Musculoskeletal screening to identify female collegiate rowers at risk for low back pain

Abstract

Context: Rowers are at risk for overuse injuries, including low back pain (LBP). Defining the utility of screening tests for identifying those at risk for LBP can aid in the development of guidelines for injury prevention. Objective: To determine if the Functional Movement Screen (FMS) and impairments can identify rowers at risk for developing LBP. Design: Prospective cohort study. Setting: Athletic training room. Patients or Other Participants: A total of 31 National Collegiate Athletic Association Division I, female, open-weight rowers (age ¼ 19.9 6 1.4 years, height ¼ 163.6 6 30.8 cm, mass ¼ 84.1 6 37.63 kg); coxswains were excluded. Main Outcome Measure(s): We assessed the FMS and 5 impairment measures of the Star Excursion Balance Test, closed kinetic chain dorsiflexion range of motion, and the plank, Sorensen, and sit-and-reach tests before the fall season. Low back pain injuries were tracked by the sports medicine staff. Impairment measures were compared between the injured and uninjured athletes. The FMS cutoff score that discriminated injured from uninjured rowers was determined using a receiver operating characteristic curve analysis. Impairments were compared between those at a higher versus lower risk of LBP. Results: Eighteen rowers sustained an LBP injury. No differences in FMS or impairments between groups were demonstrated. The FMS receiver operating characteristic curve analysis cutoff score was 16 points (area under the curve ¼ 0.60, specificity ¼ 0.67, risk ratio ¼ 1.4 [95% confidence interval ¼ 0.91, 2.11]). Rowers with an FMS score 16 had a shorter plank-test time (109.5 6 60.2 seconds) than those with less risk (175.3 6 98.6 seconds, mean difference ¼ 65.9 seconds, 95% confidence interval ¼ 129.4, 2.3; P ¼ .043). Conclusions: Those with an FMS score 16 had a shorter plank-test hold time, indicating that a lack of core endurance may contribute to the increased risk of LBP in female rowers. An FMS score 16 indicated a small increased risk (1.4) of developing LBP compared with rowers who had scores .16; however, the FMS is not recommended for widespread screening of female rowers because the risk ratio was relatively small and had a wide 95% confidence interval.