Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes - A prospective study

Objective: To assess whether athletes with strength imbalance of the hip mu sculature would be more likely to require treatment for low back pain (LBP) over the ensuing year. Design: The study population included 163 National Collegiate Athletic Asso ciation Division I college athletes (100 males and 63 females) undergoing p reparticipation sports physicals. Institutional review board approval was o btained to acquire and analyze hip muscle strength data. A commercially ava ilable dynamometer (Chatillon, Lexington, KY) incorporated into a specially designed anchoring station was used for testing the hip extensors and abdu ctors. The maximum force generated for the hip abductors and extensors was used to calculate a percentage difference between the right and left hip ex tensors and abductors. Treatment of athletes by the athletic trainers for L BP unrelated to blunt trauma over the ensuing year was recorded. Results: Of all athletes, 5 of 63 females and 8 of 100 males required treat ment for LBP. Logistic regression analysis indicated that for female athlet es, the percentage difference between the right and left hip extensors was predictive of whether treatment for LBP was required over the ensuing year (P = 0.05). There was no significant association noted for the percentage d ifference between the right and left hip abductors in females and for the p ercentage difference between both the right and left hip abductors and righ t and left hip extensors in males requiring treatment for LBP. Conclusions: These data support our results from our previous cohort study, adding validity to the concept of hip muscle imbalance being associated wi th LBP occurrence in female athletes. This research further supports the ne ed for the assessment and treatment of hip muscle imbalance in individuals with LBP.