Dynamic Functional Ability in Lacrosse Players in Relation to Development of Sport-Related Onset of Musculoskeletal Pain.

Background: Unlike other sports, the relationship between performance deficits and pain/injury in lacrosse players has not been well-investigated. Purpose: The purposes of this study were to: 1) determine whether age and sex differences exist in dynamic physical function tests and drop jump performance among lacrosse players, and 2) determine whether pre-seasonal physical function scores predict onset of either lower extremity or low back pain over time. Study Design: Prospective observational study. Methods: Lacrosse players (N=128) were stratified into three groups: 12-14.9 yrs, 15-18 yrs and >18 yrs. Thomas test (hip flexibility), Ober's test (iliotibial band tightness), and Ely's test (rectus femoris tightness) were performed. Landing Error Scoring System (LESS) scores were collected while players performed drop jumps. Sagittal and frontal plane movement from 2D video during single and double legged squats was assessed. Musculoskeletal pain symptoms or injury were tracked for six months. Age bracket, sex and physical function scores were entered into logistic regression models to determine risk factors that predicted onset of lower extremity pain and low back pain onset. Results: LESS scores and single-leg squat movement quality test scores were lowest in the 12-14.9 yr groups and highest in the >18 yr group (all p<0.05). Single leg squat performance score increased the odds risk (OR) for lower extremity pain (OR=2.62 [95% CI 1.06-6.48], p=.038) and LESS scores elevated risk for low back pain onset over six months (OR = 2.09 [95% CI 1.07- 4.06], p= .031). Conclusions: LESS scores and single legged squat performance may help identify lacrosse players at risk for musculoskeletal pain or injury onset. Detecting these pertinent biomechanical errors and subsequently developing proper training programs could help prevent lower extremity and low back pain onset. Level of Evidence: III.