Muscle activation imbalance and low-back injury in varsity athletes
Abstract
There are conflicting findings in the literature regarding erector spinae activation imbalance in people with low-back pain (LBP). Some studies have found asymmetric recruitment between muscle pairs in people with LBP, whilst other studies have not; some reported people with LBP recruit more lumbar muscles whilst other have reported greater thoracic activity. Using 242 varsity athletes, EMG activity of thoracic and lumbar erector spinae pairs was recorded during an isometric trunk extension. Activation imbalance among muscle pairs and levels was compared between athletes with and without a history of low-back injury (HxLBI). There were no group differences in the imbalance between sides, but the HxLBI group had greater activation imbalance between lumbar and thoracic levels than the No HxLBI group. Activation imbalance between levels was similar for individuals with No HxLBI and those who sustained first time injury suggesting that imbalance does not cause LBI. There was no difference between the athletes with single and multiple episode LBI, nor between short and long symptom duration suggesting that the presence of imbalance is not an impairment. Interestingly, activation imbalance occurred in both directions, meaning more thoracic activity for some, and more lumbar activity for others, which might be a functional adaptation related to pathology.
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Reeves and Cholewicki found equal activation imbalance between sides for athletes with a history of low back injury and healthy athletes.
“In a similar designed work, Reeves and Cholewicki [24] had different results of equal activation imbalance between two sides for athletes with a history of low back injury and healthy athletes.”
From Comparison of muscle activation imbalance following core stability or general exercises in nonspecific low back pain: a quasi-randomized controlled trial (2020) · cites this paper as [24]
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“On average, LBP symptoms begin between 30 and 50 years of age, although athletes might develop them as early as their twenties [3].”
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Akkuş, C., & Demirel, A. (2025) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-025-09023-x
Nicoletta, T. M. (2019) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/sdkx-5w46
신민주, 문영진, Lee, S. K., Yun, H., Song, J., Xu, J., Dong, Z., Kim, K. S., & Han, S. H. (2026) · Symmetry · doi:10.3390/sym18091566
“As problems of body imbalance among young and older people have also been reported, efforts are being directed to address these issues via a variety of approaches [7–10].”
- Authors
- Reeves, N. P., Cholewicki, J., & Silfies, S. P.
- Affiliations
- Yale University (US)
- Drexel University (US)
- Corresponding author
- Cholewicki, Jacek
- Venue
- Journal of Electromyography and Kinesiology
- Publisher
- Elsevier BV
- Published
- 2006-06
- Volume
- 16
- Issue
- 3
- Pages
- 264-272
- ISSN
- 1050-6411 (ISSN-L)
- OpenAlex
- W2136978943
- Cited by
- 65
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 1 · 2016: 5 · 2015: 2 · 2014: 3 · 2013: 8 · 2012: 3
- FWCI
- 1.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Electromyography and Kinesiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Yale University
- Natural Sciences and Engineering Research Council of Canada
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR046844, 1R01 AR46844)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- low back injury, erector spinae, thoracic erector spinae, lumbar erector spinae, low back pain, varsity athletes, functional adaptation, asymmetry
- MeSH terms
- Adult, Athletic Injuries, Postural Balance, Female, Humans, Isometric Contraction, Male, Students, Low Back Pain, Muscle, Skeletal
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