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Are flexibility and muscle-strengthening activities associated with a higher risk of developing low back pain?

Published:August 29, 2013DOI:https://doi.org/10.1016/j.jsams.2013.07.016

      Abstract

      Objectives

      To examine the association between participation in flexibility or muscle-strengthening activities with the development of low back pain.

      Design

      Observational cohort study.

      Methods

      The cohort included 4610 adults, 17% female, between 20 and 81 years of age (mean 46.6, standard deviation 4.96). The cohort was followed for a mean of 4.9 years for self-reported low back pain. All participants reported at baseline whether they performed flexibility or muscle-strengthening activities, including specific sub-types.

      Results

      Neither general performance of flexibility or muscle-strengthening activities were associated with a higher incidence of low back pain compared to those who did not perform these activities. Those who reported stretching, as a specific flexibility activity were at a higher risk of developing low back pain compared with those who performed no flexibility exercises, reported callisthenic flexibility activities, or attended exercise classes. Those who reported using weight training machines, as part of muscle-strengthening activities, had a higher risk of reporting low back pain, compared with those who did not perform muscle-strengthening activities or performed callisthenic or free weight activities.

      Conclusions

      In this sample, stretching or use of weight training machines is associated with increased risk of developing low back pain compared to use of free weights, callisthenics or exercise classes.

      Keywords

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      References

        • Hart L.G.
        • Deyo R.A.
        • Cherkin D.C.
        Physician office visits for low back pain, frequency, clinical evaluation, and treatment patterns from a US national survey.
        Spine (Phila Pa 1976). 1995; 20: 11-19
        • Dionne C.E.
        • Dunn K.M.
        • Croft P.R.
        • et al.
        A consensus approach toward the standardization of back pain definitions for use in prevalence studies.
        Spine (Phila Pa 1976). 2008; 33: 95-103
        • Hoy D.
        • Bain C.
        • Williams G.
        • et al.
        A systematic review of the global prevalence of low back pain.
        Arth Rheum. 2012; 64: 2028-2037
        • Omokhodion F.O.
        • Sanya A.O.
        Risk factors for low back pain among office workers in Ibadan: Southwest Nigeria.
        Occup Med (Lond). 2003; 53: 287-289
        • Department of Health, PA
        Health improvement and prevention, at least five a week.
        Department of Health, London2004
        • Kesaniemi A.
        • Riddoch C.J.
        • Reeder B.
        • et al.
        Advancing the future of physical activity guidelines in Canada: an independent expert panel interpretation of the evidence.
        Int J Behav Nutr Phys Act. 2010; 7: 41
        • U.S. Department of Health and Human Services
        Physical activity guidelines for americans.
        2008 (Available from: http://www.health.gov/paguidelines/pdf/paguide.pdf [cited 9 May 2012])
        • Haladay D.E.
        • Miller S.J.
        • Challis J.
        • et al.
        Quality of systematic reviews on specific spinal stabilization exercise for chronic low back pain.
        J Orthop Sports Phys Ther. 2013;
        • Liddle S.D.
        • Gracey J.H.
        • Baxter G.D.
        Advice for the management of low back pain: a systematic review of randomised controlled trials.
        Man Ther. 2007; 12: 310-327
        • Battie M.C.
        • Bigos S.J.
        • Fisher L.D.
        • et al.
        Isometric lifting strength as a predictor of industrial back pain reports.
        Spine (Phila Pa 1976). 1989; 14: 851-856
        • Sjolie A.N.
        • Ljunggren A.E.
        The significance of high lumbar mobility and low lumbar strength for current and future low back pain in adolescents.
        Spine (Phila Pa 1976). 2001; 26: 2629-2636
        • Feldman D.E.
        • Shrier I.
        • Rossignol M.
        • et al.
        Risk factors for the development of low back pain in adolescence.
        Am J Epidemiol. 2001; 154: 30-36
        • Gibbons L.E.
        • Videman T.
        • Battie M.C.
        Isokinetic and psychophysical lifting strength: static back muscle endurance, and magnetic resonance imaging of the paraspinal muscles as predictors of low back pain in men.
        Scand J Rehabil Med. 1997; 29: 187-191
        • Purepong N.
        • Jitvimonrat A.
        • Boonyong S.
        • et al.
        Effect of flexibility exercise on lumbar angle: a study among non-specific low back pain patients.
        J Bodyw Mov Ther. 2012; 16: 236-243
        • Mikkelsson L.O.
        • Nupponen H.
        • Kaprio J.
        • et al.
        Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study.
        Br J Sports Med. 2006; 40: 107-113
        • Battie M.C.
        • Bigos S.J.
        • Fisher L.D.
        • et al.
        The role of spinal flexibility in back pain complaints within industry. A prospective study.
        Spine (Phila Pa 1976). 1990; 15: 768-773
        • Blair S.N.
        • Kohl 3rd, H.W.
        • Paffenbarger Jr., R.S.
        • et al.
        Physical fitness and all-cause mortality. A prospective study of healthy men and women.
        JAMA. 1989; 262: 2395-2401
        • Cramer H.
        • Lauche R.
        • Haller H.
        • et al.
        A systematic review and meta-analysis of yoga for low back pain.
        Clin J Pain. 2012;
        • Waddell G.
        The back pain revolution.
        2nd ed. Churchill-Livingstone, New York2004
        • Levin K.
        Low back pain.
        2010 (Available from: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/neurology/low-back-pain/ [cited 18 September 2012])
        • Macpherson P.C.
        • Schork M.A.
        • Faulkner J.A.
        Contraction-induced injury to single fiber segments from fast and slow muscles of rats by single stretches.
        Am J Physiol Cell Physiol. 1996; 271: C1438-C1446
        • Halbertsma J.P.
        • Goeken L.N.
        Stretching exercises: effect on passive extensibility and stiffness in short hamstrings of healthy subjects.
        Arch Phys Med Rehabil. 1994; 75: 976-981
        • Shrier I.
        Stretching before exercise: an evidence based approach.
        Br J Sports Med. 2000; 34: 324-325
        • Goldspink D.F.
        • Cox V.M.
        • Smith S.K.
        • et al.
        Muscle growth in response to mechanical stimuli.
        Am J Physiol. 1995; 268: E288-E297
        • Exercise A.C.O.
        Free weights vs. strength-training equipment. Fit facts.
        2012 (Available from: http://www.acefitness.org/fitfacts/fitfacts_display.aspx?itemid=2655 [cited 27 September 2012])
        • Colado J.C.
        • Pablos C.
        • Chulvi-Medrano I.
        • et al.
        The progression of paraspinal muscle recruitment intensity in localized and global strength training exercises is not based on instability alone.
        Arch Phys Med Rehabil. 2011; 92: 1875-1883
        • Zatsiorsky V.M.K.W.
        Chapter 7: injury prevention, in science and practise of strength training.
        Human Kinet. 2006; : 137-154
        • Schwanbeck S.
        • Chilibeck P.D.
        • Binsted G.
        A comparison of free weight squat to Smith machine squat using electromyography.
        J Strength Cond Res. 2009; 23: 2588-2591
        • Shiri R.
        • Karppinen J.
        • Leino-Arjas P.
        • et al.
        The association between obesity and low back pain: a meta-analysis.
        Am J Epidemiol. 2010; 171: 135-154
        • Biering-Sorensen F.
        • Hilden J.
        Reproducibility of the history of low-back trouble.
        Spine (Phila Pa 1976). 1984; 9: 280-286