The effect of low back pain and lower limb injury on lumbar multifidus muscle morphology and function in university soccer players

Background: The lumbar multifidus muscle (LMM) plays a critical role to stabilize the spine. While low back pain (LBP) is a common complaint in soccer players, few studies have examined LMM characteristics in this athletic population and their possible associations with LBP and lower limb injury. Therefore, the purpose of this study was to 1) investigate LMM characteristics in university soccer players and their potential association with LBP and lower limb injury; 2) examine the relationship between LMM characteristics and body composition measurements; and 3) examine seasonal changes in LMM characteristics.

Methods: LMM ultrasound assessments were acquired in 27 soccer players (12 females, 15 males) from Concordia University during the preseason and assessments were repeated in 18 players at the end of the season. LMM cross-sectional area (CSA), echo-intensity and thickness at rest and during contraction (e.g. function) were assessed bilaterally in prone and standing positions, at the L5-S1 spinal level. A self-reported questionnaire was used to assess the history of LBP and lower limb injury. Dual-energy x-ray absorptiometry (DEXA) was used to acquire body composition measurements.

Results: Side-to-side asymmetry of the LMM was significantly greater in males (p = 0.02). LMM thickness when contracted in the prone position (p = 0.04) and LMM CSA in standing (p = 0.02) were also significantly greater on the left side in male players. The LMM % thickness change during contraction in the prone position was significantly greater in players who reported having LBP in the previous 3-months (p < 0.001). LMM CSA (r = - 0.41, p = 0.01) and echo-intensity (r = 0.69, p < 0.001) were positively correlated to total % body fat. There was a small decrease in LMM thickness at rest in the prone position over the course of the season (p = 0.03).

Conclusions: The greater LMM contraction in players with LBP may be a maladaptive strategy to splint and project the spine. LMM morphology measurements were correlated to body composition. The results provide new insights with regards to LMM morphology and activation in soccer players and their associations with injury and body composition measurements.