Epidemiology of low back pain in elite throwers

Introduction. In the literature there are no data on LBP in athletic specialties like Discus, Hammer and Javelin Throw and Shot Put; these athlets are usually overweight, practice activities requiring big efforts during competition and training, with low-grade aerobic needs; many times they use lumbar supports. Our aim was to study in elite throwers the epidemiology of LBP and its relationship with their activity. Methods. All 75 throwers (39 males - 19 Javelin, 19 Discus, and 23 Hammer Throw, 14 Shot Put) that participated to all elite competitions in Northern ltaly in 2002 agreed to participate and completed, a validated questionnaire. They were 24.5 years-old (range. 14-55); they trained 4.9 times/week, and participated to 2 competition/month. 80% used a lumbar support. Results. Life time prevalence: LBP 86.7%, sciatica: 30.7%; episodes: > 3/years 33.8% (median); the worst episode was acute (<7day) in 49.3%, and chronic (>6 months) in 5.3%; the usual episode was acute in 76.0% and lasted more than 1 month in 2.7%. Work was stopped at least once by 47.7%, training was stopped by 50.8% and reduced by 72.3%. In 37.4% pain worsened during training, in 41.3% immediately after and in 10.7% the day after. 87.1% of throwers did not have LBP before beginning competitions; 18.9% begun having problems in their first year of activity; 62.5% of those who already had LBP did not worsened with sport activities. LBP was significantly higher in males, who had higher disability, trained more and adhered less to prescribed therapies than females. Discussion. Prevalence and duration of LBP in throwers are higher than those reported in the general population and those previously found in other sports. Even if these results should be confirmed through controlled and longitudinal studies, they suggest that these athletic specialties are a problem for the spine.