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. 2014 Jun 16;2(6):2325967114537588.
doi: 10.1177/2325967114537588. eCollection 2014 Jun.

Small Multifidus Muscle Size Predicts Football Injuries

Julie A Hides  1 , Warren R Stanton  2 , M Dilani Mendis  2 , Melinda M Franettovich Smith  2 , Margot J Sexton  2
Affiliations

Small Multifidus Muscle Size Predicts Football Injuries

Julie A Hides et al. Orthop J Sports Med. .

Abstract

Background: In Australian football, lower limb injuries have had the highest incidence and prevalence rates. Previous studies have shown that football players with relatively more severe preseason and playing season hip, groin, and thigh injuries had a significantly smaller multifidus muscle compared with players with no lower limb injuries. Rehabilitation of the multifidus muscle, with restoration of its size and function, has been associated with decreased recurrence rates of episodic low back pain and decreased numbers of lower limb injuries in football players. Assessment of multifidus muscle size and function could potentially be incorporated into a model that could be used to predict injuries in football players.

Purpose: To examine the robustness of multifidus muscle measurements as a predictor of lower limb injuries incurred by professional football players.

Study design: Cohort study; Level of evidence, 2.

Methods: Ultrasound examinations were carried out on 259 male elite football players at the start of the preseason and 261 players at the start of the playing season. Injury data were obtained from records collected by the Australian Football League (AFL) club staff during the preseason and the playing season.

Results: Decreased size of the multifidus muscle at L5 consistently predicted injury in the preseason and playing season. Asymmetry of the multifidus muscle and low back pain were significantly related to lower limb injuries in the preseason, and having no preferred kicking leg was related to season injuries. Seasonal change in the size of the multifidus muscle indicating a decrease in muscle mass was linked to injury. Sensitivity and specificity of the model were 60.6% and 84.9% for the preseason and 91.8% and 45.8% for the playing season, respectively.

Conclusion: A model was developed for prediction of lower limb injuries in football players with potential utility for club medical staff. Of particular note is the finding that changes in muscle size from the preseason to the playing season predicted injury.

Clinical relevance: As size of the multifidus muscle has been shown to be modifiable with training and has been associated with reduced pain and occurrence of injuries, this information could be incorporated in current programs of injury prevention.

Keywords: football; injury; multifidus muscle; ultrasound imaging.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: This project was funded by a competitive Australian Football League Research Board grant. General Electric supplied the ultrasound equipment used.

Figures

Figure 1.
Figure 1.
(A) Transverse image of the multifidus muscle and cross-sectional area measurement at L5. SP, L5 spinous process; ST, subcutaneous tissue. (B) Parasagittal image of the multifidus muscle and thickness measurements of the muscle at rest and on contraction. S, sacrum (used to indicate direction of image); ST, subcutaneous tissue.
Figure 2.
Figure 2.
Relationship between lower limb injuries and change in multifidus cross-sectional area (CSA) from preseason to playing season.
See this image and copyright information in PMC

References

    1. Anderson K, Strickland S, Warren R. Hip and groin injuries in athletes. Am J Sports Med. 2001;29:521–533. - PubMed
    1. Arnason A, Gudmundsson A, Dahl HA, Johannsson E. Soccer injuries in Iceland. Scand J Med Sci Sports. 1996;6:40–45. - PubMed
    1. Aspden RM. Review of the functional anatomy of the spinal ligaments and the lumbar erector spinae muscles. Clin Anat. 1992;5:372–387.
    1. Bogduk N, Macintosh JE, Pearcy MJ. A universal model of the lumbar back muscles in the upright position. Spine. 1992;17:897–913. - PubMed
    1. Bogduk N, Twomey LT. Clinical Anatomy of the Lumbar Spine. 2nd ed Singapore: Churchill Livingstone; 1991.

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