Prevalence of low back pain among CrossFit participants: a cross-sectional studyABSTRACT
CrossFit is a physical conditioning modality characterized by various movement patterns, activities, and energy systems. This study aimed to investigate the prevalence of occasional low back pain in the 12 months prior the study and during the lifetime of Brazilian practitioners of CrossFit. This is a cross-sectional study designed to reach the largest possible number of participants. To achieve this, an electronic questionnaire was created using an online platform (Google Forms). The invitation to participate in the research was distributed to Brazilian practitioners via Facebook and Instagram platforms. Data were collected on prevalence of low back pain at three time points: current (occasional prevalence), in the past year, and at any moment in life (lifetime prevalence). Of the 309 participants included, 90.3% (n=279) reported low back pain at some point in their lives, whereas, 75.1% (n=232) reported at least one episode of low back pain in the last 12 months, and 15.5% (n=48) reported having low back pain while answering the questionnaire. Although low back pain was frequent among CrossFit practitioners it was generally occasional episodes, of moderate intensity and not severe enough to limit the participants’ usual activities or routine.
Keywords
Low Back Pain; Epidemiology; Exercise
RESUMO
O crossfit compreende uma modalidade de condicionamento físico caracterizada por uma variedade de padrões de movimento, atividades e sistemas de energia usados. Este estudo teve como objetivo investigar a prevalência de dor lombar pontual de praticantes brasileiros de crossfit nos últimos 12 meses e em algum momento da vida. Trata-se de um estudo transversal elaborado para atingir o maior número possível de participantes e, para isso, foi criado um questionário eletrônico utilizando uma plataforma online ( Google Forms ). O convite para participar da pesquisa foi distribuído a praticantes brasileiros por meio do Facebook e do Instagram . Foram coletadas informações sobre a dor lombar pontual, no último ano e em algum momento da vida. Dos 309 participantes incluídos, 90,3% (n=279) relataram já ter sentido dor lombar em algum momento da vida, enquanto 75,1% (n=232) relataram pelo menos um episódio de dor lombar nos últimos 12 meses e 15,5% (n=48) relataram estar com dor lombar enquanto respondiam ao questionário. A dor lombar foi uma queixa frequente entre praticantes de crossfit e, apesar de frequente, a dor lombar pontual tendeu a ter intensidade moderada e não era forte o suficiente para limitar as atividades habituais ou alterar a rotina diária dos participantes.
Descritores
Dor Lombar; Epidemiologia; Exercício Físico
RESUMEN
El CrossFit es una modalidad de acondicionamiento físico que se caracteriza por una variedad de patrones de movimiento, actividades y sistemas de energía utilizados. Este estudio tuvo el objetivo de investigar la prevalencia de dolor lumbar puntual en practicantes brasileños de CrossFit en los últimos 12 meses y en algún momento de sus vidas. Se trata de un estudio transversal creado para llegar al mayor número posible de participantes y, para ello, se utilizó un cuestionario electrónico a través de una plataforma en línea ( Google Forms ). La invitación a participar en la investigación fue distribuida a los practicantes brasileños a través de Facebook e Instagram . Se recopilaron las informaciones sobre el dolor lumbar puntual, en el último año y en algún momento de sus vidas. De los 309 participantes, el 90,3% (n=279) relató ya haber experimentado dolor lumbar en algún momento de su vida, mientras que el 75,1% (n=232) relató haber experimentado dolor lumbar al menos una vez en los últimos 12 meses y el 15,5% (n=48) relató tener dolor lumbar al contestar el cuestionario. El dolor lumbar ha sido una queja frecuente entre los practicantes de CrossFit y, a pesar de frecuente, el dolor lumbar puntual tendió a ser de intensidad moderada y no era lo suficientemente fuerte como para limitar las actividades habituales o afectar la rutina diaria de los participantes.
Palabras clave
Dolor de la Región Lumbar; Epidemiología; Ejercicio Físico
Introduction
CrossFit, also known as high-intensity functional training, is a form of physical conditioning characterized by a variety of movement patterns and activities, such as weightlifting, resistance training, gymnastics, and metabolic and aerobic conditioning. CrossFit also involves the use of different energy systems, such as ATP-CP/phosphagen, glycolytic, and oxidative pathways 1 . Although numerous health benefits have been documented 2 , some concerns have been raised regarding the seemingly random nature of exercises, the potential lack of individualized programming, and safety risks associated with the high intensity and competitive nature of the activity 3 . Moreover, a systematic review of CrossFit-related injuries identifies the lumbar spine as one of the most frequently affected body areas 4 .
Low back pain is the leading cause of years lived with disability in both developed and developing countries, and it ranks sixth in terms of global disease burden, highlighting an urgent need for further research to better understand low back pain in different contexts 5 . The study of low back pain prevalence is particularly relevant due to the persistence of symptoms and the high costs associated with medical treatment 6 . While low back pain is self-limiting in most cases, many athletes experience long-term symptoms that can affect their ability to engage in physical exercise 7 .
Guidelines for studies on low back pain prevalence recommend investigating three time periods: occasional/acute prevalence, prevalence in the past 12 months, and lifetime prevalence 8 . Even though the prevalence of low back pain is well researched in the general population, variations in definitions and study methodologies lead to considerable differences in reported rates. A systematic review using pooled data reports an average occasional prevalence of 18% for low back pain in the general population, with lifetime prevalence reaching 39% 9 , and as high as 93.3% in some cases 10 . Most studies on the topic address low back pain in sports that impose significant strain on the spine, such as rowing 11 , 12 , gymnastics 13 , 14 , wrestling 15 , weightlifting 15 , and cross-country skiing 16 , 17 . In these practices, the reported averages for occasional pain prevalence, 12-month prevalence, and lifetime prevalence of low back pain are 24%, 55%, and 61%, respectively 18 . To date, no studies have exclusively investigated the prevalence of low back pain among CrossFit practitioners. Therefore, this study aimed to determine occasional prevalence, 12-month prevalence, and lifetime prevalence of low back pain, as well as to examine the characteristics of occasional low back pain prevalence in CrossFit practitioners residing in Brazil.
METHODOLOGY
Study type, location, and sample
This is a cross-sectional, quantitative study. Participants included CrossFit practitioners of any experience level, aged 18 or older, and residing in Brazil. The exclusion criterion was any form of adapted CrossFit practice, such as using a wheelchair or assistive devices. To determine the appropriate sample size, a sample size calculator was used ( http://sampsize.sourceforge.net/iface/index.html ), with a 5% margin of error, an estimated 24% occasional prevalence of low back pain based on previous literature 18 , an estimated population of 200,000 CrossFit practitioners in Brazil, and a 95% confidence interval. This calculation yielded a minimum sample size of 280 participants.
Data collection instrument and procedures
To ensure a nationwide data collection, an electronic questionnaire was developed using the Google Forms platform. The questionnaire, which was self-administered, gathered demographic information (such as age, sex, education level, and region of residence in Brazil) along with details about the participants’ CrossFit experience and average weekly training time. Additionally, participants provided information about the occurrence of low back pain, including occasional prevalence (pain at the time of completing the questionnaire), 12-month prevalence, and lifetime prevalence.
In sports-related studies, there is no consensus on the precise definition of low back pain, with variations in its description regarding location, intensity, frequency, and duration 18 . The most commonly accepted definition is “pain or discomfort in the lower back with or without radiation to one or both legs” 11 , 12 , 16 , 19 . This definition was presented to participants in this study. To assist in accurately identifying the lumbar region, a visual illustration of the human body was included in the questionnaire.
Participants were asked three key questions to assess prevalence: (1) “Have you ever experienced low back pain in your life?”; (2) “In the past 12 months, have you experienced low back pain at any time?”; and (3) “Are you currently experiencing low back pain?” Based on their responses, participants were classified as either having low back pain or not. They were instructed to exclude pain associated with fever or menstruation. If occasional low back pain was reported, participants were directed to additional questions concerning the characteristics of their pain, including its intensity, any related disability, radiation to the legs, and possible causes. Pain intensity was measured using the Pain Numerical Rating Scale (Pain NRS), where participants rated their pain on a scale from 0 (no pain) to 10 (the worst imaginable pain).
The questionnaire was distributed using snowball sampling via social media platforms, with participants encouraged to respond and share the survey with others. Invitations to participate in the study, along with the survey link, were shared in partnerships with CrossFit-related pages on social media, including Facebook and Instagram. The research team contacted the administrators of these pages via Facebook inbox and Instagram direct messages. If administrators agreed to collaborate, they were provided with the survey link for further distribution. The research team also promoted the study through their own social media accounts.
Data analysis and processing
The collected data were organized and compiled in the Excel (Microsoft) program, while statistical analysis was conducted using SigmaPlot version 12.0. The normality of the data was assessed with the Shapiro-Wilk test. Categorical variables were described using absolute (n) and relative (%) frequencies, while numerical variables were expressed as measures of central tendency (median) and variability (interquartile range 25–75%), as the data did not follow a normal distribution according to the Shapiro-Wilk test results. Associations between the occurrence of low back pain across different periods and the variables of sex and age group were analyzed using the Chi-squared test. Comparisons between individuals who reported low back pain and those who did not, across different time periods, were performed using the Mann-Whitney test. These comparisons considered variables such as age, weekly practice time, and CrossFit experience. Statistical significance was set at 5% for all analyses.
RESULTS
A total of 310 individuals completed the survey, with 309 meeting the eligibility criteria for participation in the study. Table 1 summarizes the results regarding age, age group, sex, education level, region of residence, weekly training frequency, and time practicing CrossFit. The median age of the participants was 29 years (interquartile range 25–34), with most participants aged from 18 to 29 years (51.5%; n=159). Most participants were female (55.7%; n=172), had completed higher education (71.2%; n=220), and resided in the Northeast (27.1%; n=84) and Southeast (25.3%; n=78) regions. Smaller proportions lived in other regions of Brazil, all of which were included in this study. The median reported weekly practice time for the modality was 6 (5–7) hours, and the median duration of CrossFit experience was 32 (14–48) months.
Results regarding sex, age, age group, education level, region of residence, weekly training time, and time practicing CrossFit. Brazil, 2022 (n=309)
Of the 309 participants included, 90.3% (n=279) reported having experienced low back pain at some point in their lives, while 75.1% (n=232) reported at least one episode of low back pain in the past 12 months. Additionally, 15.5% (n=48) stated they were experiencing low back pain at the time of completing the survey. There was no association between the occurrence of low back pain in the three different periods and sex or the investigated age groups (p>0.05) as shown in Table 2 .
Table 3 presents the median ages of participants according to the occurrence of low back pain in each period. A statistically significant association was found between the occurrence of low back pain in the past 12 months and age (p=0.036). However, no such association was identified for occasional or lifetime low back pain (p>0.05).
Results regarding the prevalence of lifetime, 12-month, and occasional low back pain according to age group. Brazil, 2022 (n=309)
Results regarding the comparison between participants who reported or did not report low back pain in the different analyzed periods in relation to age.
Table 4 presents the results of the comparison of participants who reported low back pain with those who did not, across different periods concerning weekly CrossFit practice and time practicing the modality. Individuals who reported having experienced low back pain at some point in their lives had a median weekly practice lower than those without a history of low back pain (p=0.016). For the other periods analyzed, no association was identified. Regarding CrossFit experience, no association was found with the occurrence of low back pain in any of the periods examined (p>0.05).
Results regarding the comparison between participants who reported or did not report low back pain in the different analyzed periods in relation to weekly practice time and CrossFit experience.
Table 5 presents the characteristics of occasional low back pain, as reported by the participants. Overall, 29.2% (n=14) responded that the pain was strong enough to limit their usual activities, while 20.8% (n=10) reported that the pain spread to the leg. Additionally, only 16.7% (n=8) identified a specific cause of the pain, with herniated or protruded discs (75%, n=6), errors in exercise execution during training (12.5%, n=1), and pelvic retroversion (12.5%, n=1) being the only causes reported. Regarding pain intensity, the median reported score was 5 points [4–7], and Figure 1 depicts the distribution of participants according to pain intensity.
Bar graph illustrating the pain intensity based on the Numerical Rating Scale (NRS) as reported by participants experiencing occasional low back pain (n=48).
DISCUSSION
This study aimed to identify the prevalence of low back pain across different periods among CrossFit practitioners residing in Brazil and to characterize occasional low back pain in this population. Our results indicated occasional prevalence, 12-month prevalence, and lifetime prevalence rates of approximately 16%, 75%, and 90%, respectively. Among those with occasional low back pain, although we identified a median pain intensity corresponding to moderate intensity, less than 30% reported pain severe enough to cause functional limitations.
While other studies on injuries among CrossFit practitioners have been published, our study specifically focused on the prevalence of low back pain, marking it as a novel contribution. Furthermore, it included a representative sample with participants from all regions of Brazil, enabling a diverse demographic and contributing to robust findings. However, some limitations must be considered. The cross-sectional design of the study does not account for individuals who may have stopped practicing CrossFit due to severe low back pain complaints, potentially underestimating the true prevalence and intensity of occasional low back pain. Additionally, the retrospective nature of the data may introduce recall bias, particularly regarding the recollection of low back pain occurrences in the past 12 months. Conversely, individuals with a history of low back pain might have been more inclined to participate, which could potentially overestimate the prevalence data.
The occurrence of lumbar spine injuries has been extensively investigated in epidemiological studies on CrossFit-related injuries 20 . In these studies, the lumbar region is consistently among the most affected areas 21 - 23 . Our results suggest that the prevalence of low back pain among CrossFit practitioners is higher than that in the general population 5 , 10 , 24 and among elite athletes in sports that place considerable overload on the lumbar region 18 , particularly regarding 12-month and lifetime prevalence rates. A study conducted with a large urban population cohort in Brazil reported occasional, 12-month, and lifetime prevalence rates of 9.8%, 48.1%, and 62.6%, respectively 24 . In a systematic review by Hoy et al. 9 on low back pain prevalence, which aggregated data from studies conducted in various countries, average occasional prevalence was found to be 18.3%, 12-month prevalence was 38.0%, and lifetime prevalence was 38.9%. Despite the observed differences, the cross-sectional design of this study does not allow for causal inferences between CrossFit practice and these findings, requiring caution in interpreting the results.
The frequent complaints of low back pain among CrossFit practitioners have been attributed to the high levels of stress placed on the musculoskeletal system. This stress may arise from performing complex movements with high repetition counts and an emphasis on speed, which could lead to unproper technique and subsequent injuries 25 . However, further studies are needed to investigate the role of technical quality and training intensity in the occurrence of frequent complaints, such as low back pain. Moreover, due to the variety of movement patterns and activities inherent to the modality, it is possible that practitioners are more aware of and attentive to potential discomfort during training, which could explain the high prevalence rates observed in this study.
Hopkins et al. 26 analyzed medical records of CrossFit practitioners hospitalized for low back pain complaints and found that, although most cases were managed conservatively, the average duration of symptoms exceeded six months. This underscores the importance of investigating low back pain complaints and the potential risk factors for its onset. In our study, we identified an association between age and the occurrence of low back pain in the past 12 months. Those who reported a history of pain had a lower median age compared to those who did not, suggesting that younger CrossFit practitioners need to be more mindful of potential discomfort in the lumbar and may benefit from preventive strategies. In the general population, the frequency of low back pain increases with age 9 , 24 , 27 , 28 . However, when athlete cohorts are analyzed, this association appears to differ across sports modalities 16 , 29 - 33 .
In addition to age, lower weekly practice time was associated with the occurrence of lifetime low back pain. It is possible that individuals with higher weekly practice time develop better conditioning and are less likely to experience pain complaints. However, since weekly practice time was not associated with other prevalence periods, further studies are needed to clarify the true role of practice time in the onset of low back pain among CrossFit practitioners.
Finally, this study results revealed considerable prevalence rates of low back pain among CrossFit practitioners, emphasizing the importance of properly preparing coaches and sports medicine professionals to manage low back pain and implement preventive measures. As such, there is a continued need for longitudinal studies to gain a more comprehensive and reliable understanding of the impact of low back pain in this population and its risk factors, guiding the development of precise preventive measures.
FINAL CONSIDERATIONS
We observed that the occurrence of low back pain was a frequent complaint among CrossFit practitioners, with occasional prevalence, 12-month prevalence, and lifetime prevalence rates of 15.5%, 75.1%, and 90.3%, respectively. Despite being common, occasional low back pain tended to exhibit moderate intensity and was not severe enough to limit participants’ usual activities or alter their routines. Moreover, our results suggest that the prevalence of low back pain is higher compared to other forms of physical exercise, underscoring the need for specific attention to preventive strategies and management of the condition to maintain practitioners’ well-being.
REFERENCES
-
1. Dominski FH, Tibana RA, Andrade A. “Functional Fitness Training”, CrossFit, HIMT, or HIFT: What Is the Preferable Terminology? Front Sport Act Living. 2022;4:e882195. doi: 10.3389/fspor.2022.882195
» https://doi.org/10.3389/fspor.2022.882195 -
2. Heinrich KM, Becker C, Carlisle T, Gilmore BS, Hauser BS, Frye J, et al. High-intensity functional training improves functional movement and body composition among cancer survivors: a pilot study. Eur J Cancer Care (Engl). 2015;24(6):812-7. doi: 10.1111/ecc.12338
» https://doi.org/10.1111/ecc.12338 -
3. Bergeron MF, Nindl BC, Deuster PA, Baumgartner N, Kane SF, Kraemer WJ, et al. Consortium for health and military performance and American College of sports medicine consensus paper on extreme conditioning programs in military personnel. Curr Sports Med Rep. 2011;10(6):383-9. doi: 10.1249/JSR.0b013e318237bf8a
» https://doi.org/10.1249/JSR.0b013e318237bf8a -
4. Rodríguez MA, García-Calleja P, Terrados N, Crespo I, Del Valle M, Olmedillas H. Injury in CrossFit®: a systematic review of epidemiology and risk factors. Phys Sportsmed. 2022;50(01):3-10. doi: 10.1080/00913847.2020.1864675
» https://doi.org/10.1080/00913847.2020.1864675 -
5. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769-81. doi: 10.1016/j.berh.2010.10.002
» https://doi.org/10.1016/j.berh.2010.10.002 -
6. Kim LH, Vail D, Azad TD, Bentley JP, Zhang Y, Ho AL, et al. Expenditures and health care utilization among adults with newly diagnosed low back and lower extremity pain. JAMA Netw Open. 2019;2(5):e193676. doi: 10.1001/jamanetworkopen.2019.3676
» https://doi.org/10.1001/jamanetworkopen.2019.3676 -
7. Mortazavi J, Zebardast J, Mirzashahi B. Low Back Pain in Athletes. Asian J Sports Med. 2015;6(2):e24718. doi: 10.5812/asjsm.6(2)2015.24718
» https://doi.org/10.5812/asjsm.6(2)2015.24718 -
8. Dionne CE, Dunn KM, Croft PR, Nachemson AL, Buchbinder R, Walker BF, et al. A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine (Phila Pa 1976). 2008;33(1):95-103. doi: 10.1097/BRS.0b013e31815e7f94
» https://doi.org/10.1097/BRS.0b013e31815e7f94 -
9. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al.. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37. doi: 10.1002/art.34347
» https://doi.org/10.1002/art.34347 -
10. Nascimento PRC, Pena Costa LO. Low back pain prevalence in Brazil: a systematic review. Cad Saude Publica. 2015;31(6):1141-56. doi: 10.1590/0102-311X00046114
» https://doi.org/10.1590/0102-311X00046114 -
11. Foss IS, Holme I, Bahr R. The prevalence of low back pain among former elite cross-country skiers, rowers, orienteerers, and nonathletes: a 10-year cohort study. Am J Sports Med. 2012;40(11):2610-6. doi: 10.1177/0363546512458413
» https://doi.org/10.1177/0363546512458413 -
12. Maselli F, Ciuro A, Mastrosimone R, Canone M, Nicoli P, Signori A, et al. Low back pain among Italian rowers: a cross-sectional survey. J Back Musculoskelet Rehabil. 2015;28(2):365-76. doi: 10.3233/BMR-140529
» https://doi.org/10.3233/BMR-140529 -
13. Bennett DL, Nassar L, DeLano MC. Lumbar spine MRI in the elite-level female gymnast with low back pain. Skeletal Radiol. 2006;35:503-9. doi: 10.1007/s00256-006-0083-7
» https://doi.org/10.1007/s00256-006-0083-7 -
14. Cugusi L, Manca A, Sarritzu S, Bergamin M, Gobbo S, Di Blasio A, et al. Risk factors associated with low back pain in competitive female gymnasts: a meta-analytic approach. J Sports Sci. 2020;38(22):2543-52. doi: 10.1080/02640414.2020.1793644
» https://doi.org/10.1080/02640414.2020.1793644 -
15. Baranto A, Hellström M, Cederlund CG, Nyman R, Swärd L. Back pain and MRI changes in the thoraco-lumbar spine of top athletes in four different sports : a 15-year follow-up study. Knee Surg Sports Traumatol Arthrosc. 2009;17(9):1125-34. doi: 10.1007/s00167-009-0767-3
» https://doi.org/10.1007/s00167-009-0767-3 -
16. Bahr R, Andersen SO, Løken S, Fossan B, Hansen T, Holme I. Low back pain among endurance athletes with and without specific back loading: a cross-sectional survey of cross-country skiers, rowers, orienteerers, and nonathletic controls. Spine (Phila Pa 1976). 2004;29(4):449-54. doi: 10.1097/01.brs.0000096176.92881.37
» https://doi.org/10.1097/01.brs.0000096176.92881.37 -
17. Eriksson K, Németh G, Eriksson E. Low back pain in elite cross-country skiers. Scan J Med Sci Sports. 1996;6(1):31-5. doi: 10.1111/j.1600-0838.1996.tb00067.x
» https://doi.org/10.1111/j.1600-0838.1996.tb00067.x -
18. Trompeter K, Fett D, Platen P. Prevalence of Back Pain in Sports: a systematic review of the literature. Sport Med. 2017;47(6):1183-1207. doi: 10.1007/s40279-016-0645-3
» https://doi.org/10.1007/s40279-016-0645-3 -
19. Tunås P, Nilstad A, Myklebust G. Low back pain in female elite football and handball players compared with an active control group. Knee Surg Sports Traumatol Arthrosc. 2015;23(9):2540-7. doi: 10.1007/s00167-014-3069-3
» https://doi.org/10.1007/s00167-014-3069-3 -
20. Dominski FH, Siqueira TC, Tibana RA, Andrade A. Injuries in functional fitness: an updated systematic review. J Sports Med Phys Fitness. 2022;62(5):673-83. doi: 10.23736/S0022-4707.21.12218-2
» https://doi.org/10.23736/S0022-4707.21.12218-2 -
21. Minghelli B, Vicente P. Musculoskeletal injuries in Portuguese CrossFit practitioners. J Sports Med Phys Fitness. 2019;59(7):1213-20. doi: 10.23736/S0022-4707.19.09367-8
» https://doi.org/10.23736/S0022-4707.19.09367-8 - 22. Montalvo AM, Shaefer H, Rodriguez B, Li T, Epnere K, Myer GD. Retrospective injury epidemiology and risk factors for injury in CrossFit. J Sport Sci Med. 2017;16(1):53-9.
-
23. Weisenthal BM, Beck CA, Maloney MD, DeHaven KE, Giordano BD. Injury rate and patterns among crossfit athletes. Orthop J Sport Med. 2014;2(4): 2325967114531177. doi: 10.1177/2325967114531177
» https://doi.org/10.1177/2325967114531177 -
24. Gonzalez GZ, Silva T, Avanzi MA, Macedo GT, Alves SS, Indini LS, et al. Low back pain prevalence in Sao Paulo, Brazil: A cross-sectional study. Braz J Phys Ther. 2021;25(6):837-45. doi: 10.1016/j.bjpt.2021.07.004
» https://doi.org/10.1016/j.bjpt.2021.07.004 -
25. Hak PT, Hodzovic E, Hickey B. The nature and prevalence of injury during CrossFit training. J Strength Cond Res. Nov 22, 2013. doi: 10.1519/jsc.0000000000000318
» https://doi.org/10.1519/jsc.0000000000000318 -
26. Hopkins BS, Cloney MB, Kesavabhotla K, Yamaguchi J, Smith ZA, Koski TR, et al. Impact of CrossFit-Related Spinal Injuries. Clin J Sport Med. 2019;29(6):482-5. doi: 10.1097/JSM.0000000000000553
» https://doi.org/10.1097/JSM.0000000000000553 -
27. Silva MC, Fassa AG, Valle NCJ. Dor lombar crônica em uma população adulta do Sul do Brasil: prevalência e fatores associados. Cad Saude Publica. 2004;20(2):377-85. doi: 10.1590/s0102-311x2004000200005
» https://doi.org/10.1590/s0102-311x2004000200005 -
28. Meucci RD, Fassa AG, Paniz VMV, Silva MC, Wegman DH. Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil. BMC Musculoskelet Disord. 2013;14:155. doi: 10.1186/1471-2474-14-155
» https://doi.org/10.1186/1471-2474-14-155 -
29. Fett D, Trompeter K, Platen P. Back pain in elite sports: A cross-sectional study on 1114 athletes. PLoS One. 2017;12(6):e0180130. doi: 10.1371/journal.pone.0180130
» https://doi.org/10.1371/journal.pone.0180130 -
30. Newlands C, Reid D, Parmar P. The prevalence, incidence and severity of low back pain among international-level rowers. Br J Sports Med. 2015;49(14):951-6. doi: 10.1136/bjsports-2014-093889
» https://doi.org/10.1136/bjsports-2014-093889 -
31. Malliaropoulos N, Bikos G, Meke M, Tsifountoudis I, Pyne D, Korakakis V. Mechanical low back pain in elite track and field athletes: an observational cohort study. J Back Musculoskelet Rehabil. 2017;30(4):681-9. doi: 10.3233/BMR-150390
» https://doi.org/10.3233/BMR-150390 -
32. Ansell W, Rivett D, Callister R. Characteristics, training loads, injury patterns and stretching habits of Australian Ironman Triathletes. J Sci Med Sport. 2012;15:S133. doi: 10.1016/j.jsams.2012.11.321
» https://doi.org/10.1016/j.jsams.2012.11.321 -
33. 33. Schulz SS, Lenz K, Büttner-Janz K. Severe back pain in elite athletes: a cross-sectional study on 929 top athletes of Germany. Eur Spine J. 2016;25(4):1204-10. doi:10.1007/s00586-015-4210-9
» https://doi.org/10.1007/s00586-015-4210-9
-
Preliminary results presented at the III Integrated Congress of Unigran Capital, Campo Grande, June 21 st , 2022.
-
Study carried out at the Universidade Federal de Mato Grosso do Sul (UFMS). Faculdade de Medicina. Mato Grosso do Sul, MS, Brazil.
-
Financing source:
Programa Institucional de Pesquisa do Centro Universitário Unigran Capital – Approved by the Research Ethics Committee of the Centro Universitário da Grande Dourados under resolution no. 5.068.397 (CAAE 51513021.7.0000.5159).
