LOW BACK PAIN INCIDENCE IN NEW ZEALAND ROWERS AND ITS RELATIONSHIP WITH FUNCTIONAL MOVEMENT PATTERNS Craig Newlands Supervisor: Duncan Reid A thesis submitted to Auckland University of Technology in partial fulfillment of the requirements for the degree of Master of Health Science October 2013 i TABLE OF CONTENTS LIST OF FIGURES ......................................................................................................... iv LIST OF TABLES ............................................................................................................ v CERTIFICATE OF AUTHORSHIP ................................................................................ vi ACKNOWLEDGEMENTS ............................................................................................ vii ABSTRACT ..................................................................................................................... ix Chapter One Introduction .............................................................................................. 1 1.1 Statement of the problem ................................................................................... 1 1.2 Purpose of the study ........................................................................................... 3 1.3 Significance of the problem................................................................................ 3 Chapter Two Review of Literature ............................................................................... 5 Introduction .................................................................................................................... 5 2.1 Kinematics of rowing ......................................................................................... 5 2.2 Low back pain in rowing .................................................................................... 7 2.2.1 Literature review ............................................................................................. 8 2.2.2 Prevalence ....................................................................................................... 8 2.2.3 Possible risk factors associated with low back pain ..................................... 17 2.2.4 Relationship between training volume and low back pain ........................... 18 2.2.5 Effect of low back pain on training .............................................................. 19 2.2.6 Intervention studies on low back pain in rowing .......................................... 20 2.3 Functional movement screening ....................................................................... 24 2.3.1 Movement competency screen ...................................................................... 25 2.3.2 Literature review ........................................................................................... 26 2.3.3 Functional movement screening tools reliability .......................................... 27 2.3.4 The relationship between functional screening tools and injury .................. 38 2.3.5 The relationship between functional screening tools and performance ........ 50 2.3.6 Screening tools intervention studies ............................................................. 53 2.4 Conclusion ........................................................................................................ 58 Chapter Three Methods .............................................................................................. 60 Introduction .................................................................................................................. 60 3.1 Study Design ......................................................................................................... 60 3.2 Participants ....................................................................................................... 60 ii 3.3 Measurements ................................................................................................... 61 3.3.1 Questionnaire ................................................................................................ 61 3.3.2 Musculo-skeletal screening........................................................................... 63 3.4 Movement Competency Screen reliability study ............................................. 71 3.5 Data Analysis ................................................................................................... 71 Chapter Four Results .................................................................................................... 73 4.1 Subjects ............................................................................................................ 73 4.2 Injury Incidence, Prevalence and Severity ....................................................... 77 4.2.1 Injury Incidence ............................................................................................ 77 4.2.2 Injury Prevalence and Severity ..................................................................... 78 4.2.3 Life-time Prevalence ..................................................................................... 78 4.3 Relationship between training load and low back pain .................................... 79 4.3.1 Relationship between training hours and distance rowed. ............................ 79 4.3.2 Relationship between new low back injuries and subjects currently experiencing low back injuries. ................................................................................ 80 4.3.3 Relationship between training hours and low back injury ............................ 80 4.4 Association between possible risk factors, movement competency and low back pain. ..................................................................................................................... 81 4.4.1 Association between new low back injuries and possible risk factors. ........ 81 4.4.2 Association between any low back injury and possible risk factors............. 82 4.4.3 Association between previous history of low back pain and possible risk factors 83 Chapter Five Discussion ............................................................................................. 84 5.1 Subjects ............................................................................................................ 84 5.2 Incidence, Prevalence and Severity of Low Back Pain .................................... 86 5.2.1 Incidence rate ................................................................................................ 86 5.2.2 Prevalence rate .............................................................................................. 87 5.2.3 Lifetime Prevalence ...................................................................................... 88 5.2.4 Severity ......................................................................................................... 90 5.3 Relationship between training load and low back pain. ................................... 93 5.3.1 Training load and low back pain................................................................... 93 5.3.2 Time of year injuries occur ........................................................................... 94 5.4 Risk factors ....................................................................................................... 96 5.4.1 Correlation between movement competency and the development of low back pain ................................................................................................................... 96 iii 5.4.2 Correlation between previous history of low back pain and age on the development of low back pain .................................................................................. 98 5.4.3 Other risk factors .......................................................................................... 98 5.5 Limitations of the Study ................................................................................... 99 5.6 Conclusion ...................................................................................................... 100 5.7 Future research ............................................................................................... 102 Appendices ................................................................................................................... 103 Appendix 1 ................................................................................................................. 103 Appendix 2 ................................................................................................................. 105 Appendix 3 ................................................................................................................. 109 Appendix 4 ................................................................................................................. 110 Appendix 5 ................................................................................................................. 113 Appendix 6 ................................................................................................................. 115 Appendix 7 ................................................................................................................. 119 References .................................................................................................................... 122 iv LIST OF FIGURES Figure 2.1 The drive phase of the rowing stroke. ............................................................. 7 Figure 3.1 Body weight squat ........................................................................................