Small multifidus muscle size predicts football injuries

Journal article

Hides, Julie Anne, Stanton, Warren Robert, Mendis, Marianne Dilani, Franettovich Smith, Melinda M. and Sexton, Margot. (2014). Small multifidus muscle size predicts football injuries. Orthopaedic Journal of Sports Medicine. 2(6), pp. 1 - 9. https://doi.org/10.1177/2325967114537588
AuthorsHides, Julie Anne, Stanton, Warren Robert, Mendis, Marianne Dilani, Franettovich Smith, Melinda M. and Sexton, Margot
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.

Keywordsfootball; injury; multifidus muscle; ultrasound imaging
Year2014
JournalOrthopaedic Journal of Sports Medicine
Journal citation2 (6), pp. 1 - 9
PublisherSAGE Publications Inc.
ISSN2325-9671
Digital Object Identifier (DOI)https://doi.org/10.1177/2325967114537588
Scopus EID2-s2.0-84930488958
Open accessOpen access
Page range1 - 9
Research GroupSchool of Allied Health
Publisher's version
License
Place of publicationUnited States of America
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Hides, Julie Anne, Lambrecht, G., Richardson, C A., Stanton, W., Armbrecht, G., Pruett, C., Damann, V., Felsenberg, D. and Belavy, D.. (2011). The effects of rehabilitation on the muscles of the trunk following prolonged bed rest. European Spine Journal (online version). 20(5), pp. 808 - 818. https://doi.org/10.1007/s00586-010-1491-x
Magnetic resonance imaging assessment of regional abdominal muscle function in elite AFL players with and without low back pain
Hides, Julie Anne, Hughes, Brita and Stanton, Warren Robert. (2011). Magnetic resonance imaging assessment of regional abdominal muscle function in elite AFL players with and without low back pain. Manual Therapy (online version). 16(3), pp. 279 - 284. https://doi.org/10.1016/j.math.2010.11.009
Psoas and quadratus lumborum muscle asymmetry among elite Australian Football League players
Hides, Julie Anne, Fan, Theresa, Stanton, Warren Robert, Stanton, P, McMahon, Catherine and Wilson, Stephen. (2010). Psoas and quadratus lumborum muscle asymmetry among elite Australian Football League players. British Journal of Sports Medicine. 44(8), pp. 563 - 567. https://doi.org/10.1136/bjsm.2008.048751
Consistency in size and asymmetry of the psoas major muscle among elite footballers
Stewart, Stephen, Stanton, Warren Robert, Wilson, Stephen and Hides, Julie Anne. (2010). Consistency in size and asymmetry of the psoas major muscle among elite footballers. British Journal of Sports Medicine. 44(16), pp. 1173 - 1177. https://doi.org/10.1136/bjsm.2009.058909
Validity of real-time ultrasound imaging to measure anterior hip muscle size: A comparison with magnetic resonance imaging
Mendis, Dilani, Wilson, Stephen, Stanton, Warren and Hides, Julie. (2010). Validity of real-time ultrasound imaging to measure anterior hip muscle size: A comparison with magnetic resonance imaging. Journal of Orthopaedic and Sports Physical Therapy. 40(9), pp. 577 - 581. https://doi.org/10.2519/jospt.2010.3286
A magnetic resonance imaging investigation of the transversus abdominins muscle during drawing-in of the abdominal wall in elite Australian football league players with and without low back pain
Hides, Julie Anne, Boughen, Carly, Stanton, Warren Robert, Strudwick, Mark and Wilson, Steve. (2010). A magnetic resonance imaging investigation of the transversus abdominins muscle during drawing-in of the abdominal wall in elite Australian football league players with and without low back pain. Journal of Orthopaedic and Sports Physical Therapy. 40(1), pp. 4 - 10. https://doi.org/10.2519/jospt.2010.3177
Countermeasures against lumbar spine deconditioning in prolonged bed rest : resistive exercise with and without whole body vibration
Hides, Julie Anne, Belavy, Daniel, Armbrecht, Gabriele, Richardson, Carolyn, Felsenberg, Dieter and Gast, U. (2010). Countermeasures against lumbar spine deconditioning in prolonged bed rest : resistive exercise with and without whole body vibration. Journal of Applied Psychology. 109(6), pp. 1801 - 1811. https://doi.org/10.1152/japplphysiol.00707.2010
Retraining motor control of abdominal muscles among elite cricketers with low back pain
Hides, Julie Anne, Stanton, Warren Robert, Wilson, Stephen, Freke, Matt, McMahon, Shaun and Sims, K. (2010). Retraining motor control of abdominal muscles among elite cricketers with low back pain. Scandinavian Journal of Medicine & Science in Sports. 20(6), pp. 834 - 842. https://doi.org/10.1111/j.1600-0838.2009.01019.x
The reliability and validity of the alcohol, smoking and substance involvement screening test (assist)
Hides, L., Cotton, Sue, Berger, G., Gleeson, John, O'Donnell, C., Proffitt, T., McGorry, Patrick and Lubman, Dan. (2009). The reliability and validity of the alcohol, smoking and substance involvement screening test (assist). Addictive Behaviors. 34(10), pp. 821 - 825. https://doi.org/10.1016/j.addbeh.2009.03.040
Different ways to balance the spine: Subtle changes in sagittal spinal curves affect regional muscle activity
Claus, Andrew, Hides, Julie, Moseley, G. Lorimer and Hodges, Paul. (2009). Different ways to balance the spine: Subtle changes in sagittal spinal curves affect regional muscle activity. Spine. 34(6), pp. 208 - 214. https://doi.org/10.1097/BRS.0b013e3181908ead
The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles
Grimaldi, Alison, Richardson, Carolyn, Durbridge, Gail, Donnelly, William, Darnell, Ross and Hides, Julie Anne. (2009). The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles. Manual Therapy. 14(6), pp. 611 - 617. https://doi.org/10.1016/j.math.2008.11.002
The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle
Wallwork, Tracy, Stanton, Warren, Freke, Matt and Hides, Julie. (2009). The effect of chronic low back pain on size and contraction of the lumbar multifidus muscle. Manual Therapy. 14(5), pp. 496 - 500. https://doi.org/10.1016/j.math.2008.09.006
Effect of prolonged bed rest on the anterior hip muscles
Mendis, Dilani, Hides, Julie, Wilson, Stephen, Grimaldi, Alison, Belavy, Daniel, Stanton, Warren, Felsenberg, Dieter, Rittweger, Jorn and Richardson, Carolyn A.. (2009). Effect of prolonged bed rest on the anterior hip muscles. Gait & Posture. 30(4), pp. 533 - 537. https://doi.org/10.1016/j.gaitpost.2009.08.002
The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles
Grimaldi, Alison, Richardson, Carolyn, Stanton, Warren Robert, Durbridge, Gail, Donnelly, William and Hides, Julie Anne. (2009). The association between degenerative hip joint pathology and size of the gluteus medius, gluteus minimus and piriformis muscles. Manual Therapy. 14(6), pp. 605 - 610. https://doi.org/10.1016/j.math.2009.07.004
Altered response of the anterolateral abdominal muscles to stimulated weight-bearing in subjects with low back pain
Hides, Julie, Belavy, Daniel, Cassar, Lana, Willia, Michelle, Wilson, Stephen and Richardson, Carolyn A.. (2009). Altered response of the anterolateral abdominal muscles to stimulated weight-bearing in subjects with low back pain. European Spine Journal. 18(3), pp. 410 - 418. https://doi.org/10.1007/s00586-008-0827-2
Is 'ideal' sitting posture real?: Measurement of spinal curves in four sitting postures
Claus, Andrew, Hides, Julie, Moseley, G. Lorimer and Hodges, Paul. (2009). Is 'ideal' sitting posture real?: Measurement of spinal curves in four sitting postures. Manual Therapy. 14(4), pp. 404 - 408. https://doi.org/10.1016/j.math.2008.06.001
MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain
Hides, Julie, Stanton, Warren, Freke, Matt, Wilson, Stephen, McMahon, Shaun and Richardson, Carolyn A.. (2008). MRI study of the size, symmetry and function of the trunk muscles among elite cricketers with and without low back pain. British Journal of Sports Medicine. 42(10), pp. 809 - 813. https://doi.org/10.1136/bjsm.2007.044024
Sitting versus standing: Does the intradiscal pressure cause disc degeneration or low back pain?
Claus, Andrew, Hides, Julie, Moseley, G. Lorimer and Hodges, Paul. (2008). Sitting versus standing: Does the intradiscal pressure cause disc degeneration or low back pain? Journal of Electromyography and Kinesiology. 18(4), pp. 550 - 558. https://doi.org/10.1016/j.jelekin.2006.10.011
Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-res
Belavy, Daniel, Hides, Julie, Wilson, Stephen, Stanton, Warren, Dimeo, Fernando, Rittweger, Jorn, Felsenberg, Dieter and Richardson, Carolyn A.. (2008). Resistive simulated weightbearing exercise with whole body vibration reduces lumbar spine deconditioning in bed-res. Spine. 33(5), pp. 121 - 131. https://doi.org/10.1097/BRS.0b013e3181657f98
Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain
Hides, Julie, Stanton, Warren, McMahon, Shaun, Si, K. and Richardson, Carolyn A.. (2008). Effect of stabilization training on multifidus muscle cross-sectional area among young elite cricketers with low back pain. Journal of Orthopaedic and Sports Physical Therapy. 38(3), pp. 101 - 108. https://doi.org/10.2519/jospt.2008.2658
Multifidus size and symmetry among chronic IBP and healthy asymptomatic subjects
Hides, Julie, Gilmore, Craig, Stanton, Warren and Bohlscheid, Emma. (2008). Multifidus size and symmetry among chronic IBP and healthy asymptomatic subjects. Manual Therapy. 13(1), pp. 43 - 49. https://doi.org/10.1016/j.math.2006.07.017
Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial
Challis, Murray, Jull, Gwendolen, Stanton, Warren and Welsh, Mark. (2007). Cyclic pneumatic soft-tissue compression enhances recovery following fracture of the distal radius: a randomised controlled trial. Journal of Physiotherapy. 53(4), pp. 247 - 252. https://doi.org/10.1016/S0004-9514(07)70005-3
Assessment of abdominal muscle function during a simulated unilateral weigh bearing task using ultrasound imaging
Hides, Julie, Wong, Ian, Wilson, Stephen, Belavy, Daniel and Richardson, Carolyn A.. (2007). Assessment of abdominal muscle function during a simulated unilateral weigh bearing task using ultrasound imaging. Journal of Orthopaedic and Sports Physical Therapy. 37(8), pp. 467 - 471. https://doi.org/10.2519/jospt.2007.2417
Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: an intrarater reliability study
Richardson, Carolyn A., Miokovic, Tanja, Belavy, Daniel, Stanton, Warren and Hides, Julie. (2007). Ultrasound imaging assessment of abdominal muscle function during drawing-in of the abdominal wall: an intrarater reliability study. Journal of Orthopaedic and Sports Physical Therapy. 37(8), pp. 480 - 486. https://doi.org/10.2519/jospt.2007.2416
Rehabilitative ultrasound imaging of the posterior paraspinal muscles
Stokes, Maria, Hides, Julie, Elliott, James, Kiesel, Kyle and Hodges, Paul. (2007). Rehabilitative ultrasound imaging of the posterior paraspinal muscles. Journal of Orthopaedic and Sports Physical Therapy. 37(10), pp. 581 - 595. https://doi.org/10.2519/jospt.2007.2599
The ability to predict dynamic foot posture from static measurements
Franettovich-Smith, M., McPoil, T. G., Russell, T., Skardoon, G and Vicenzino, Bill. (2007). The ability to predict dynamic foot posture from static measurements. Journal of the American Podiatric Medical Association. 97(2), pp. 115 - 120. https://doi.org/10.7547/0970115
Rehabilitative ultrasound imaging of the abdominal muscles
Teyhen, Deydre, Gill, Norman, Whitake, Jackie, Henry, Sharon, Hides, Julie and Hodges, Paul. (2007). Rehabilitative ultrasound imaging of the abdominal muscles. Journal of Orthopaedic and Sports Physical Therapy. 37(8), pp. 450 - 466. https://doi.org/10.2519/jospt.2007.2558
Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest
Hides, Julie, Belavy, Daniel, Stanton, Warren, Wilson, Stephen, Rittweger, Jorn, Felsenberg, Dieter and Richardson, Carolyn A.. (2007). Magnetic resonance imaging assessment of trunk muscles during prolonged bed rest. Spine. 32(15), pp. 1687 - 1692. https://doi.org/10.1097/BRS.0b013e318074c386
Intrarater and interrater reliability of assessment of lumbar multifidus thickness using rehabilitative ultrasound imaging
Wallwork, Tracy, Hides, Julie and Stanton, Warren. (2007). Intrarater and interrater reliability of assessment of lumbar multifidus thickness using rehabilitative ultrasound imaging. Journal of Orthopaedic and Sports Physical Therapy. 37(10), pp. 608 - 612. https://doi.org/10.2519/jospt.2007.2418
Lateral positioning of ventilated intensive care patients: A study of oxygenation, respiratory mechanics, hemodynamics, and adverse events
Thomas, Peter, Paratz, Jennifer, Lipman, Jeffery and Stanton, Warren. (2007). Lateral positioning of ventilated intensive care patients: A study of oxygenation, respiratory mechanics, hemodynamics, and adverse events. Heart & Lung: the journal of acute and critical care. 36(4), pp. 277 - 286. https://doi.org/10.1016/j.hrtlng.2006.10.008
Determinants of stages of smoking uptake among secondary school students
Baade, Peter and Stanton, Warren. (2006). Determinants of stages of smoking uptake among secondary school students. Addictive Behaviors. 31(1), pp. 143 - 148. https://doi.org/10.1016/j.addbeh.2005.04.007
Sitting posture affects pelvic floor muscle activity in parous women: An observational study
Sapsford, Ruth, Richardson, Carolyn A. and Stanton, Warren. (2006). Sitting posture affects pelvic floor muscle activity in parous women: An observational study. Journal of Physiotherapy. 52(3), pp. 219 - 222. https://doi.org/10.1016/S0004-9514(06)70031-9
A pilot study of the initial effects of anti-pronation taping on electromyographic activity of lower leg muscles during walking
Franettovich, M., Chapman, A. and Vicenzino, B.. (2006). A pilot study of the initial effects of anti-pronation taping on electromyographic activity of lower leg muscles during walking. Journal of Science and Medicine in Sport. 9(1), pp. 33-34. https://doi.org/10.1016/j.jsams.2006.12.078
Predictors of smoking cessation processes among secondary school students
Stanton, Warren, Baade, Peter and Moffatt, Jenny. (2006). Predictors of smoking cessation processes among secondary school students. Substance Use and Misuse. 41(13), pp. 1683 - 1694. https://doi.org/10.1080/10826080601006284
An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall
Hides, Julie, Wilson, Stephen, Stanton, Warren, McMahon, Shaun, Keto, Heidi, McMahon, Catherine, Bryant, Mary and Richardson, Carolyn A.. (2006). An MRI investigation into the function of the transversus abdominis muscle during "drawing-in" of the abdominal wall. Spine. 31(6), pp. 175 - 178. https://doi.org/10.1097/01.brs.0000202740.86338.df
The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects
Van, Khai, Hides, Julie and Richardson, Carolyn A.. (2006). The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects. Journal of Orthopaedic and Sports Physical Therapy. 36(12), pp. 920 - 925. https://doi.org/10.2519/jospt.2006.2304
Low back pain patients demonstrate increased hip extensor muscle activity during standardized submaximal rotational efforts
Pirouzi, Soraya, Hides, Julie, Richardson, Carolyn A., Darnell, Ross and Toppenberg, Rowena. (2006). Low back pain patients demonstrate increased hip extensor muscle activity during standardized submaximal rotational efforts. Spine. 31(26), pp. 999 - 1005. https://doi.org/10.1097/01.brs.0000250076.74366.9d
Positioning practices for ventilated intensive care patients: Current practice, indications and contraindications
Thomas, Peter, Paratz, Jennifer, Stanton, Warren, Deans, Renae and Lipman, Jeffery. (2006). Positioning practices for ventilated intensive care patients: Current practice, indications and contraindications. Australian Critical Care. 19(4), pp. 122 - 132. https://doi.org/10.1016/S1036-7314(06)80025-1
Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running
Vicenzino, Bill, Franettovich-Smith, M., McPoil, T. G., Russell, T and Skardoon, G. (2005). Initial effects of anti-pronation tape on the medial longitudinal arch during walking and running. British Journal of Sports Medicine. 39(12), pp. 939 - 943. https://doi.org/10.1136/bjsm.2005.019158
Community perceptions of suspicious pigmented skin lesions: are they accurate when compared to general practitioners?
Baade, Peter, Balanda, Kevin, Stanton, Warren, Lowe, John and Del Mar, Chris B.. (2005). Community perceptions of suspicious pigmented skin lesions: are they accurate when compared to general practitioners? Cancer Epidemiology: the international journal of cancer epidemiology, detection and prevention. 29(3), pp. 267 - 275. https://doi.org/10.1016/j.cdp.2004.06.007
MRI measures of the lumbo-pelvic muscles in bedrest and follow-up: Implications for exercise countermeasures in microgravity.
Richardson, Carolyn A., Hides, Julie, Wilson, Stephen, Belavy, Daniel, Stanton, Warren, McCook, D, Elmann-Larsen, B, Rittweger, Jorn and Felsenberg, Dieter. (2005). MRI measures of the lumbo-pelvic muscles in bedrest and follow-up: Implications for exercise countermeasures in microgravity. Journal of Gravitational Physiology. 12(1), pp. 117 - 118.
The effect of weightbearing exercise with low frequency, whole body vibration on lumbosacral proprioception: A pilot study on normal subjects
Fontana, Tania, Richardson, Carolyn A. and Stanton, Warren. (2005). The effect of weightbearing exercise with low frequency, whole body vibration on lumbosacral proprioception: A pilot study on normal subjects. Journal of Physiotherapy. 51(4), pp. 259 - 263. https://doi.org/10.1016/S0004-9514(05)70007-6
Long-term overactivity in the abdominal oblique muscle after 8 weeks bed-rest - possible implications for musculoskeletal health
Belavy, Daniel, Richardson, Carolyn A., Wilson, Stephen, Darnell, Ross, Hides, Julie, Toppenberg, Rowena, Elmann-Larsen, B, Rittweger, Jorn and Felsenberg, Dieter. (2005). Long-term overactivity in the abdominal oblique muscle after 8 weeks bed-rest - possible implications for musculoskeletal health. Journal of Gravitational Physiology. 12(1), pp. 117 - 118.
Community perceptions of adequate levels and reasons for skin protection
Stanton, Warren, Moffatt, Jenny and Clavarino, Alexandra. (2005). Community perceptions of adequate levels and reasons for skin protection. Behavioral Medicine: relating behavior and health. 31(1), pp. 5 - 15. https://doi.org/10.3200/BMED.31.1.5-17
Guaiac versus immunochemical tests: Faecal occult blood test screening for colorectal cancer in a rural community
Hughes, Karen, Leggett, Barbara, Del Mar, Chris B., Croese, John, Fairley, Stephen, Masson, John, Aitken, Joanne, Clavarino, Alexandra, Janda, Monika, Stanton, Warren, Tong, Shilu and Newman, Beth. (2005). Guaiac versus immunochemical tests: Faecal occult blood test screening for colorectal cancer in a rural community. Australian and New Zealand Journal of Public Health. 29(4), pp. 358 - 364. https://doi.org/10.1111/j.1467-842X.2005.tb00207.x
Suntans and sun protection in Australian teen media: 1999 to 2000
McDermott, Liane, Lowe, John, Stanton, Warren and Clavarino, Alexandra. (2005). Suntans and sun protection in Australian teen media: 1999 to 2000. Health Education & Behavior. 32(4), pp. 504 - 513. https://doi.org/10.1177/1090198105276214
Predictors of responsiveness to physiotherapy management of cervicogenic headache
Jull, Gwendolen and Stanton, Warren. (2005). Predictors of responsiveness to physiotherapy management of cervicogenic headache. Cephalalgia: an international journal of headache. 25(2), pp. 101 - 108. https://doi.org/10.1111/j.1468-2982.2004.00811.x
Smoking and parenting among males in low socio-economic occupations
Moffatt, Jenny and Stanton, Warren. (2005). Smoking and parenting among males in low socio-economic occupations. International Journal of Health Promotion and Education. 43(3), pp. 81 - 86. https://doi.org/10.1080/14635240.2005.10708045