females « climber’s back -...
TRANSCRIPT
Postural adaptations of female elite Rock Climbers
Females « Climber’s back »L. Rolland!L. Allet!C. Linhart!J-L. Ziltener
L. Rolland, Pontresina 19/09/14
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
L. Rolland, Pontresina 19/09/14
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; 1987!2. Folkl; 2013!3. Schweizer; 2012 !4. Neuhof and al; 2011!5. Dalichau; 2001
L. Rolland, Pontresina 19/09/14
Males…
!
❖ Increase of the spine curves in the sagittal plan!!
❖ Proportional to performance level !!
❖ Hyper-solicitation of pectoralis muscles
Förster and al; 2009
L. Rolland, Pontresina 19/09/14
Question
Do female rock climbers present the same static and dynamic spine alterations?
http://www.climbing.com/skill/new-workouts-to-refresh-your-gym-training/
L. Rolland, Pontresina 19/09/14
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.
L. Rolland, Pontresina 19/09/14
Spinal shape & mobilityMedimouse® (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; 2004 2. Post and al;2004
L. Rolland, Pontresina 19/09/14
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; 2000 http
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L. Rolland, Pontresina 19/09/14
Pectoralis MajorSternocostal 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
L. Rolland, Pontresina 19/09/14
Hamstrings & IliopsoasHamstrings!
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
L. Rolland, Pontresina 19/09/14
Results - Spinal shape
Upright position: !• Reduced thoracic kyphosis
✓ Th1/2!✓ Th2/3!
!• Cranial displacement of thoraco-lumbar curves inflection point !
✓ Th11-Th12
L. Rolland, Pontresina 19/09/14
* p < 0,05. ** p < 0,01
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
L. Rolland, Pontresina 19/09/14
* p < 0,05. ** p < 0,01
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
L. Rolland, Pontresina 19/09/14
* p < 0,05. ** p < 0,01
Results - Muscular extensibility
✦ Pectoralis major : not significantly shortened!
✦ Hamstrings & Ilio-Psoas : shortened (scores 1 and 2) on the left side
http://www.sports-extremes.net/2012/05/15/les-pin-up-du-mardi-grimpeuses-sexy/
L. Rolland, Pontresina 19/09/14
DiscussionGender differences in climbers’ thoracic spine :
➡ different climbing techniques? ✴ Lower muscular strength and muscle power !
✴ 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
L. Rolland, Pontresina 19/09/14
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 ?
http://www.sports-extremes.net/wp-content/uploads/2012/05/escalade-sexy-06.jpg
L. Rolland, Pontresina 19/09/14
ConclusionSpinal 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
L. Rolland, Pontresina 19/09/14
References
1. Burtscher M, Jenny E. Häufigste. Trainingsbedingte Beschwerden und Verletzungen bei Sportkletterern. Praktische Sport- und Traumatologie und Sportmedizin 1987;2/87:15–21.!
2. Folkl AK. Characterizing the consequences of chronic climbing-related injury in sport climbers and boulderers. Wilderness Environ Med. 2013 Jun;24(2):153-8. doi: 10.1016/j.wem.2012.11.010. Epub 2013 Feb 21.!
3. Schweizer A. Sport climbing from a medical point of view. Swiss Med Wkly. 2012 Oct 11;142:w13688. doi: 10.4414/smw.2012.13688.!4. Neuhof A, Hennig FF, Schöffl I. Injury risk in sport climbing. Int J Sports Med. 2011 Oct;32(10):794-800. doi: 10.1055/
s-0031-1279723. Epub 2011 Sep 12. !5. Dalichau S. Der Einfluss sportmechanischer Belastungsprofile auf die thorakolumbale Wirbelsäulenform. Butzbach-Griedel : Afra ; 2001 :
88!6. 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 : 53-59!7. 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: 122-136!
8. Post RB, Leferink VJ. Spinal mobility: sagittal range of motion measured with the spinalmouse, a new non-invasive device. Arch Orthop Trauma Surg 2004; 124:187-1921. !
9. Janda V. Manuelle Muskelfunktionsdiagnostik. 4th ed. München: Urban & Fischer; 2000
L. Rolland, Pontresina 19/09/14
Thanks for your attention !
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