-->

Wednesday, April 24, 2013

Preventing Lumbar Injuries in Rotational Striking Athletes



The Hammer Throw does not require twisting of the torso, but is a rotation around the axis of the body. This requires stabilization, not increasing the range of spinal rotation.

We've posted some things in the past about the difference between rotation and twisting. Many "strength and conditioning coaches" seem to think that rotational force is developed by doing twisting movements. I would argue that twisting the spine beyond it's range of motion with additional weight is a recipe for injury. In fact, I would argue that trying to increase the range of motion beyond what the spinal discs are designed to rotate is unnecessary and deleterious. Below is an article that appeared in the April 2013 Strength and Conditioning Journal that supports this idea.

I only printed the conclusion below. I also included the references for any academic types out there. The entire article can be read on the NSCA website or in the journal. It points out that the most injurious position is when the back is rotated while in extension. 
The human back is an amazing structure that allows us to do many things. My experience is that the spinal musculature is best strengthened by staying with in the normal spinal range of motion. While there are some individuals with "iron backs" who can get away with trying to stretch the spine beyond it's range of motion, most of us eventually will end up with disc herniation if we persist in chronically over stretching the spine. My best advice, and it's also backed up by research, is strengthen the supportive musculature around the spine by doing heavy overhead work, squatting and pulling movements without a belt as much as possible, along with various varieties of back raises, side bend work, abdominal work...etc. Excessive twisting and trying to stretch the spine, especially when it is in extension, causes cumulative microtruama and will eventually result in a herniated disc. Often the disc will "blowout" doing a simple movment like a pull, deadlift, or even bending over to pick up something and the athlete will think that this was the cause, when actually it was just the "straw that broke the camels back." Train smart. Think stabilizaton, not pushing the range of motion when training the low back.


Preventing Lumbar Injuries in Rotational Striking Athletes

Gillies, Aaron MS, CSCS1; Dorgo, Sandor PhD, CSCS2


CONCLUSION
In summary, training for rotational sports involves increasing stability of the spine rather than improving mobility. Some programs indicate rotary motion with the pelvis fixed and violent rotation of the shoulders and spine, known as the “X-factor.” Developing high levels of rotary torque is not a task for the lumbar spine and abdominal musculature; it is a task for the hip and shoulder joints. Increased X-factor or angle difference between the pelvis and shoulders increases strain on the IVD as well as stress on the pars region of the vertebrae, which overtime can lead to herniated disks or stress fractures. Transferring the high levels of rotary torque from the lower body to the upper body is the task of the trunk muscles. To reduce the risk of a lumbar spine injury, these muscle systems should thus be trained as a cohesive unit rather than in isolated segments.
By progressing through a progressive training program that includes neuromuscular facilitation, endurance, strength, and power phases that improve lumbar stability during rotation, athletes can reduce the risk of lumbar injury during sport participation. Performance in rotary sport movements such as a golf swing, baseball swing, discuss throw, and hockey slap shot can benefit from the outlined program.
 REFERENCES

1. Alyas F, Turner M, Connell D. MRI findings in the lumbar spine of asymptomatic, adolescent, elite tennis players. Br J Sports Med, 41: 836–841, 2007.
Cited Here... | View Full Text | PubMed | CrossRef

2. Ashish A, Shweta S, Singh SJ. Comparison of lumbar and abdominal muscle activation during two types of golf swing: an EMG analysis. Int J Sport Sci 12: 59–71, 2008.
Cited Here...

3. Campbell R, Dunn A. Sports-related disorders of the spine and sacrum. In: Essential Radiology for Sports Medicine. Robinson P, ed. New York, NY: Springer, 2010. pp. 217–240.
Cited Here...

4. Cardosa-Marques MA. Strength training in adult elite tennis players. Strength Cond J 27: 34–41, 2005.
Cited Here... | View Full Text | CrossRef

5. Carpenter DM, Nelson BW. Low back strengthening for the prevention and treatment of low back pain. Med Sci Sports Exerc 31: 18–24, 1999.
Cited Here...

6. Chan S, Ferguson S, Wuertz K, Ganten-bein-Ritter B. Biological response of the inter-vertebral disc to repetitive short term cyclic torsion. Spine 36: 2021–2030, 2011.
Cited Here... | View Full Text | PubMed

7. Cholewicki J, Van Vliet JJ IV. Relative contributions of trunk muscles to the stability of the lumbar spine during isometric exertions. Clin Biomechan (Bristol Avon) 17: 99–105, 2002.
Cited Here...

8. Cole MH, Grimshaw PN. Electromyography of the trunk and abdominal muscles in golfers with and without low back pain. J Sci Med Sport 11: 174–181, 2008.
Cited Here... | PubMed | CrossRef

9. Cole MH, Grimshaw PN. Trunk muscle onset and cessation in golfers with and without low back pain. J Biomechan 41: 2829–2833, 2008.
Cited Here... | PubMed | CrossRef

10. Costi JJ, Stokes IA, Gardner-Morse M, Laible JP, Scoffone HM, Iatridis JC. Direct measurement of intervertebral disc maximum shear strain on six degrees of freedom: Motions that place disc tissue at risk of injury. J Biomechan, 40: 2457–2466, 2007.
Cited Here... | PubMed | CrossRef

11. Drake JDM, Callaghan JP. Do flexion/extension postures affect the in vivo passive lumbar spine response to applied axial twist moments? Clin Biomechan (Bristol Avon) 23: 510–519, 2008.
Cited Here...

12. Earp JE, Kraemer WJ. Medicine ball training implication for rotational power sports. Strength Cond J 32: 20–25, 2010.
Cited Here...

13. Ebraheim NA, Hassan A, Lee M, Rongming X. Functional anatomy of the lumbar spine. Semin Pain Med 2: 131–137, 2004.
Cited Here...

14. Evans C, Odreive W. A study to investigate whether golfers with a history of low back pain show a reduced endurance of transversus abdominis [abstract]. J Man Manip Ther 8: 162–174, 2000.
Cited Here...

15. Gardner-Morse MG, Stokes IAF. The effects of abdominal muscle coactivation on lumbar spine stability. Spine 23: 86–92, 1998.
Cited Here... | View Full Text | PubMed | CrossRef

16. Garges KJ, Nourbakhsh A, Morris R, Yang J, Mody M, Patterson R. A comparison of the torsional stiffness of the lumbar spine in flexion and extension. J Manipulative Physiol Ther 31: 563–569, 2008.
Cited Here... | View Full Text | PubMed | CrossRef

17. Gosheger G, Liem D, Ludwig K, Greshake O, Winkelmann W. Injuries and overuse syndromes in golf. Am J Sports Med 31: 438–443, 2003.
Cited Here... | PubMed

18. Hangai M, Kaneoka K, Hinotsu S`, Shimizu K, Okubo Y, Miyakawa S, Mukai N, Sakane M, Ochiai N. Lumbar intervertebral disk degeneration in athletes. Am J Sports Med 37: 149–155, 2009.
Cited Here... | View Full Text | PubMed | CrossRef

19. Hindle RJ, Pearcy MJ. Rotational mobility of the human back in forward flexion. J Biomed Eng 11: 219–223, 1989.
Cited Here... | PubMed | CrossRef

20. Hodges PW, Richardson CA. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Arch Phys Med Rehabil 80: 1005–1012, 1999.
Cited Here... | PubMed | CrossRef

21. Horton JF, Lindsay DM, Macintosh BR. Abdominal muscle activation of elite golfers with chronic low back pain. Med Sci Sports Exerc 33: 1647–1654, 2001.
Cited Here... | View Full Text | PubMed | CrossRef

22. Hume PA, Keogh J, Reid D. The role of biomechanics in maximizing distance and accuracy of golf shots. Sports Med 35: 429–449, 2005.
Cited Here... | View Full Text | PubMed | CrossRef

23. Jackson JK, Shepared TR, Kell RT. The influence of periodized resistance training on recreationally active males with chronic nonspecific low back pain. J Strength Cond Res 25: 242–251, 2011.
Cited Here... | View Full Text | PubMed | CrossRef

24. Johnson MA, Polgar J, Weightman D, Appleton D. Data on the distribution of fibre types in thirty-six human muscles: an autopsy study. J Neurol Sci 18: 111–129, 1973.
Cited Here...

25. Kell RT, Asmundson GJG. Comparison of two forms of periodized exercise rehabilitaton programs in the management of chronic non-specific low-back pain. J Strength Cond Res 22: 513–523, 2009.
Cited Here...

26. Keogh JWL, Aickin SE, Oldham ARH. Can common measures of core stability distinguish performance in a shoulder pressing task under stable and unstable conditions? J Strength Cond Res 24: 422–429, 2010.
Cited Here...

27. Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ 332: 1430–1434, 2006.
Cited Here... | View Full Text | PubMed | CrossRef

28. Kraemer WJ, Hakkinen K, Triplett-McBride NT, Fry AC, Koziris LP, Ratamess NA, Bauer JE, Volek JS, McConnell T, Newton RU, Gordon SE, Cummings D, Hauth J, Pullo F, Lynch JM, Mazzetti SA, Knutgen HG. Physiological changes with periodized resistance training in women tennis players. Med Sci Sports Exerc 35: 157–168, 2003.
Cited Here... | View Full Text | PubMed | CrossRef

29. Kumar S, Narayan Y, Garand D. Electroymyography of trunk muscles in graded axial rotation. J Electromyogr Kinesiol 12: 317–328, 2002.
Cited Here... | PubMed

30. Lephart SM, Smoliga JM, Myers JB, Sell TC, Tsai Y. An eight-week golf-specific exercise program improves physical characteristics, swing mechanics, and golf performance in recreational golfers. J Strength Cond Res 21: 860–869, 2007.
Cited Here... | View Full Text | PubMed | CrossRef

31. Marshall PWM, Murphy BA. Evaluation of functional and neuromuscular changes after exercise rehabilitation for low back pain using a Swiss ball: A pilot study. J Manipulative Physiol Ther 29: 550–560, 2006.
Cited Here...

32. McGill SM, Grenier S, Bluhm M, Preuss R, Brown S, Russell C. Previous history of LBP with work loss is related to lingering effects in biomechanical physiological, personal, and psychosocial characteristics. Ergonomics 46: 731–746, 2003.
Cited Here... | PubMed | CrossRef

33. McGill SM, Grenier S, Kavcic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol 13: 353–359, 2003.
Cited Here... | PubMed | CrossRef

34. McHardy A, Pollard H. Muscle activity during the golf swing. Br J Sports Med 39: 799–804, 2005.
Cited Here... | View Full Text | PubMed

35. McHardy A, Pollard H, Luo K. One-year prospective study on golf injuries in Australian amateur golfers. J Sci Med Sport 9: 28, 2006.
Cited Here... | CrossRef

36. Murray E, Birley E, Twycross-Lewis R, Morrissey D. The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: An observational study. Phys Ther Sport 10: 131–135, 2009.
Cited Here... | PubMed | CrossRef

37. Ng JKF, Richardson CA, Parnianpour M, Kippers V. EMG activity of trunk muscles and torque output during isometric axial rotation exertion: a comparison between back pain patients and matched controls. J Orthop Res 20: 112–121, 2002.
Cited Here... | PubMed | CrossRef

38. Ochia RS, Inoue N, Renner S, Lorenz EP, Lim T, Andersson G, An HS. Three-dimensional in vivo measurement of the lumbar spine segmental motion. Spine 31: 2073–2078, 2006.
Cited Here... | View Full Text | PubMed | CrossRef

39. O’Sullivan PB, Twomey L, Allison GT. Altered abdominal recruitment in patients with chronic back pain following a specific exercise intervention. J Orthop Sports Phys Ther 27: 114–124, 1998.
Cited Here... | View Full Text | PubMed

40. Panjabi MM. The stabilizing system of the spine. Part I. Functions, dysfunction, adaptation and enhancement. J Spinal Disord Techn 5: 383–389, 1992.
Cited Here...

41. Parizale JR, Mallon WJ. Golf injuries and rehabilitation. Phys Med Rehabil Clin N Am 17: 589–607, 2006.
Cited Here... | PubMed | CrossRef

42. Renkawitz T, Boluki D, Grifka J. The association of low back pain, neuromuscular imbalance, and trunk extension strength in athletes. Spine J 6: 673–683, 2006.
Cited Here... | PubMed | CrossRef

43. Richardson C, Toppenberg R, Jull G. An initial evaluation of eight abdominal exercises for their ability to provide stabilization for the lumbar spine. Aust J Physiother 36: 6–11, 1990.
Cited Here...

44. Shirazi-Adl A. Nonlinear stress analysis of the whole lumbar spine in torsion—Mechanics of facet articulation. J Biomechan 27: 289–299, 1994.
Cited Here...

45. Stevens VK, Coorevits PL, Bouche KG, Mahieu NN, Vanderstraeten GG, Danneels LA. The influence of specific training on trunk muscle recruitment patterns in healthy subjects during stabilization exercises. Man Ther 12: 271–279, 2007.
Cited Here... | PubMed | CrossRef

46. Szymanski D, Fredrick GA College baseball/softball periodized torso program. Strength Cond J 21: 42–47, 1999.
Cited Here...

47. Szymanski DJ, McIntyre JS, Szymanski JM, Bradford TJ, Schade RL, Madsen NH, Pascoe DD. Effect of torso rotational strength on angular hip, angular shoulder, and linear bat velocities of high school baseball players. J Strength Cond Res 21: 1117–1125, 2007.
Cited Here... | View Full Text | PubMed | CrossRef

48. Tanaka ML, Nussbaum MA, Ross SD. Evaluation of the threshold of stability for the human spine. J Biomechan 42: 1017–1022, 2009.
Cited Here... | PubMed | CrossRef

49. Thompson CJ, Cobb KM, Blackwell J. Functional training improves club head speed and functional fitness in older golfers. J Strength Cond Res 21: 131–137, 2007.
Cited Here... | View Full Text | PubMed | CrossRef

50. Urquhart DM, Hodges PW, Allen TJ, Story IH. Abdominal muscle recruitment during a range of voluntary exercises. Man Ther 10: 144–153, 2005.
Cited Here... | PubMed | CrossRef

51. Vad VB, Bhat AL, Basrai D, Gebeh A, Aspergren, Andrews JR. Low back pain in professional golfers: The role of associated hip and low back range-of-motion deficits. Am J Sports Med 32: 494–497, 2004.
Cited Here... | View Full Text | PubMed | CrossRef

52. Van Dillen LR, Bloom NJ, Gombatto SP, Susco TM. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Phys Ther Sport 9: 72–81, 2008.
Cited Here... | PubMed | CrossRef

53. Watkins RG, Dillin WH. Lumbar spine injury in the athlete. Clin Sports Med 9: 419–448, 1990.
Cited Here... | PubMed

54. Watkins RG, Uppal GS, Perry J, Pink M, Dinsay JM. Dynamic electromyographic analysis of trunk musculature in professional golfers. Am J Sports Med 24: 535–539, 1996.
Cited Here... | PubMed | CrossRef

55. Welch CM, Banks SA, Cook FF, Draovitch P. Hitting a baseball: A biomechanical description. J Orthop Sports Phys Ther 22: 193–201, 1995.
Cited Here... | PubMed

56. Willems JM, Jull GA, Ng JK-F. An in vivo study of the primary and coupled rotations of the thoracic spine. Clin Biomechan (Bristol Avon) 11: 311–316, 1996.
Cited Here...

No comments:

Post a Comment