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Faculty of Health Sciences

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    The epidemiology of low back pain in male adolescent field hockey players in the eThekwini municipality
    (2019-09-05) De Wit, Dale Cameron; Pillay, Julian David; Ducray, Jennifer Frances
    Background: Field hockey is a popular international sport which is played in 132 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk for pain and injury to the lumbar spine. Due to the popularity of the sport of field hockey more empirical randomised controlled studies and/or observational studies need to be conducted to determine the pathomechanics of the nature of lower back pain and injury among players. Objectives: The objectives of this study were to determine the prevalence and incidence of low back pain in male adolescent field hockey players; to determine the characteristics of the low back pain in terms of location, chronicity, disability and treatment sought; and to determine the selected risk factors (demographics, equipment, health and lifestyle) of low back pain in male adolescent field hockey players. Method: A descriptive study of cross-sectional design, using a survey data collection tool was used on 112 male adolescent field hockey players in the eThekwini Municipality. The questionnaire data were then statistically analysed using IBM SPSS version 25 with statistical significance set at p value <0.05. Descriptive statistics such as mean and standard deviation, or median and inter-quartile range were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi square test and t-tests as appropriate. Results: A total of 68 participants completed and returned their questionnaires yielding a participation rate of 60.7%. The period prevalence of low back pain was 63.2% and the incidence was 38.2%. Point prevalence at the beginning of the season, mid-season, and end of season was 25%, 32.4% and 22.1% respectively. The most common location for low back pain was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their low back pain. The results were found to be statistically significant between hydration and low back pain (p = 0.050) i.e. those individuals who did not hydrate frequently during matches and training were significantly more likely to experience low back pain. Conclusion: Low back pain in male adolescent field hockey players is a common phenomenon. The results of this study, although limited to a select group of adolescents, showed a slightly higher prevalence of LBP to that of previous studies. More importantly, even though most participants did not experience low back pain classified as a disability, low back pain still had a large impact on participants, as nearly half of participants consulted with a medical professional for treatment. The study further indicates the need for frequent hydration during matches and training as inadequate hydration was found to be significantly related to low back pain. We highlight this as a novel finding and recommend special consideration to this by athletes and coaches. Moreover, the need for the development of strategies in the prevention and management of low back pain in field hockey is further recommended.
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    The immediate effect of spinal manipulative therapy on drag flicking performance of field hockey players
    (2015) Wiggett, Michael; Kretzmann, Heidi
    Background In sport, competitive athletes are required to perform to the best of their ability, with some athletes seeking the use of chiropractic treatment to improve performance. For example, hockey players are required to perform at peak physical function whilst executing a drag flick. The action of a drag flick involves a player hunched over low down in front of the ball and the hook of the hockey stick makes contact with the ball, which is then ball is pushed along the ground with the ball moving slightly up the shaft of the stick. The player then performs ‘slinging’ action, which means they ‘flick’ the ball towards the goal posts. The drag flick is an explosive sequential movement involving the player’s pelvis, trunk and upper limbs, requiring the use of the spine to generate the speed of the stick and ball. As a result any decreased spinal movement could reduce performance. Therefore this study attempted to assess the use of spinal manipulative therapy (SMT) in improving the drag flicking performance of hockey players. SMT has been shown to be a safe and effective way of increasing spinal joint mobility Objectives To determine and compare the effect of placebo and spinal manipulative therapy in terms of subjective and objective measurements on drag flicking performance of premier league field hockey players. Methods A comparative, experimental study of forty asymptomatic premier league hockey drag flickers were divided into two groups of twenty each. Group A received SMT of fixated joints of the spine (cervical, thoracic and lumbar) as determined by motion palpation by an experienced qualified chiropractor. Group B received sham manipulation. Pre and post intervention ROM of the spine and drag flicking speed where measured using CROM, Inclinometer, BROM II and Speed TracX Speed Sport Radar. The subject’s perception of a change in drag flicking speed post intervention was also recorded. SPSS version 21 was used to analyse the data. A p value of 0.05 was considered statistically significant. Results Significant differences in ROM were noticed in the inter-group analysis in cervical: extension; LLF; RR PA, thoracic: extension; LLF, RLF, lumbar: extension, LLF, RLF. There was a significant increase in drag flicking speed post SMT, but between the SMT and sham manipulation groups were not significantly different. A significant correlation was seen between subjects’ perception of change in drag flicking speed post intervention and the objective results obtained. Conclusion The immediate effect of SMT on drag flicking performance of hockey players was inconclusive. The outcomes of this study suggests that SMT results in an increase in the average speed of drag flicking, however further larger studies are required to confirm this.