Differences in Movement Pattern in Low Back Pain
Many studies have shown that people with low back pain (LBP) also have less hip rotation motion when compared with people who don't have LBP. In this study, physical therapists look at the timing of hip and lumbopelvic rotation movement.
They propose that if different movement patterns are linked with LBP, then different treatment may be needed. This study was done in a university-based motion science lab. The therapists measured hip and lumbopelvic rotation in two groups of patients with LBP. One group was more limited in lumbar rotation (Rot). The other group was classified as RotExt because their symptoms occurred when they rotated or extended the spine.
The patients were tested in the prone (lying face down) position. With the knee bent 90-degrees, the leg was rotated inward and hip motion measured. The examiners also recorded if there was any lumbopelvic rotation during the first 50 per cent of hip lateral rotation (HLR) movement.
The purpose of the study was to see if there was equal timing of lumbopelvic rotation on both sides during HLR. All patients were athletes who had LBP for at least one year. Their symptoms were worse during or after sports play. Their sport involved repeated hip and lumbopelvic rotation.
The Rot group had more symmetry in the timing of their HLR compared to the RotExt group. The results show that people in the RotExt group have different timing of low back, hip, and pelvic motion from one side to the other.
This is the first step in understanding how different movement patterns of the hip and pelvis might affect LBP. Asymmetry (more movement on one side compared to the other) may increase the load on one or more lumbar segments. The result may be LBP. The authors suggest that symptoms will come back if the movement pattern is not corrected.
Linda R. Van Dillen, PhD, PT, et al. Symmetry of Timing of Hip and Lumbopelvic Rotation Motion in 2 Different Subgroups of People with Low Back Pain. In Archives of Physical Medicine and Rehabilitation. March 2007. Vol. 88. No. 3. Pp. 351-360.