Kinematics of Shooting in High School and Collegiate Lacrosse Players With and Without Low Back Pain

BACKGROUND: Low back pain (LBP) and motion alterations can occur in athletes who engage in high-speed throwing motions. The relationship between LBP and shooting motion in lacrosse players is not yet known. PURPOSE: To quantify the effects of LBP on key kinematic parameters of the lacrosse shot and determine the contribution of the severity of LBP on specific kinematic parameters of the shooting motion. STUDY DESIGN: Controlled laboratory study. METHODS: High school and collegiate players (N = 24) were stratified into 2 groups based on back pain symptoms (LBP or no pain). Three-dimensional motion capture of overhead throws was used to collect data on knee, pelvis, trunk, and shoulder kinematics as well as crosse stick (the stick capped with a strung net) and ball speed. RESULTS: Mean low back numeric pain rating scale (NRS(pain)) score was 2.9. Knee flexion at ball release was greater in the LBP than no pain group, indicating a more bent knee (P = .04). The LBP group demonstrated less angular velocity transfer from pelvis to trunk than the no pain group (P = .05). Total range of motion of the pelvis and shoulders during the shot and follow-through were less in the LBP group than the no pain group (83.6° ± 24.5° vs 75.9° ± 24.5°, P = .05). Age- and sex-adjusted regression analyses revealed that the low back NRS(pain) rating contributed 6.3% to 25.0% of the variance to the models of shoulder transverse rotation range of motion, trunk and shoulder rotation angular velocities, and knee flexion angle (P < .05). CONCLUSION: LBP severity significantly contributes to trunk and shoulder motion restriction during lacrosse shooting. Inclusion of lumbopelvic and core training and prehabilitation programs for high school and collegiate players may reduce pain in affected players as well as help them to attain appropriate motion parameters and avoid secondary musculoskeletal injuries. CLINICAL RELEVANCE: This research identified a prehabilitation need in the understudied lacrosse population. Therapeutic strategies can be developed to strengthen the throwing motion, which could control mechanical loading patterns on the low back and minimize pain symptoms in players with chronic LBP.