{"id":268,"date":"2010-08-02T03:30:39","date_gmt":"2010-08-02T03:30:39","guid":{"rendered":"http:\/\/optimumsportsperformance.com\/blog\/?p=268"},"modified":"2019-01-19T23:26:57","modified_gmt":"2019-01-19T23:26:57","slug":"the-lumbar-flexion-debate-mma-athletes","status":"publish","type":"post","link":"https:\/\/optimumsportsperformance.com\/blog\/the-lumbar-flexion-debate-mma-athletes\/","title":{"rendered":"The Lumbar Flexion Debate &#8211; MMA Athletes"},"content":{"rendered":"<p>The debate about whether or not to do lumbar flexion exercises (sit ups, knee ins, bicycles, v-ups, etc) is a heated one.\u00a0 To tell you the truth, it probably wont ever end\u00a0as professionals will always reside on one side of the fence (lumbar flexion isn\u2019t that bad!)\u00a0or the other (stabilize, stabilize, stabilize!).<\/p>\n<p>Dr. Stuart McGill has done a great job conducting research on the topic and lecturing around the world regarding appropriate training strategies for strength coaches, fitness professionals, and rehabilitation specialists.\u00a0 However, one of the common debates that often comes up is,\u00a0<em>\u201cCompetitive fighting\u00a0athletes go through lumbar flexion (sometimes very aggressive lumbar flexion)\u00a0in their sport and thus we must train that movement to ensure that they are adequately prepared for competition.\u201d<\/em><\/p>\n<p>Sounds good, right?\u00a0 After\u00a0all, the role of the strength coach is to prepare the athlete for their competitive endeavors!<\/p>\n<p>The only problem I see with this argument is that as the strength coach, we need to ensure that the athletes are healthy and injury free.\u00a0 If we know that the mechanism of disc injury is repeated flexion, and we know that the athletes go through this movement in their sports training and competition, is this a movement that we really need to do more of in the gym?\u00a0 To me, that sounds like the same as doing a high volume plyometric program for an inseason basketball or volleyball athlete.\u00a0 They are already getting a lot of contacts in practice and games, why do we need to load that up more?\u00a0 In fact, we should unload that and do something with less impact that sufficiently addresses the strength needs of those athletes.\u00a0 Speaking of basketball, when taking a jump shot, athletes will typically go into knee valgus.\u00a0 With this same mentality, shouldn\u2019t we train that movement it so that they are prepared for it when it happens in a dynamic environment like competition?\u00a0 Obviously I don\u2019t expect anyone to\u00a0answer<em>\u201cyes\u201d\u00a0<\/em>to that question.<\/p>\n<p>The next\u00a0point that is always brought up is\u00a0<em>\u201cAthletes who fight competitively all over the world train using lumbar flexion exercises and then go and practice and compete and do more lumbar flexion and don\u2019t seem to have problems.\u00a0 Maybe it isn\u2019t such a big deal.\u201d<\/em><\/p>\n<p>One of the things science does is helps us to remove our assumptions of what we think is going on based on our observations.\u00a0 Our assumptions\u00a0are brought\u00a0about by several factors\u00a0including the sample size of people we are working with and our own personal bias towards what we are doing.\u00a0 Basically, we put it in the hands of a neutral third party who tests these assumptions and then comes back to us an either says,\u00a0<em>\u201cYep, you were right!\u00a0 It looks like that is happening\u201d, or \u201cActually, we tested your assumption and we found the opposite to be true.\u201d\u00a0\u00a0<\/em>This of course leads to more research and more questions and eventually theories are developed to help give us a larger explanation of what is taking place.<\/p>\n<p>While the idea that,\u00a0<em>\u201cTraining these movements is essential because they happen in sport\u201d\u00a0<\/em>may sound good on paper, are the programs being created really helping these athletes compete without incident?<\/p>\n<p>A 2007 study conducted by Okada et al, looked at the prevalence of nonspecific low back pain\u00a0and lumbar radicular abnormalities in 82 male judo athletes in three different weight classes \u2013 light, middle, and heavyweight.<\/p>\n<p><strong>Back pain:<\/strong><\/p>\n<ul>\n<li>10 out of 29 lightweight athletes had nonspecfic low back pain (34.5%)<\/li>\n<li>10 out of 31 middleweight athletes had nonspecific low back pain (32.3%)<\/li>\n<li>9 out of 22 heavyweight athletes had nonspecific low back pain (40.9%)<\/li>\n<\/ul>\n<p><strong>Lumbar radicular abnormalities:<\/strong><\/p>\n<ul>\n<li>19 out of 29 lightweight athletes exhibited lumbar radicular abnormalities (65.5%)<\/li>\n<li>28 out 31 middleweight athletes exhibited lumbar radicular abnormalities (90.3%)<\/li>\n<li>20 out of 22 heavyweight athletes exhibited lumbar radicular abnormalities (90.9%)<\/li>\n<\/ul>\n<p><strong>With lumbar radicular abnormalities and WITH low back pain:<\/strong><\/p>\n<ul>\n<li>50% in the lightweight group<\/li>\n<li>100% in the middle weight group<\/li>\n<li>88.9% in the heavy weight group<\/li>\n<\/ul>\n<p><strong>With lumbar radicular abnormalities and WITHOUT low back pain:<\/strong><\/p>\n<ul>\n<li>73.7% in the lightweight group<\/li>\n<li>85.7% in the middleweight group<\/li>\n<li>92.3% in the heavyweight group<\/li>\n<\/ul>\n<p>The researchers concluded that the prevalence of low back pain in this group ranged from 30-40% and that the prevalence of lumbar radicular abnormalities with nonspecific low back pain (79.3%) and without nonspecific low back pain (83%) suggest a lack of association between back pain and imaging (<em>this should come as no surprise since it has been indicated in previous research).\u00a0<\/em>While medical imaging\u00a0didn\u2019t\u00a0give us the full picture as some athletes had pain without positive imaging and others with positive imaging did not have pain, low back pain appears to be a problem in this group of athletes and Okada et al state,\u00a0<em>\u201cBecause nonspecific low back pain is a common complaint among athletes, it is important that the athletes and their coaches work towards prevention so that athletes can continue their sports activities.\u201d<\/em><\/p>\n<p>In the wrestling community, reports of low back pain have been shown to be as high as 69%.\u00a0 Wrestlers are a group who spend a lot of time on the mat getting into and (hopefully) out of a variety of positions.\u00a0Iwai and colleagues (2004) evaluated trunk muscle strength and functional disability of chronic low back pain in 53 college wrestlers.\u00a0 The wrestlers were evaluated for radiological abnormalities and isokinetic trunk muscle strength.\u00a0 They found that 14 of the subjects with radiological abnormalities had low back pain (40%) and 8 of the subjects without radiological abnormalities had low back pain (44%).\u00a0 Similar to the study by Okada et al, we see that the percentage of those with low back pain\u00a0and with or without radiological findings is relatively close.\u00a0 Iwai et al, concluded that low trunk extensor strength may be a potential factor in chronic nonspecific low back pain in this population of athletes.\u00a0 Which would be in contrast to those supporting more lumbar flexion training for these types of athletes.<\/p>\n<p>Just looking at these two studies, we see that maybe\u00a0the assumptions being made regarding lumbar flexion training and competitive fighting athletes is not a good one.\u00a0 Perhaps the anecdotal information that we get from other coaches is not valid?\u00a0 In other parts of the world, how much pain\/injury goes undocumented or maybe the athletes don\u2019t even bring it to the coach\u2019s attention?\u00a0 How well is the record keeping of these coaches?\u00a0 Everyone seems to remember the \u201chits\u201d,\u00a0<em>\u201cThis is how we\u2019ve have always done\u00a0it and we have had 10 world champions.\u201d\u00a0\u00a0<\/em>However, they failed to remember the 30 other athletes that were sidelined with injury.\u00a0 Are we missing people?<\/p>\n<p><strong>Conclusions<\/strong><\/p>\n<p>Low back pain is common in sports and the training program should be comprehensive and well thought out in a manner that helps to prevent or reduce the incidence of injury.\u00a0 While some potentially injurious movements happen in sport that doesn\u2019t necessarily mean that we need to further train those movements in the gym.\u00a0 Rather, it may be more advantageous to prepare athletes to handle the loads and forces placed upon them in competition with a strength and conditioning program\u00a0that teaches healthy movement and does not seek to overtrain\/overuse patterns that are commonly performed in both sports preparation and competition.<\/p>\n<p><strong>References<\/strong><\/p>\n<p>Okada T., Nakazato K. Iwai K., Tanabe M., Irie K., Nakajima H.\u00a0<strong>Body Mass, Nonspecific Low Back Pain, and Anatomical Changes in the Lumbar Spine in Judo Athletes.\u00a0<\/strong><em>JSOPT\u00a0<\/em>2007;37(11):688-693.<\/p>\n<p>Iwai K., Nakazato K., Irie K., Fujimoto H., Nakajima H.,\u00a0<strong>Trunk muscle strength and disability level of low back pain in collegiate wrestlers.\u00a0<\/strong><em>Med Sci Sport Exer\u00a0<\/em>2004;36(8):1296-1300.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The debate about whether or not to do lumbar flexion exercises (sit ups, knee ins, bicycles, v-ups, etc) is a heated one.\u00a0 To tell you the truth, it probably wont ever end\u00a0as professionals will always reside on one side of the fence (lumbar flexion isn\u2019t that bad!)\u00a0or the other (stabilize, stabilize, stabilize!). Dr. Stuart McGill [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[27],"tags":[],"class_list":["post-268","post","type-post","status-publish","format-standard","hentry","category-strength-and-conditioning"],"_links":{"self":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts\/268","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/comments?post=268"}],"version-history":[{"count":1,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts\/268\/revisions"}],"predecessor-version":[{"id":269,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/posts\/268\/revisions\/269"}],"wp:attachment":[{"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/media?parent=268"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/categories?post=268"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/optimumsportsperformance.com\/blog\/wp-json\/wp\/v2\/tags?post=268"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}