Lumbopelvic exercise reduces lower limb muscle strain injury in recreational athletes

Background: Lower limb muscle strain injury (LLMSI) has a high incidence in sport. Reports of injury reduction after lower limb stretching and strengthening interventions have been inconsistent; however, it has been proposed that poor proximal control may predispose athletes to LLMSI. Deficits in lumbopelvic stabilizers, reduced trunk control, pelvic strength imbalance, poor balance and reduced hip flexibility have been reported as risk factors for leg muscle injuries including hamstring, groin and thigh strain. Exercise interventions targeting the lumbopelvic region may be effective in preventing LLMSI. Objective: To determine if lumbopelvic exercise interventions reduce the incidence of LLMSI. Methods: Databases were searched for exercise trials that targeted the lower back, abdomen, pelvis and hip. The search included a range of interventions: lumbopelvic stability, resistance training, muscle stretching and posture or balance exercise. Quality of included trials was assessed using the PEDro scale. Results: Six studies were identified that compared lumbopelvic exercise with other interventions or usual training and reported the incidence of LLMSI. Lumbopelvic exercise intervention was favoured with a significant effect size both in a meta-analysis (OR=0.40, 95% CI 0.17-0.94, P=0.03) and in a sensitivity analysis based on one high quality study (OR=0.27, 95% CI 0.09-0.75, P=0.01). Sub-group analysis of three balance studies did not show a significant effect in reducing LLMSI. Conclusions: Lumbopelvic exercise reduces the incidence of LLMSI. Stabilization, agility and neuromuscular were the most successful interventions.