Rückenschmerzproblematik im Sport unter besonderer Berücksichtigung der Sportart Rudern

Rückenschmerz stellt ein zentrales gesundheitliches Problem im Sport dar, das zu einer verminderten Lebensqualität und Leistungseinschränkungen der Betroffenen führen kann. Um geeignete Präventionsstrategien entwickeln zu können, ist eine Analyse der Rückenschmerzproblematik im Sport notwendig. Übergeordnete Ziele der vorliegenden Dissertation waren daher die Erstellung einer sportartenvergleichenden Übersicht, die Identifikation von Sportarten mit erhöhtem und reduziertem Rückenschmerzpotential sowie von Risikofaktoren für Rückenschmerz im Sport. Zudem sollte eine detaillierte Analyse in Risikosportarten am Beispiel Rudern erfolgen, die epidemiologische und biomechanische Aspekte berücksichtigte, um präventive, sportartspezifische Handlungsempfehlungen abzuleiten. Die Bearbeitung erfolgte im Rahmen verschiedener methodischer Schritte, die in vier aufeinander aufbauenden Untersuchungen realisiert und in Form von fünf Manuskripten in internationalen Fachzeitschriften publiziert wurden

Back pain in elite sports

$\bf Objectives$ To establish the prevalence of back pain in German elite athletes; examine the influence of age, sex, sports discipline and training volume; and compare elite athletes with a physically active control group. $\bf Methods$ A standardized and validated online back pain questionnaire was sent by the German Olympic Sports Confederation to approximately 4,000 German national and international elite athletes, and a control group of 253 physically active but non-elite sports students. $\bf Results$ We received responses from 1,114 elite athletes (46.5% male and 53.1% female, mean age 20.9 years $\pm$ 4.8 years, mean height 176.5 $\pm$ 11.5 cm, mean weight 71.0 $\pm$ 10.3 kg) and 166 physically active sports students (74.7% male and 24.1 female, mean age 21.2 $\pm$ 2.0 years, mean height 180.0 $\pm$ 8.0 cm, mean weight 74.0 $\pm$ 14.5 kg). In elite athletes, the lifetime prevalence of back pain was 88.5%, the 12-month prevalence was 81.1%, the 3-month prevalence was 68.3% and the point prevalence was 49.0%, compared with 80.7%, 69.9%, 59.0% and 42.8%, respectively in the control group. The lifetime, 12-month and 3-month prevalences in elite athletes were significantly higher than in the control group. Regarding the individual sports disciplines, the prevalence of back pain was significantly higher in elite rowers, dancers, fencers, gymnasts, track and field athletes, figure skaters and marksmen, and those who play underwater rugby, water polo, basketball, hockey and ice hockey compared with the control group. The prevalence of back pain was significantly lower in elite triathletes. $\bf Conclusions$ Back pain is a common complaint in German elite athletes. Low back pain seems to be a problem in both elite athletes and physically active controls. A high training volume in elite athletes and a low training volume in physically active individuals might increase prevalence rates. Our findings indicate the necessity for specific prevention programs, especially in high-risk sports. Further research should investigate the optimal dose-effect relationship of sporting activity for the general population to prevent back pain

Prevalence of back pain in a group of elite athletes exposed to repetitive overhead activity

$\bf Background$ The prevalence of back pain in athletes has been investigated in several studies, but there are still under- or uninvestigated sports discipline like sports exposed to repetitive overhead activity. Elite athletes spend much time in training and competition and, because of the nature of their disciplines, subject their bodies to a great deal of mechanical strain, which puts a high level of stress on their musculoskeletal systems. From this it is hypothesized that elite athletes who engage in repetitive overhead motions experience a higher strain on their spine and thus possibly a higher prevalence of back pain compared with an active control group. $\bf Objectives$ To examine the prevalence of back pain and the exact location of pain in a cohort of elite athletes with repetitive overhead activity and in a control group of physically active sport students. Additionally, to examine different characteristics of pain, and to evaluate the influence of confounders on back pain. $\bf Methods$ A standardized and validated online back pain questionnaire was sent by the German Olympic Sports Confederation to German national and international elite athletes, and a control group of physically active but non-elite sports students. $\bf Results$ The final sample comprised 181 elite athletes of the sports disciplines badminton, beach volleyball, handball, tennis and volleyball and 166 physically active controls. In elite athletes, lifetime prevalence of back pain was 85%, 12-month prevalence was 75%, 3-month prevalence was 58% and point prevalence was 38%; for the physically active control group, these prevalences were 81%, 70%, 59% and 43%, respectively. There was no significant group difference in prevalence over all time periods. The lower back was the main location of back pain in elite athletes across all disciplines and in controls; additionally a distinct problem of upper back pain was found among volleyball players. $\bf Conclusion$ Despite the high mechanical load inherent in the sport disciplines included in this study, the elite athletes who engaged in repetitive overhead activities did not suffer more from back pain than the physically active controls. This suggests that other mechanisms may be influencing back pain prevalences in a positive way in these athletes. Furthermore, these disciplines may practice preventive factors for back pain that outweigh their detrimental factors. Therefore, we posit that extensive prevention work is already being implemented in these sports and that there are additional individual protection factors in play. More research is required to explore these suppositions, and should include investigations into which preventive training programs are being used. Nevertheless, in volleyball particularly, a focus on stabilization/preventive training should be applied to the upper back and neck

Prävalenz von Rückenschmerzen bei Elitesportlern

$\bf Objectives:$ The primary objectives of this investigation were to provide an overview of data about back pain prevalence in athletes, to analyse the prevalence in the German elite athletic population, and to compare it with physically-active individuals. $\bf Methods:$ 1. A comprehensive analysis of the literature was undertaken, using specifically developed search strategies for relevant epidemiological research on back pain. 2. An online back pain questionnaire was sent to approximately 4,000 German elite athletes and a control group of 253 physically-activeindividuals. $\bf Results:$ Lifetime and point prevalence were the most commonly researched episodes and the lower back was the most common location of pain. Lifetime prevalence of low back pain in athletes was 1-94%, and point prevalence was 18-65%. In German elite athletes,prevalence rates were 77% and 34%, respectively, and were slightly higher in athletes than inactive controls (71% and 29%, respectively) and the general population (11-84% and 7-33%, respectively). Prevalence of back pain varied between athletes of different disciplines. $\bf Conclusion:$ Back pain is a common complaint in athletes and in the general population. A high training volume in athletes and a low training volume in the general population might increase prevalence rates. Our findings indicate the necessity for specific prevention programs, especially in high-risk sports. Further research should investigate the optimal dose-effect relationship of sporting activity to prevent back pain.$\bf Ziele:$ Hauptziel dieser Untersuchung war es, eine Übersicht zur Rückenschmerzprävalenz von Sportler*innen zu erstellen, die Prävalenz in der deutschen Leistungssportelite zu analysieren und diese mit körperlich aktiven Personen zu vergleichen. $\bf Methodik:$ 1. Es wurde eine umfassende Literaturanalyse mit speziell entwickelten Suchstrategien für relevante epidemiologische Rückenschmerzforschung durchgeführt. 2. Ein Online-Rückenschmerzfragebogen wurde an ca. 4000 deutsche Leistungssportler*innen und eine Kontrollgruppe von 253 körperlich aktiven Personen verschickt. $\bf Ergebnisse:$ In der internationalen Literatur waren Lebenszeit- und Punktprävalenz die am häufigsten untersuchten Episoden und der untere Rücken war die häufigste Lokalisation für Schmerzen. Die Lebenszeitprävalenz von Rückenschmerzen bei Sportler*innen betrug 1-94% und die Punktprävalenz betrug 18-65%. Bei deutschen Spitzensportler*innen lagen die Prävalenzen bei 77% bzw. 34% und waren höher im Vergleich zur aktiven Kontrollgruppe (71% bzw. 29%) und der Allgemeinbevölkerung (11-84% und 7-33%). Die Prävalenz von Rückenschmerzen variierte zwischen Sportler*innen verschiedener Disziplinen. $\bf Schlussfolgerung:$ Rückenschmerzen sind ein häufiges gesundheitliches Problem bei Sportler*innen und in der Allgemeinbevölkerung. Ein hohes Trainingsvolumen bei Sportler*innen und ein niedriges Trainingsvolumen in der Allgemeinbevölkerung könnten die Prävalenzraten erhöhen. Die vorliegenden Ergebnisse weisen auf die Notwendigkeit spezifischer Präventionsprogramme hin, insbesondere in risikoreichen Sportarten. Weitere Forschung sollte die optimale Dosis-Wirkungs-Beziehung sportlicher Aktivität untersuchen, um Rückenschmerzen zu verhindern