current complaint of numbness or tingling in the lower-extremity, and no history of surgery in the lower-extremity or legs. Interventions: Each participant received each intervention separated by at least 96 hours in a randomized order: hamstring foam rolling, lacrosse ball on the plantar surface of the foot, and a combination of both. Main Outcome Measures: The sit-and-reach test evaluated hamstring flexibility of each participant before and immediately after each intervention. Results: There were no significant differences found among the SMR techniques on sit-and-reach distance (F2,41 = 2.7, P = .08, ). However, at least 20% of participants in each intervention improved sit-and-reach distance by 2.5 cm. Conclusions: SMR may improve sit-and-reach distance, but one technique of SMR does not seem to be superior to another.

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Atraumatic Bilateral Lumbar Pedicle Fractures in a Patient with Back Pain and History of Long- Term Bisphosphonate Therapy: A Case Report

Pain Management Case Reports ◽

10.36076/pmcr.2020/4/97 ◽

2020 ◽

pp. 97-102

Author(s):

Alec L. Meleger

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Case Report ◽

Lumbar Spine ◽

Conservative Management ◽

Chronic Low Back Pain ◽

Bisphosphonate Therapy ◽

Low Back ◽

History Of ◽

Lumbar Pedicle

of atypical femoral fractures is a known complication of chronic bisphosphonate therapy; however, the finding of atraumatic lumbar pedicle fractures without a prior history of spinal surgery or contralateral spondylolysis is rare. While a few cases of osteoporotic pedicle fractures associated with adjacent vertebral compression fractures have been reported, only a single case of isolated atraumatic bilateral pedicle fractures has been published in a patient who had been on chronic risedronate therapy of 10-year duration. Case Report: The present case report illustrates a 63-year-old man who developed isolated atraumatic bilateral lumbar pedicle fractures after 3 years and 5 months on alendronate treatment. The patient’s past medical history had been significant for osteoporosis with a lumbar spine T-score of -2.7. At the time of initial diagnosis, a comprehensive work-up for secondary causes of osteoporosis proved to be negative; this was followed by initiation of bisphosphonate treatment with 70 mg of alendronate once per week. Ten months after starting bisphosphonate therapy, he underwent magnetic resonance imaging (MRI) of the lumbar spine for low back pain that had not responded to conservative management, with imaging not revealing any evidence of pedicle fractures or pedicle stress reaction. He was again seen in the spine clinic, for atraumatic exacerbation of his chronic low back pain with concurrent right lower extremity radiation, 6 months after stopping bisphosphonate therapy. Since the patient failed to respond to conservative management over the ensuing 6 months, a repeat MRI was obtained, which showed new acute/subacute bilateral L5 pedicle fractures. Conclusion: An isolated atraumatic lumbar pedicle fracture may be an additional type of atypical fracture associated with chronic bisphosphonate therapy in an osteoporotic patient. Key words: Chronic low back pain, bisphosphonate, alendronate, pedicle fracture Pain Medicine

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