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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Nadler 2002.

Core strength does not reduce low back pain recurrence, trial

updated
Nadler SF, Malanga GA, Bartoli LA, Feinberg JH, Prybicien M, Deprince M. Hip muscle imbalance and low back pain in athletes: influence of core strengthening. Medicine & Science in Sports & Exercise. 2002 Jan;34(1):9–16. PubMed #11782641.
Tags: back pain, exercise, pain problems, spine, self-treatment, treatment

PainSci summary of Nadler 2002?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★☆☆☆?2-star ratings are for studies with flaws, bias, and/or conflict of interest; published in lesser journals. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

In this 2002 study in Medicine & Science in Sports & Exercise, the core strength of college athletes was tested in 1998-1999, and then in 2000 they participated in “a structured core-strengthening program, which emphasized abdominal, paraspinal, and hip extensor strengthening.” I bet they did a lot of crunches. Boo-yah. Too bad about the total lack of results! There was no change in the rates of low back pain before and after all those crunches, and the authors concluded that there was “no significant advantage of core strengthening in reducing LBP occurrence.” Rates of low back pain were low overall in these athletes to begin with, however, so the study is of limited value. Still, it doesn’t exactly make core strengthening look good.

~ Paul Ingraham

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

PURPOSE: The influence of a core-strengthening program on low back pain (LBP) occurrence and hip strength differences were studied in NCAA Division I collegiate athletes.

METHODS: In 1998, 1999, and 2000, hip strength was measured during preparticipation physical examinations and occurrence of LBP was monitored throughout the year. Following the 1999-2000 preparticipation physicals, all athletes began participation in a structured core-strengthening program, which emphasized abdominal, paraspinal, and hip extensor strengthening. Incidence of LBP and the relationship with hip muscle imbalance were compared between consecutive academic years.

RESULTS: After incorporation of core strengthening, there was no statistically significant change in LBP occurrence. Side-to-side extensor strength between athletes participating in both the 1998-1999 and 1999-2000 physicals were no different. After core strengthening, the right hip extensor was, on average, stronger than that of the left hip extensor (P = 0.0001). More specific gender differences were noted after core strengthening. Using logistic regression, female athletes with weaker left hip abductors had a more significant probability of requiring treatment for LBP (P = 0.009)

CONCLUSION: The impact of core strengthening on collegiate athletes has not been previously examined. These results indicated no significant advantage of core strengthening in reducing LBP occurrence, though this may be more a reflection of the small numbers of subjects who actually required treatment. The core program, however, seems to have had a role in modifying hip extensor strength balance. The association between hip strength and future LBP occurrence, observed only in females, may indicate the need for more gender-specific core programs. The need for a larger scale study to examine the impact of core strengthening in collegiate athletes is demonstrated.

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