Takaya Narita

Critical factors for the prevention of low back pain in elite junior divers

Background/Aim During competitive diving, divers jump up from 1 to 3 m springboards or 5 to 10 m platforms and dive into the water. The impact forces are very large in the water entry phase, and, as such, microtraumatic injuries are common due to the tremendous physical stress placed on the diver. Low-back pain (LBP) is the most frequently reported symptom in divers. This study aimed to extract possible risk factors related to LBP from physical and technical characteristics in Japanese elite junior divers. Methods Eighty-three elite junior divers (42 men and 41 women) in Japan were included in this study. LBP was assessed by a questionnaire, interview and physical examination during a national training camp. Morphological data, physical fitness and diving skills were also evaluated. The factors related to LBP were extracted by using logistic-regression analysis and the forward-selection method (likelihood ratio). Results A total of 37.3% (31 reports) of back pain occurred in the lumbar region. Shoulder flexibility (OR 0.919; 95% CI 0.851 to 0.992) and age (OR 0.441; 95% CI 0.239 to 0.814) were recognised as factors related to LBP in male-elite junior divers, whereas only age (OR 0.536; 95% CI 0.335 to 0.856) was a factor in female-elite junior divers. Conclusions Our results suggest that shoulder flexibility is important for preventing LBP in elite-male junior divers, since they require full shoulder flexion during the water entry phase. Limited shoulder flexibility could cause lumbar hyperextension when adjusting for the angle of water entry.

Unstable rocker shoes promote recovery from marathon-induced muscle damage in novice runners

We recently reported that wearing unstable rocker shoes (Masai Barefoot Technology: MBT) may enhance recovery from marathon race‐induced fatigue. However, this earlier study only utilized a questionnaire. In this study, we evaluated MBT utilizing objective physiological measures of recovery from marathon‐induced muscle damages. Twenty‐five university student novice runners were divided into two groups. After running a full marathon, one group wore MBT shoes (MBT group), and the control group (CON) wore ordinary shoes daily for 1 week following the race. We measured maximal isometric joint torque, muscle hardness (real time tissue elastography of the strain ratio) in the lower limb muscles before, immediately after, and 1, 3, and 8 days following the marathon. We calculated the magnitude of recovery by observing the difference in each value between the first measurement and the latter measurements. Results showed that isometric torques in knee flexion recovered at the first day after the race in the MBT group while it did not recover even at the eighth day in the CON group. Muscle hardness in the gastrocnemius and vastus lateralis showed enhanced recovery in the MBT group in comparison with the CON group. Also for muscle hardness in the tibialis anterior and biceps femoris, the timing of recovery was delayed in the CON group. In conclusion, wearing MBT shoes enhanced recovery in lower leg and thigh muscles from muscle damage induced by marathon running.

Foot posture alteration and recovery following a full marathon run

Abstract Prolonged running results in lowering of the foot arch and a low arch is associated with subsequent chronic injuries. Foot posture alteration and recovery following a marathon run remain unknown. Therefore, the present study aimed to evaluate foot posture alteration following a full marathon run. The three-dimensional foot posture data of 11 collegiate runners were obtained using an optical foot scanner system before, and immediately, 1 day, 3 days, and 8 days after a full marathon. The navicular height and arch height ratio significantly decreased from before to immediately, 1 day, 3 days, and 8 days after the marathon (navicular height: before, 44.2 ± 5.0 mm; immediately after, 39.4 ± 5.5 mm; 1 day, 37.7 ± 6.2 mm; 3 days, 38.7 ± 5.5 mm; 8 days, 37.6 ± 5.7 mm; arch height ratio: before, 18.4 ± 1.9; immediately after, 16.5 ± 2.5; 1 day, 15.7 ± 2.5; 3 days, 16.2 ± 2.6; 8 days, 15.6 ± 2.2, P < 0.001, respectively). By contrast, the dorsal height significantly increased from before and immediately after to 1 day after the marathon, and then significantly decreased until 8 days after the marathon (P < 0.001). These results indicate that the recovery patterns of the dorsal and navicular heights following a marathon did not coincide; the dorsal height rose temporally at 1 day after and subsequently decreased, but the navicular height decreased throughout the 8-day period after the marathon. More than one week may be necessary for sufficient foot alignment recovery from marathon-induced changes.

The Prevention of Low Back Disorders in Divers

During competitive diving events, divers jump up from 1 to 3 m springboards or 5–10 m platforms and dive into the water. The impact forces are very large in the water entry phase, and therefore, the divers experience a great deal of physical stress. This chapter is comprised of four sections on the prevention of low back pain(LBP) in divers. The first section is an introduction. The second section describes the very high incidence rate of LBP in Japanese elite junior divers. The third section details the importance of shoulder flexibility and age as critical factors for the prevention of LBP in elite junior divers. The fourth section describes investigations on the influence of the shoulder angle on entry alignment and compares the differences in entry phase alignment between the divers in the LBP diver group and non-LBP diver group. The results showed a negative correlation (r = −0.623) between the shoulder flexion angle and trunk extension angle for the entry phase. Four of 13 male divers experienced LBP. The trunk angle showed a significant difference between the LBP group (210.4 ± 5.7°) and no-LBP group (199.9 ± 9.0°). Our results suggested that shoulder flexibility is an important factor in the prevention of LBP in elite male junior divers.