A magnetic resonance imaging investigation of the transversus abdominis muscle during drawing-in of the abdominal wall in elite Australian Football League players with and without low back pain

Julie A Hides, Carly L Boughen, Warren R Stanton, Mark W Strudwick, Stephen J Wilson
Journal of Orthopaedic and Sports Physical Therapy 2010, 40 (1): 4-10

STUDY DESIGN: Single-blinded quasi-experimental study.

OBJECTIVE: To investigate the ability of elite football players with and without low back pain (LBP) to voluntarily draw-in the abdominal wall.

BACKGROUND: While there has been considerable debate regarding the contribution of the transversus abdominis (TrA) muscle to control the lumbar spine and pelvis, there is evidence that retraining motor control of the deep trunk muscles is commensurate with decreases in LBP. Magnetic resonance imaging (MRI) has been used to assess the TrA muscle during the draw-in maneuver, with the contraction of the TrA muscle reducing the circumference of the trunk. Impairments in performance of the draw-in maneuver have been shown in people with LBP.

METHODS: Forty-three elite players from a team in the Australian Football League were allocated to 3 groups: those with "no LBP," "a history of LBP but no current LBP," or "current LBP." MRI was used to image the cross-sectional area (CSA) of the trunk at the level of the L3-4 disc at the start and end of the draw-in maneuver.

RESULTS: There was a significant decrease in the CSA of the trunk with the performance of the draw-in maneuver (P<.001). Subjects in the "no LBP" group were better able to "draw-in" the abdominal wall than subjects with current LBP (P = .015).

CONCLUSIONS: This study provides evidence of an altered ability to draw-in the abdominal wall in footballers with current LBP. Retraining contraction of the TrA muscle may constitute one part of an exercise-therapy approach for athletes with current LBP.

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