External Training Load and the Association With Back Pain in Competitive Adolescent Tennis Players: Results From the SMASH Cohort Study

Johansson, Fredrik and Gabbett, Tim and Svedmark, Per and Skillgate, Eva (2021) External Training Load and the Association With Back Pain in Competitive Adolescent Tennis Players: Results From the SMASH Cohort Study. Sports Health. pp. 1-8. ISSN 1941-7381

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Abstract

Background: In young tennis players, high loads on the spine and high training volumes in relation to age are associated with a high lifetime prevalence of back pain. The primary aim of this study was to investigate if accumulated external workload “spikes” in the acute: chronic workload ratio (ACWR) of tennis training, match play, and fitness training, and if high or low workload/age ratio were associated with back pain events in competitive adolescent tennis players. Additional aims were to report the incidence of back pain stratified by sex and level of play and to describe the characteristics of players with back pain. Hypothesis: Rapid increases in external workload are associated with the incidence of back pain. Study Design: Cohort study of 198 competitive tennis players, 13 to 19 years, with a weekly follow-up for 52 consecutive weeks. Level of Evidence: Level 3. Methods: Accumulated external workload spikes (uncoupled ACWR >1.3), and the workload/age ratio, were time-varying exposures in Cox regression analyses with the outcome back pain (pain intensity ≥2/10 in the lower back and/or in the upper back/neck with a pain-related disability). Results: For each additional workload spike in tennis training/match play, the hazard rate ratio (HRR) was 1.17 (95% CI, 1.06-1.28) for back pain. The corresponding HRR for fitness training was 1.13 (95% CI, 1.05-1.22). Training workload/age ratio was not related to back pain. Conclusion: Accumulated external workload spikes of tennis training, match play, and/or fitness training are associated with a higher rate of back pain events in competitive adolescent tennis players. Clinical Relevance: Back pain is a troublesome clinical problem that may affect the performance of talented young tennis players. Structuring the training schedule to minimize rapid increases (ie, spikes) of training load on a weekly basis may enhance performance and reduce back pain in adolescent tennis players.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 08 Dec 2021 00:08
Last Modified: 13 Dec 2021 02:51
Uncontrolled Keywords: acute: chronic workload ratio (ACWR); adolescent; back pain; cohort study; injury; tennis; workload
Fields of Research (2008): 11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
Fields of Research (2020): 42 HEALTH SCIENCES > 4207 Sports science and exercise > 420799 Sports science and exercise not elsewhere classified
Identification Number or DOI: https://doi.org/10.1177/19417381211051636
URI: http://eprints.usq.edu.au/id/eprint/44650

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