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Small Multifidus Muscle Size Predicts Football Injuries.

Hides JA, Stanton WR, Mendis MD, Franettovich Smith MM, Sexton MJ - Orthop J Sports Med (2014)

Bottom Line: Seasonal change in the size of the multifidus muscle indicating a decrease in muscle mass was linked to injury.Of particular note is the finding that changes in muscle size from the preseason to the playing season predicted injury.As size of the multifidus muscle has been shown to be modifiable with training and has been associated with reduced pain and occurrence of injuries, this information could be incorporated in current programs of injury prevention.

View Article: PubMed Central - PubMed

Affiliation: School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia. ; Mater/ACU Back Stability Clinic, Mater Health Services, South Brisbane, Queensland, Australia.

ABSTRACT

Background: In Australian football, lower limb injuries have had the highest incidence and prevalence rates. Previous studies have shown that football players with relatively more severe preseason and playing season hip, groin, and thigh injuries had a significantly smaller multifidus muscle compared with players with no lower limb injuries. Rehabilitation of the multifidus muscle, with restoration of its size and function, has been associated with decreased recurrence rates of episodic low back pain and decreased numbers of lower limb injuries in football players. Assessment of multifidus muscle size and function could potentially be incorporated into a model that could be used to predict injuries in football players.

Purpose: To examine the robustness of multifidus muscle measurements as a predictor of lower limb injuries incurred by professional football players.

Study design: Cohort study; Level of evidence, 2.

Methods: Ultrasound examinations were carried out on 259 male elite football players at the start of the preseason and 261 players at the start of the playing season. Injury data were obtained from records collected by the Australian Football League (AFL) club staff during the preseason and the playing season.

Results: Decreased size of the multifidus muscle at L5 consistently predicted injury in the preseason and playing season. Asymmetry of the multifidus muscle and low back pain were significantly related to lower limb injuries in the preseason, and having no preferred kicking leg was related to season injuries. Seasonal change in the size of the multifidus muscle indicating a decrease in muscle mass was linked to injury. Sensitivity and specificity of the model were 60.6% and 84.9% for the preseason and 91.8% and 45.8% for the playing season, respectively.

Conclusion: A model was developed for prediction of lower limb injuries in football players with potential utility for club medical staff. Of particular note is the finding that changes in muscle size from the preseason to the playing season predicted injury.

Clinical relevance: As size of the multifidus muscle has been shown to be modifiable with training and has been associated with reduced pain and occurrence of injuries, this information could be incorporated in current programs of injury prevention.

No MeSH data available.


Related in: MedlinePlus

Relationship between lower limb injuries and change in multifidus cross-sectional area (CSA) from preseason to playing season.
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fig2-2325967114537588: Relationship between lower limb injuries and change in multifidus cross-sectional area (CSA) from preseason to playing season.

Mentions: Although relatively smaller multifidus size at the start of the preseason and playing season independently predicted lower limb injuries, change in size over this time was also examined as a possible risk factor. For example, players with small multifidus size at the start of the preseason who lose further muscle mass could be at relatively higher odds of an injury. This compounding effect of change in multifidus size over the preseason, showing a relative increase in size for some players and a decrease for others, was found to be a significant predictor of injury in the playing season (P < 0.05) (Table 3). With regard to change in multifidus size from the start of the preseason to the start of the playing season (marginal mean ± SD, –0.56 ± 1.16 cm2), each 1-unit decrease in multifidus size below the marginal mean increased the odds of an injury in the playing season by 63% (OR, 1.63). The preseason and playing season means for the multifidus muscle (Figure 2) depict the relationship between change in size and lower limb injury. Players injured in the preseason on average had smaller multifidus muscles before the injury. Players with larger multifidus size who retained their multifidus size tended not to incur an injury in the preseason or playing season. Notably, among players who had a preseason injury, those who recovered their multifidus size tended not to incur further injury, but additional loss of multifidus size was related to another injury in the playing season.


Small Multifidus Muscle Size Predicts Football Injuries.

Hides JA, Stanton WR, Mendis MD, Franettovich Smith MM, Sexton MJ - Orthop J Sports Med (2014)

Relationship between lower limb injuries and change in multifidus cross-sectional area (CSA) from preseason to playing season.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555600&req=5

fig2-2325967114537588: Relationship between lower limb injuries and change in multifidus cross-sectional area (CSA) from preseason to playing season.
Mentions: Although relatively smaller multifidus size at the start of the preseason and playing season independently predicted lower limb injuries, change in size over this time was also examined as a possible risk factor. For example, players with small multifidus size at the start of the preseason who lose further muscle mass could be at relatively higher odds of an injury. This compounding effect of change in multifidus size over the preseason, showing a relative increase in size for some players and a decrease for others, was found to be a significant predictor of injury in the playing season (P < 0.05) (Table 3). With regard to change in multifidus size from the start of the preseason to the start of the playing season (marginal mean ± SD, –0.56 ± 1.16 cm2), each 1-unit decrease in multifidus size below the marginal mean increased the odds of an injury in the playing season by 63% (OR, 1.63). The preseason and playing season means for the multifidus muscle (Figure 2) depict the relationship between change in size and lower limb injury. Players injured in the preseason on average had smaller multifidus muscles before the injury. Players with larger multifidus size who retained their multifidus size tended not to incur an injury in the preseason or playing season. Notably, among players who had a preseason injury, those who recovered their multifidus size tended not to incur further injury, but additional loss of multifidus size was related to another injury in the playing season.

Bottom Line: Seasonal change in the size of the multifidus muscle indicating a decrease in muscle mass was linked to injury.Of particular note is the finding that changes in muscle size from the preseason to the playing season predicted injury.As size of the multifidus muscle has been shown to be modifiable with training and has been associated with reduced pain and occurrence of injuries, this information could be incorporated in current programs of injury prevention.

View Article: PubMed Central - PubMed

Affiliation: School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia. ; Mater/ACU Back Stability Clinic, Mater Health Services, South Brisbane, Queensland, Australia.

ABSTRACT

Background: In Australian football, lower limb injuries have had the highest incidence and prevalence rates. Previous studies have shown that football players with relatively more severe preseason and playing season hip, groin, and thigh injuries had a significantly smaller multifidus muscle compared with players with no lower limb injuries. Rehabilitation of the multifidus muscle, with restoration of its size and function, has been associated with decreased recurrence rates of episodic low back pain and decreased numbers of lower limb injuries in football players. Assessment of multifidus muscle size and function could potentially be incorporated into a model that could be used to predict injuries in football players.

Purpose: To examine the robustness of multifidus muscle measurements as a predictor of lower limb injuries incurred by professional football players.

Study design: Cohort study; Level of evidence, 2.

Methods: Ultrasound examinations were carried out on 259 male elite football players at the start of the preseason and 261 players at the start of the playing season. Injury data were obtained from records collected by the Australian Football League (AFL) club staff during the preseason and the playing season.

Results: Decreased size of the multifidus muscle at L5 consistently predicted injury in the preseason and playing season. Asymmetry of the multifidus muscle and low back pain were significantly related to lower limb injuries in the preseason, and having no preferred kicking leg was related to season injuries. Seasonal change in the size of the multifidus muscle indicating a decrease in muscle mass was linked to injury. Sensitivity and specificity of the model were 60.6% and 84.9% for the preseason and 91.8% and 45.8% for the playing season, respectively.

Conclusion: A model was developed for prediction of lower limb injuries in football players with potential utility for club medical staff. Of particular note is the finding that changes in muscle size from the preseason to the playing season predicted injury.

Clinical relevance: As size of the multifidus muscle has been shown to be modifiable with training and has been associated with reduced pain and occurrence of injuries, this information could be incorporated in current programs of injury prevention.

No MeSH data available.


Related in: MedlinePlus