Females «Climber s back»

Transcription

1 Postural adaptations of female elite Rock Climbers Females «Climber s back» L. Rolland L. Allet C. Linhart J-L. Ziltener

2 I. Introduction II. Method a. Population b. Spinal shape and mobility c. Muscular length III. Results a. Spinal shape b. Spine mobility c. Muscular extensibility IV. Discussion V. Conclusion

3 Introduction High level rock climbing & overhanging walls: Back and abdominal muscles heavily used Compressive forces on spine 1 Lumbar pain 1, 2, 3, 4 Biomechanical stresses on the spine functional and postural adaptations 5 1. Burtscher and al; Folkl; Schweizer; Neuhof and al; Dalichau; 2001

4 Males Increase of the spine curves in the sagittal plan Proportional to performance level Hyper-solicitation of pectoralis muscles Förster and al; 2009

5 Question Do female rock climbers present the same static and dynamic spine alterations?

6 Population 19 Elite rock climbers French and Swiss national team > 9 UIAA level 17 non-climbers Medicine faculty of Geneva Sport on a non-regular basis Inclusion criteria: female, > 18 years-old Exclusion criteria: Dorso-lumbar pain during the examination. Recreational or regular climber for the non-climbers group.

7 Spinal shape & mobility Medimouse (Idiag, Fehraltdorf, Suisse) Shape in upright, flexion and extension positions Thoracic and lumbar curves Segmental angles Mobility between maximal flexion and extension Thoracic and lumbar movement amplitude segmental movement amplitude Precise, objective, reproducible, validated, reliable, noninvasive and non-irradiating Statistical differences: Unpaired Student s t-test 1. Mannion and al; Post and al;2004

8 Muscular length Muscular groups tested: Pectoralis major Iliopsoas Hamstrings Jenda's protocol 1 : 0 = no shortening 1= minor shortening 2 = major shortening Statistical differences: Cochran-Armitage test 1. Janda;

9 L. Rolland, Pontresina 19/09/14 Pectoralis Major Sternocostal part Arm relaxed at 90 of abduction. Reach horizontal spontaneously -> score 0 With external help -> score 1 Not even with help -> score 2 Abdominal part Arm is relaxed at 160 of abduction. Spine of scapula spontaneously touches table -> score is 0. With help -> score 1 Not even with help -> score 2. Janda; 2000

10 L. Rolland, Pontresina 19/09/14 Hamstrings & Iliopsoas Hamstrings Hip is in passive flexion with knee in extension. Hip flexion reaches at least 90 -> scored 0 80 to 90 of flexion -> scored 1 < 80 -> scored 2 Iliopsoas Hip extension > 0 -> score 0 With vertical pressure on the knee -> score 1 Not even with help -> score 2 Janda; 2000

11 Results - Spinal shape Upright position: Reduced thoracic kyphosis Th1/2 Th2/3 Cranial displacement of thoraco-lumbar curves inflection point Th11-Th12 * p < 0,05. ** p < 0,01

12 Results - Spinal Shape Flexion position: Decrease of thoracic kyphosis Th2/3, Th5/6, Th6/7, Th11/12 Increase of lumbar kyphosis L1/2, L2/3, and L3/4 * p < 0,05. ** p < 0,01

13 Results - Spine mobility Decrease of thoracic mobility Th4/5, Th5/6, Th6/7, Th7/8 Increase of lumbar mobility L1/2, L2/3, L3/4 * p < 0,05. ** p < 0,01

14 Results - Muscular extensibility Pectoralis major : not significantly shortened Hamstrings & Ilio-Psoas : shortened (scores 1 and 2) on the left side

15 Discussion Gender differences in climbers thoracic spine : Lower muscular strength and muscle power different climbing techniques? Focus on technique More stretched positions, using maximum amplitudes -> highest possible point of wall. Dorsal muscles (latissimus dorsi, rhomboid and serratus anterior muscles) -> decrease of the thoracic kyphosis. No shortening of pectoralis major -> no increase of thoracic kyphosis. Bouldering vs lead climbing

16 Discussion Shortening of hamstrings : Heeling technique: flexion of hip and knee + strong contraction of hamstrings. Physiologically more flexible -> lower muscular shortenings -> more limited impact on posture. Lateralization on the left Right-handed?

17 Conclusion Spinal adaptations of high-level female rock climbers different from male counterparts. Climbing technique Muscles morphology Further studies are needed to: confirm results understand the mechanisms involved evaluate the pathological consequences provide evidence based prevention recommendations to the climbers

18 References 1. Burtscher M, Jenny E. Häufigste. Trainingsbedingte Beschwerden und Verletzungen bei Sportkletterern. Praktische Sport- und Traumatologie und Sportmedizin 1987;2/87: Folkl AK. Characterizing the consequences of chronic climbing-related injury in sport climbers and boulderers. Wilderness Environ Med Jun;24(2): doi: /j.wem Epub 2013 Feb Schweizer A. Sport climbing from a medical point of view. Swiss Med Wkly Oct 11;142:w doi: /smw Neuhof A, Hennig FF, Schöffl I. Injury risk in sport climbing. Int J Sports Med Oct;32(10): doi: / s Epub 2011 Sep Dalichau S. Der Einfluss sportmechanischer Belastungsprofile auf die thorakolumbale Wirbelsäulenform. Butzbach-Griedel : Afra ; 2001 : R. Förster, G. Penka, T. Bösl, R. V. Schöffl. Climber s back Form and mobility of the thoracolombar spine leading to postural adaptations in male high ability rock climbers. Int J Sports Med 2009 ; 30 : Mannion AF, Knecht K, Balaban G, Dvorak J, Grob D. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine : reliability of measurements and comparison with data reviewed from the literature. Eur Spine J 2004; 13: Post RB, Leferink VJ. Spinal mobility: sagittal range of motion measured with the spinalmouse, a new non-invasive device. Arch Orthop Trauma Surg 2004; 124: Janda V. Manuelle Muskelfunktionsdiagnostik. 4 th ed. München: Urban & Fischer; 2000

19 Thanks for your attention