Differences Exist In Spine Flexion And Bodyweight Bilateral Squat Among Powerlifters With And Without Lower Back Pain History

Low back pain (LBP) is a prevalent yet debilitating condition that affects athletes and non-athletes. Powerlifters have elevated risk for LBP. LBP may change physical function and joint motion patterns with key movements such as spine flexion and bodyweight bilateral squat - both of which are integral to daily living and sport performance. PURPOSE: To quantify functional differences in forward flexion spine movement and bodyweight bilateral squat mechanics between powerlifters with and without LBP history. METHODS: This cross-sectional study enrolled powerlifters with LBP (N = 8; 37.5% female; 27.9 ± 7.9 yr; height 166 ± 9 cm; 33% currently competing) and without LBP history (N = 16; 80% female; 25.9 ± 7.8 yr; height 176 ± 7.8 cm; 61.5% currently competing). Demographics, medical and LBP history (occurrence, treatment) were collected. An 8-camera markerless motion system (DARI Motion, Inc.) record forward spine flexion (‘forward fold’) and bodyweight bilateral squat motion at full ROM. Flexion, extension and rotation mobility was quantified at the ankle, knee, hip, spine using DARI AI algorithms. RESULTS: Powerlifters with LBP history had more bilateral thoracic flexion compared to those without LBP (48.6° ± 8.2° versus 38.9° ± 9.4 °), p = 0.018). Bilateral lumbar flexion in powerlifters with history of LBP was higher than in lifters without LBP history (47.9° ± 8.3° versus 38.6° ± 9.2°; p = 0.022). While squat depth was not different by LBP history, powerlifters with LBP had 16% lower bilateral hip mobility during the bilateral squat compared to those with LBP history (p = 0.029). Ankle rotation, femoral rotation, and tibial rotation in the transverse plane were 64% (2°), 66% (2.2°) and 68% (2.5°) higher respectively, in lifters without LBP (all p < 0.05). CONCLUSIONS: LBP does affect joint motion patterns during spine flexion and bilateral squat mechanics among powerlifters. The motion differences detected here could be potential compensatory patterns with pain or restricted mobility in other parts of the kinetic chain to 1) maintain squat depth, or 2) potentially protect the lower spine region during bodyweight squat. In the future, longitudinal changes in these metrics in parallel with pain tracking can guide further injury prevention, management, and targeted interventions. Supported by: UF Strategic Funding Initiative, UF Sports and Collaborative