Factors associated with episodes of low back pain in elite alpine ski racers: A prospective case series

Abstract Background and Aim Given the high risk of low back pain (LBP) in alpine ski racers, this study investigated episodes of LBP over a competitive ski season and examined associated factors. Methods A prospective non-consecutive case series ( n = 5) of international alpine ski racers was conducted over 36 weeks. Participant characteristics, previous injury, and measure of trunk strength were collected at the start of the season whilst information on LBP was collected fortnightly. Descriptive statistics and odds ratio (OR) from a generalised linear model are presented. Results Three female and two male cases were involved. Response rates ranged from 83 to 94%. All cases reported experiencing LBP (6.7–88.0% of responses). Most cases continued normal training or competition, though training was reduced (cases 2 and 5) or stopped (case 5) due to LBP in some cases. All but one case reported LBP impacting performance (minor to major) extent. Older (OR = 0.43, p = 0.048) and male (OR = 0.09, p < 0.001) racers had less odds of an episode of LBP. Taller individuals (OR = 1.39, p = 0.004), the pre-season phase (OR = 5.12, p = 0.045) and on-snow training hours (OR = 1.07, p = 0.192) were associated with greater odds ofepisodes of LBP. Inconclusive associations were found for trunk strength, competition, and off-snow training (OR = 0.54–1.01, p = 0.215–0.602). Conclusion Alpine ski racers commonly report low back pain, necessitating training modifications and impacting performance. Practitioners working in alpine skiing should consider strategies to better manage the pre-season period and prolonged periods of on-snow training, particularly for athletes with known risk factors (e.g. taller individuals) or a history of LBP.