Development of a comprehensive clinical assessment protocol for low back and hip pain in powerlifters: a feasibility study

Background Low back and hip pain problems are frequent in powerlifting. There is a lack of information on the specific pain phenotypes and specific impairments in body function associated with these pain problems, as well as how to reach a clinical diagnosis relevant for powerlifters' pain problems. Therefore, the aim was to develop a comprehensive clinical assessment protocol for pain and function in powerlifters with low back and/or hip pain and evaluate its feasibility for use in further epidemiological or clinical studies of powerlifters.MethodsThe study was conducted in two phases. In phase one, the protocol was developed according to literature regarding musculoskeletal assessment and sports injuries, and in phase two, feasibility was evaluated. Eight powerlifters with low back/hip pain were included in phase two. Four of them were examined independently by two physical therapists, and the other four were examined by one of the physical therapists. The time spent on the examination, whether the physical therapists could reach a clinical diagnosis without adding items to the protocol, and whether the two physical therapists were consistent in terms of the clinical diagnosis, were evaluated.ResultsThe protocol was developed including subjective examination, physical examination, and a clinical diagnosis based mainly on signs and symptoms of associated neurophysiological pain mechanisms and the specific impairments in body functions associated with the powerlifter's pain problem. The protocol met the feasibility criteria. The examination lasted approximately 1 h, no items needed to be added, and both physical therapists were able to make a consistent clinical diagnosis. Visual observation and alteration of movement strategy of the squat/deadlift were thought to be crucial for assessing the powerlifters' pain problem.ConclusionsThis is the first comprehensive clinical assessment protocol developed to describe powerlifters' pain problems/injuries with a clinical diagnosis based on the dominating neurophysiological pain mechanism and impairments in body functions. However, before use in larger studies, it is recommended that the protocol be further evaluated by a larger number of physical therapists and powerlifters to evaluate its reliability and whether the content of the protocol should be further expanded.