Department of Orthopaedics and Rehabilitation, Division of Research, Interdisciplinary Center for Musculoskeletal Training and Research, University of Florida, Gainesville, Florida, USA.
Orthop J Sports Med. 2016 Jul 25;4(7):2325967116657535. doi: 10.1177/2325967116657535. eCollection 2016 Jul.
BACKGROUND: Low back pain (LBP) and motion alterations can occur in athletes who engage in high-speed throwing motions. The relationship between LBP and shooting motion in lacrosse players is not yet known. PURPOSE: To quantify the effects of LBP on key kinematic parameters of the lacrosse shot and determine the contribution of the severity of LBP on specific kinematic parameters of the shooting motion. STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate players (N = 24) were stratified into 2 groups based on back pain symptoms (LBP or no pain). Three-dimensional motion capture of overhead throws was used to collect data on knee, pelvis, trunk, and shoulder kinematics as well as crosse stick (the stick capped with a strung net) and ball speed. RESULTS: Mean low back numeric pain rating scale (NRSpain) score was 2.9. Knee flexion at ball release was greater in the LBP than no pain group, indicating a more bent knee (P = .04). The LBP group demonstrated less angular velocity transfer from pelvis to trunk than the no pain group (P = .05). Total range of motion of the pelvis and shoulders during the shot and follow-through were less in the LBP group than the no pain group (83.6° ± 24.5° vs 75.9° ± 24.5°, P = .05). Age- and sex-adjusted regression analyses revealed that the low back NRSpain rating contributed 6.3% to 25.0% of the variance to the models of shoulder transverse rotation range of motion, trunk and shoulder rotation angular velocities, and knee flexion angle (P < .05). CONCLUSION: LBP severity significantly contributes to trunk and shoulder motion restriction during lacrosse shooting. Inclusion of lumbopelvic and core training and prehabilitation programs for high school and collegiate players may reduce pain in affected players as well as help them to attain appropriate motion parameters and avoid secondary musculoskeletal injuries. CLINICAL RELEVANCE: This research identified a prehabilitation need in the understudied lacrosse population. Therapeutic strategies can be developed to strengthen the throwing motion, which could control mechanical loading patterns on the low back and minimize pain symptoms in players with chronic LBP.
背景：从事高速投掷运动的运动员可能会出现下腰痛（LBP）和运动改变。曲棍球运动员的 LBP 与射击运动之间的关系尚不清楚。 目的：量化 LBP 对曲棍球射门关键运动学参数的影响，并确定 LBP 严重程度对射门运动特定运动学参数的贡献。 研究设计：对照实验室研究。 方法：根据背部疼痛症状（LBP 或无疼痛）将高中和大学运动员（N = 24）分为 2 组。使用三维运动捕捉进行头顶投掷，以收集膝关节、骨盆、躯干和肩部运动学以及曲棍球棒（带串网的棒）和球速的数据。 结果：平均下腰痛数字疼痛评分量表（NRSpain）得分为 2.9。与无痛组相比，LBP 组在球释放时的膝关节屈曲更大，表明膝关节更弯曲（P =.04）。LBP 组从骨盆到躯干的角速度传递小于无痛组（P =.05）。LBP 组的骨盆和肩部在射击和随球动作中的总运动范围小于无痛组（83.6°±24.5°对 75.9°±24.5°，P =.05）。年龄和性别调整的回归分析表明，下腰痛 NRS 评分对肩横向旋转运动范围、躯干和肩部旋转角速度以及膝关节屈曲角度模型的变异性贡献了 6.3%至 25.0%（P <.05）。 结论：LBP 严重程度显著限制了曲棍球投篮时的躯干和肩部运动。为高中和大学运动员制定包括腰骨盆和核心训练以及预康复计划可能会减轻受影响运动员的疼痛，并帮助他们达到适当的运动参数并避免继发性肌肉骨骼损伤。 临床相关性：这项研究确定了在研究不足的曲棍球人群中存在预康复需求。可以制定治疗策略来加强投掷运动，这可以控制下背部的机械载荷模式，并最大限度地减少慢性 LBP 运动员的疼痛症状。
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