Low-back pain is one of the most common injuries in competitive swimmers. Therefore, the prevention of low-back pain would contribute to improved performance of swimmers. A biomechanical analysis is necessary to prevent the sports-related injuries. However, only lumbar movement has been analyzed in swimmers with low-back pain. Lumbar spine movement is closely associated with the pelvis and hip joint. Thus, not only the lumbar joint but also the pelvis and hip joint should be analyzed to determine the cause of low-back pain.The aim of this study was to investigate the relationship of the effect of underwater movement on the motion characteristics of the lumbar, lumbosacral, and hip joints with trunk flexion-extension in the standing position.Fourteen male competitive swimmers were recruited for this study. Trunk flexion-extension motion in the standing position and underwater dolphin kick motion were captured in the saggital plane on a digital video camera. A 2D motion analysis was performed to determine the lumbar, lumbosacral, and hip joint angles during these motions.The results demonstrated that the lumbar angle during the dolphin kick motion was associated with the angle in the standing position when the trunk was extended; and the lumbosacral angle during the same motion was associated with the angle in the standing position when the trunk was flexed.Additionally, the subjects who tilted their pelvis anteriorly while swimming exhibited a bit of pelvis motion during trunk movement in the standing position. Thus, the anterior tilting of the pelvis during swimming leads to low-back pain in swimmers.

Decrease in the hip extension range of motion (HE-ROM) can cause lumbar hyperlordosis. Hyperlordosis is one of the mechanisms underlying low back pain. A diagnosis of low back pain from hyperlordosis can be used to detect the area in which hyperlordosis occurs more easily—the upper or lower lumbar spine. Twenty-one men were recruited for this study. HE-ROM was measured manually. Lumbar alignment was measured on a bed in a prone position. We extended the subject's hip by bending the bed at 4 angles (0°, 10°, 15°, 30°) and measured the spinal alignment by using a SpinalMouse. The results showed that lumbar lordosis increased at the bed angles of 15°and 30°. Only when the bed angle was changed from 0° to 30°, the increased angle of the lumbar spine was negatively correlated to the HE-ROM (r=-0.46, p<0.05), particularly that of the lower lumbar spine (r=-0.47, p<0.05). These findings suggested that lower lumbar lordosis tends to increase in individuals with poor HE-ROM. Additionally, increase in lower lumbar lordosis is attributed to the tendency to have low back pain in the lower lumbar spine.