Perceptions of low back pain in elite gymnastics: a multi-disciplinary qualitative focus group study

Objectives: To explore the multidisciplinary team experience of Low Back Pain (LBP) in elite gymnastics.

Design: A qualitative focus group.

Setting: British Gymnastics.

Participants: Ten coaching, sports science and medicine multidisciplinary team members working with British gymnasts.

Main outcome measures: A topic guide informed by literature/expert opinion enabled discussion that was recorded/transcribed verbatim. Initial inductive analytic process developed theoretical insights. Manual coding using constant comparative methods categorised meaningful themes and sub-themes.

Results: Two key aspects were identified. Emerging themes for LBP presentation included: early
identification LBP and influence of multidisciplinary team members on outcomes; factors influencing LBP
reporting e.g. coach-athlete relationship; frequent presentations of LBP and accepted norms; athlete
history and physical examination e.g. training load. Emerging themes for causation of LBP included:
intrinsic risk factors e.g. growth and maturation; extrinsic risk factors e.g. equipment.

Conclusions: Individual responses of a gymnast to experiencing LBP were important across all themes.
Some LBP was perceived as normal. The coach-athlete relationship and support team are crucial decision-makers around training load and adaptation. Early detection will help minimise time loss from training/performance to expedite healing.