In this 3-yr longitudinal study we investigated the occurrence of low-back pain and anatomic changes in the low back in relation to loading and injuries among 98 adolescents: 33 nonathletes (16 boys,17 girls), 34 boy athletes (17 ice hockey, 17 soccer players), and 31 girl athletes (17 figure skaters, 14 gymnasts). During the 3-yr follow-up, low-back pain lasting longer than 1 wk was reported by 29 (45%; 95% CI, 32%-57%) athletes and by 6 (18%; 95% CI, 7%-35%) nonathletes (P = 0.0099). Acute back injury was reported by 17 of 19 subjects who also reported low-back pain (89%; 95% CI, 67%-99%) and by 2 of 63 of those without prolonged low-back pain (3%; 95% CI, 0%-11%)(P < 0.0001). Among 43 girls participating in baseline and follow-up MRI examinations of the lumbar spine, new MRI abnormalities were found in 6 of 8 reporting acute back injury (75%; 95% CI, 35%-97%) and in 8 of the remaining 35 girls (23%; 95% CI 10% to 40%) (P = 0.018). In conclusion, excessive loading that involves a risk for acute low-back injuries during the growth spurt is harmful to the lower back.
Unit for Sports and Exercise Medicine, Institute of Biomedicine; Department of Public Health, University of Helsinki, FIN-00250 Helsinki, FINLAND; and Department of Diagnostic Radiology; University of Turku; Department of Physical Medicine and Rehabilitation, Turku University Hospital, FIN-20520 Turku, FINLAND
Submitted for publication November 1994.
Accepted for publication March 1995.
The authors gratefully acknowledge the skillful assistance of Ms. Laura Jaakkola, Ms. Maija Kopo, and Ms. Minna Riitamaa. The study was financially supported by the Finnish Ministry of Education.
Address for correspondence: Urho Kujala, M.D., Unit for Sports and Exercise Medicine, Töölö Sports Hall, Mannerheimintie 17, FIN-00250 Helsinki, Finland.