What daily factors increase the risk of lower back pain in young athletes?

Posted on December 8, 2017

(Last Updated On: December 8, 2017)

Our reference,

Evaluation of factors associated with severe and frequent back pain in high school athletes

We looked at a bunch of potential factors. Which ones correlated to having highly intense and frequent back pain in athletes 14-20 years old?

When we say a bunch of potential factors, we mean a bunch.

Association (χ2) and prevalence ratio of back pain intensity with independent variables

-(demographic, socioeconomic, anthropometric, and psychosocial)

-(exercise level, behavioural, and postural)

Association (χ2) and prevalence ratio of back pain frequency with independent variables

-(demographic, socioeconomic, anthropometric, and psychosocial)

-(exercise level, behavioural, and postural)

After all that, what factors were most associated with intense and frequent back pain? Highlighting factors where the prevalence changed by 10% or more:


“Bivariate analysis revealed an association of back pain intensity with behavioural and postural variables, and back pain frequency with sex, exercise level, and postural variables.

After performing multivariate analysis, only the time spent using a computer and sitting in a posture to write and use a computer remained associated with back pain intensity, and reading or studying in bed and the method of carrying a backpack remained associated with back pain frequency. These behavioural and postural factors were associated with increasing back pain frequency and back pain intensity. Athletes who used a non-recommended sitting posture to write and use computer demonstrated higher prevalence ratios and were more predisposed to greater back pain intensity.”

1. This is a great study to illustrate the importance of the other 23 hours a day. This study was meant to examine athletes, yet found all the non-athletic postures and movements were more relevant than the sport the athlete played!

-Five years ago: Why you’re still in pain

2. Predictably, none of the pain science world evangelists seemed to mention this study. Those championing the hell out of the biopsychosocial model of pain. Because frankly, this study only found bio was relevant. Even for the sleep numbers, which did have some (non-statistically significant) relationship, one has to laugh when you see the authors go,

“Although sleep time was not associated with [back pain], insufficient sleep may impair athletes’ musculoskeletal tissue recovery and make them more tired, contributing to the adoption of inappropriate postures.”

So when biopsychosocial zealots harp on things like sleep quality, who says they aren’t still harping on a bio factor? A posture factor?

-> We are not saying psychological and sociological factors don’t matter. We’re saying considering them as wholly separate from biology is precarious, and for some, the pendulum has swung too far away from biology.

In fact, many talk about lack of sleep, but this study found TOO MUCH sleep was something worth considering too. And even that has a direct biological implication at the spine,

Exercising in space- when spinal DEcompression is a concern for lower back pain

 (Astronauts are renown for lower back pain because they don’t compress their spine in microgravity. The more you lay down / sleep, the less you compress your spine = potential for more back pain.)

It’s no different than harping on those who are depressed being more likely to have lower back pain. Sure, there is always the chicken and the egg issue, but many of us have no problem spotting depressed posture either e.g. hunched over.

It’s pretty damn hard, if not impossible, to parse out depression, or sleep, from the rest of the day.

Meanwhile, this is a solid look at an inordinate amount of biopsychosocial factors and back pain. Going all the way to hand grip strength. It’s not even close how many of the factors are non-psychosocial. If you look at the highlighted numbers, you can see posture related factors overwhelmingly were most predictive.

The “posture doesn’t matter” crowd wants to single out “somebody stands still, looking at a wall” as examining posture. The rest of us aren’t so literal. We understand posture has a more dynamic definition. How you stand when holding your kid vs when using a standing desk, how you sit while typing at a desk, how you sit when relaxing on the couch, how you lay down when reading vs sleeping, how you walk freely vs how you walk when holding a backpack of five overpriced textbooks.

That does matter.


Learn about the most common posture issues

Exercises to fix common postural problems

Or get specific help assessing and changing your own posture


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