369: Strength and Range of Motion in Hip and Trunk, and Back Pain in Adolescent Female Football Players

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Acute musculoskeletal pain, Pain in Special Populations

Background and Aims: Back pain is common in young athletes (1). Back pain is one of very few established risk factors for later episodes of back pain in emerging adults (2). Cohort studies of factors associated with the incidence of back pain in adolescent female football players is scarce. The objective was to investigate whether hip and trunk range of motion (ROM) and strength are associated with the incidence of low back pain (LBP) in adolescent female football players.

Methods: Adolescent female football players in Sweden (12-17 years), without LBP at baseline (n=352), were included in this cohort study (3). Several reliable tests of strength and ROM were used for baseline assessments. The players were followed for one year with weekly web-based surveys, where LBP intensity was measured on a numeric rating scale (NRS 0 -10). The outcome LBP was defined as ≥4 on the NRS. Multivariable Cox proportional hazard models, for each exposure, computed the hazard rate ratios (HRR), and 95% confidence intervals (CI) for the association between the exposures and the first event of the outcome.

Results: HRR for the incidence of LBP in players in the highest quartile ROM in comparison with the players in the lowest quartile ROM in the hip was 0.50 (0.29-0.84), and in the trunk 0.92 (0.57-1.50). HRR for the incidence of LBP in players in the highest quartile strength in comparison with the players in the lowest quartile strength in the hip was 0.60 (0.37-0.99), and in the trunk 0.78 (0.48-1.36). The HRR for players in the highest quartile endurance in the trunk in comparison with the players in the lowest quartile was 1.00 (0.61-1.62).

Conclusions: A higher general range of motion and strength in the hip is associated with a lower incidence of low back pain in adolescent female football players.

References: 1. Wall J, Meehan WP 3rd, Trompeter K, Gissane C, Mockler D, van Dyk N, Wilson F. Incidence, prevalence and risk factors for low back pain in adolescent athletes: a systematic review and meta-analysis. Br J Sports Med. 2022 Nov;56(22):1299-1306. doi: 10.1136/bjsports-2021-104749. Epub 2022 Sep 23. PMID: 36150752.

2. Øiestad BE, Hilde G, Tveter AT, Peat GG, Thomas MJ, Dunn KM, Grotle M. Risk factors for episodes of back pain in emerging adults. A systematic review. Eur J Pain. 2020 Jan;24(1):19-38. doi: 10.1002/ejp.1474. Epub 2019 Sep 3. PMID: 31433541.

3. Tranaeus U, Weiss N, Lyberg V, Hagglund M, Waldén M, Johnson U, Asker M, Skillgate E. Study protocol for a prospective cohort study identifying risk factors for sport injury in adolescent female football players: the Karolinska football Injury Cohort (KIC). BMJ Open. 2022 Jan 12;12(1):e055063. doi: 10.1136/bmjopen-2021-055063. PMID: 35022175; PMCID: PMC8756291.

Presenting Author: Eva Skillgate
Submitting Author: Eva Skillgate

Senior Author: Martin Asker

IASP 2026 Global Year theme of Neuropathic Pain: No

• David Ebrahimi: NA - Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
• Ulrika Tranaeus: PhD - Department of PNB, The Swedish school of Sport and Health Sciences, Stockholm Sweden
• Nathan Weiss: PhD - Department of health promotion science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
• Martin Asker: PhD - Department of health promotion science, Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden