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Int J Sports Med 2018; 39(08): 630-635
DOI: 10.1055/a-0631-3111
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Multifidus Muscle Size and Symmetry in Ballroom Dancers with and without Low Back Pain

Alyssa Smyers Evanson
1   Department of Exercise Sciences, Brigham Young University, Provo, United States
,
Joseph William Myrer
1   Department of Exercise Sciences, Brigham Young University, Provo, United States
,
Dennis L. Eggett
2   Statistics, Brigham Young University, Provo, United States
,
Ulrike H. Mitchell
1   Department of Exercise Sciences, Brigham Young University, Provo, United States
,
A. Wayne Johnson
1   Department of Exercise Sciences, Brigham Young University, Provo, United States
› Author Affiliations
Further Information

Publication History



accepted 09 April 2018

Publication Date:
08 June 2018 (online)

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Abstract

The incidence of low back pain (LBP) among elite ballroom dancers is high and understanding associations between muscle morphology and pain may provide insight into treatment or training options. Research has linked multifidus muscle atrophy to LBP in the general and some athletic populations; however, this has not been examined in ballroom dancers. We compared the lumbar multifidus cross-sectional area (CSA) at rest in 57 elite level ballroom dancers (age 23±2.4 years; height, 174±11 cm; mass, 64±10 kg) divided into one of three pain groups, according to their self-reported symptoms, 1) LBP group (n=19), 2) minimal LBP (n=17), and 3) no LBP (n=21). There were no significant difference in demographics between the groups (P>0.05). The LBP group demonstrated significant differences in reported pain and Oswestry Disability Index scores compared to the other two groups. There was no significant difference between groups in multifidus cross-sectional area (P=0.49). Asymmetry was found in all groups with the overall left side being significantly larger than the right (P<0.002). Pain associated with segmental decrease in multifidus CSA was not observed in ballroom dancers with LBP, suggesting other reasons for persistent LBP in ballroom dancers.

Key words

spine musculoskeletal ultrasound imaging - core strength in dancers - imaging dancers
 

  • References

  • 1 Alderson J, Hopper L, Elliott B, Ackland T. Risk factors for lower back injury in male dancers performing ballet lifts. J Dance Med Sci 2009; 13: 83-89
    PubMedSearch in Google Scholar
  • 2 Barker KL, Shamley DR, Jackson D. Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: The relationship to pain and disability. Spine (Phila Pa 1976) 2004; 29: E515-E519
    CrossrefPubMedSearch in Google Scholar
  • 3 Chatfield SJ, Krasnow DH, Herman A, Blessing G. A descriptive analysis of kinematic and electromyographic relationships of the core during forward stepping in beginning and expert dancers. J Dance Med Sci 2007; 11: 76-84
    PubMedSearch in Google Scholar
  • 4 Coldron Y, Stokes M, Cook K. Lumbar multifidus muscle size does not differ whether ultrasound imaging is performed in prone or side lying. Man Ther 2003; 8: 161-165
    CrossrefPubMedSearch in Google Scholar
  • 5 Danneels LA, Vanderstraeten GG, Cambier DC, Witvrouw EE, De Cuyper HJ. CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects. Eur Spine J 2000; 9: 266-272
    CrossrefPubMedSearch in Google Scholar
  • 6 DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: Intrasubject variability and correlation with a numeric scale. Anesth Analg 1998; 86: 102-106
    PubMedSearch in Google Scholar
  • 7 DeMann Jr LE. Sacroiliac dysfunction in dancers with low back pain. Man Ther 1997; 2: 2-10
    CrossrefPubMedSearch in Google Scholar
  • 8 Demuth N, Gross B, Sullivan PE. Relationship of lumbar mobility, lumbar curve and hip flexibility to low-back pain in female ballet dancers. Phys Ther 1988; 68: 842-842
    PubMedSearch in Google Scholar
  • 9 Dickx N, Cagnie B, Parlevliet T, Lavens A, Danneels L. The effect of unilateral muscle pain on recruitment of the lumbar multifidus during automatic contraction. An experimental pain study. Man Ther 2010; 15: 364-369
    CrossrefPubMedSearch in Google Scholar
  • 10 Fairbank JC. CJDJ The oswestry low back pain disability questionnaire. Physiotherapy 1980; 66: 271-273
    PubMedSearch in Google Scholar
  • 11 Fairbank JC, Pynsent PB. The oswestry disability index. Spine (Phila Pa 1976) 2000; 25: 2940-2952 discussion 2952
    CrossrefPubMedSearch in Google Scholar
  • 12 Fett D, Trompeter K, Platen P. Back pain in elite sports: A cross-sectional study on 1114 athletes. PLoS One 2017; 12: e0180130
    CrossrefPubMedSearch in Google Scholar
  • 13 Gildea JE, Hides JA, Hodges PW. Size and symmetry of trunk muscles in ballet dancers with and without low back pain. J Orthop Sports Phys Ther 2013; 43: 525-533
    CrossrefPubMedSearch in Google Scholar
  • 14 Gupta A, Fernihough B, Bailey G, Bombeck P, Clarke A, Hopper D. An evaluation of differences in hip external rotation strength and range of motion between female dancers and non-dancers. Br J Sports Med 2004; 38: 778-783
    CrossrefPubMedSearch in Google Scholar
  • 15 Harriss DJ, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 update. Int J Sports Med 2017; 38: 1126-1131
    Thieme ConnectPubMedSearch in Google Scholar
  • 16 Hides J, Gilmore C, Stanton W, Bohlscheid E. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther 2008; 13: 43-49
    CrossrefPubMedSearch in Google Scholar
  • 17 Hides J, Richardson C, Jull G. Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain. Spine 1996; 21: 2763-2769
    CrossrefPubMedSearch in Google Scholar
  • 18 Hides J, Saide M, Stokes M, Jull G. Evidence of lumbar multifidus wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine 1994; 19: 165-172
    CrossrefPubMedSearch in Google Scholar
  • 19 Hides J, Stanton W, McMahon S, Sims K, Richardson C. Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain. J Orthop Sports Phys Ther 2008; 38: 101-108
    CrossrefPubMedSearch in Google Scholar
  • 20 Koppenhaver SL, Fritz JM, Herbert JJ. Association between Changes in Abdominal and Lumbar Multifidus Muscle Thickness and Clinical Improvement after Spinal Manipulation. J Orthop Sports Phys Ther 2011; 41: 389-399
    CrossrefPubMedSearch in Google Scholar
  • 21 Koutedakis Y, Pacy PJ, Carson RJ, Dick F. Health and Fitness in Professional Dancers. Med Probl Perform Art 1997; 12: 23-27
    PubMedSearch in Google Scholar
  • 22 Macdonald DA, Dawson AP, Hodges PW. Behavior of the lumbar multifidus during lower extremity movements in people with recurrent low back pain during symptom remission. J Orthop Sports Phys Ther 2011; 41: 155-164
    CrossrefPubMedSearch in Google Scholar
  • 23 Mannion AF, Pulkovski N, Toma V, Sprott H. Abdominal muscle size and symmetry at rest and during abdominal hollowing exercises in healthy control subjects. J Anat 2008; 213: 173-182
    CrossrefPubMedSearch in Google Scholar
  • 24 McGregor AH, Anderton L, Gedroyc WM. The trunk muscles of elite oarsmen. Br J Sports Med 2002; 36: 214-217
    CrossrefPubMedSearch in Google Scholar
  • 25 Myrer JW, Johnson AW, Mitchell UH, Measom GJ, Fellingham GW. Topical analgesic added to paraffin enhances paraffin bath treatment of individuals with hand osteoarthritis. Disabil Rehabil 2011; 33: 467-474
    CrossrefPubMedSearch in Google Scholar
  • 26 Noon M, Hoch AZ, McNamara L, Schimke J. Injury patterns in female Irish dancers. PM R 2010; 2: 1030-1034
    CrossrefPubMedSearch in Google Scholar
  • 27 Peltonen JE, Taimela S, Erkintalo M, Salminen JJ, Oksanen A, Kujala UM. Back extensor and psoas muscle cross-sectional area, prior physical training, and trunk muscle strength–a longitudinal study in adolescent girls. Eur J Appl Physiol 1998; 77: 66-71
    PubMedSearch in Google Scholar
  • 28 Puentedura EJ, Landers MR, Hurt K, Meissner M, Mills J, Young D. Immediate effects of lumbar spine manipulation on the resting and contraction thickness of transversus abdominis in asymptomactic individuals. J Orthop Sports Phys Ther 2011; 41: 13-21
    CrossrefPubMedSearch in Google Scholar
  • 29 Sitilertpisan P, Hides J, Stanton W, Paugmali A, Pirunsan U. Multifidus muscle size ans symmetry among elite weightlifters. Phys Ther Sport 2011; 4: 11-15
    PubMedSearch in Google Scholar
  • 30 Stokes M, Rankin G, Newham DJ. Ultrasound imaging of lumbar multifidus muscle: normal reference ranges for measurements and practical guidance on the technique. Man Ther 2005; 10: 116-126
    CrossrefPubMedSearch in Google Scholar
  • 31 Swain C, Redding E. Trunk muscle endurance and low back pain in female dance students. J Dance Med Sci 2014; 18: 62-66
    CrossrefPubMedSearch in Google Scholar
  • 32 Teyhen DS, Bluemle LN, Dolbeer JA, Baker SE, Molloy JM, Whittaker J, Childs JD. Changes in lateral abdominal muscle thickness during the abdominal drawing-in maneuver in those with lumbopelvic pain. J Orthop Sports Phys Ther 2009; 39: 791-798
    CrossrefPubMedSearch in Google Scholar
  • 33 Teyhen DS, Gill NW, Whittaker JL, Henry SM, Hides JA, Hodges P. Rehabilitative ultrasound imaging of the abdominal muscles. J Orthop Sports Phys Ther 2007; 37: 450-466
    CrossrefPubMedSearch in Google Scholar
  • 34 Van K, Hides JA, Richardson CA. The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects. J Orthop Sports Phys Ther 2006; 36: 920-925
    CrossrefPubMedSearch in Google Scholar
  • 35 Wallwork TL, Stanton WR, Freke M, Hides JA. The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Man Ther 2009; 14: 496-500
    CrossrefPubMedSearch in Google Scholar