BRIEF REVIEW: Hip & Lumbar Range of Motion and Lower Back Pain



Most musculoskeletal injury is multifaceted, with biomechanics, i.e. the way we move, one potential aspect that may lead to the occurrence of either a gradual-onset or acute-onset injury. It is thought that suboptimal biomechanics (tightness, weakness, impaired motor control etc.) in certain areas of the body may lean to increased mechanical load in other areas. 

The prevalence of lower back pain in judo athletes has been reported to be as high as 62% (1). The sport requires a high volume of rapid rotation, particularly into internal rotation of the hip of the supporting leg. Decreased hip rotation range of motion has been associated with lower back pain in adolescent judoka (2), as well as in other rotational sports such as golf (3). The aim of this study was to determine a link between hip, as well as lumbar spine range of motion and back pain in adult judo athletes 


62 judo athletes aged between 18-40 years (average age 25) with an average of 16 years judo experience, were grouped according to whether (29) or not (33) they had experienced ongoing lower back pain over the previous 6 months. The back pain group reported an average of 31/100 in terms of pain levels. All athletes underwent measurement of hip internal rotation and external rotation, as well as lumbar flexion and extension.


Athletes with lower back pain had on average 7 degrees less passive and active internal rotation on their non-dominant side, 8 degrees less lumbar flexion and 6 degrees less lumbar extension that the non-lower back pain controls.


Given the correlation between lack of hip range of motion and lower back pain in this cohort there may be a role for screening of this area in judo athletes, and where necessary, including interventions to optimise this quality in strength and conditioning programs and warm-up routines. 

The reduced lumbar range of motion may be causative of the back pain seen in these subjects, but may also have been caused by fear avoidance, muscle guarding, and impaired motor control secondary to their pain. Therefore, judo athletes experiencing lower back pain should have the condition investigated to identify the likely cause.


  1. Okada T, Nakazato K, Iwai K, Tanabe M, Irie K, Nakajima H. Body mass, nonspecific low back pain, and anatomical changes in the lumbar spine in judo athletes. J Orthop Sports Phys Ther. 2007;37(11):688–693.
  2. Almeida GPL, de Souza VL, Sano SS, Saccol MF, Cohen M. Comparison of hip rotation range of motion in judo athletes with and without history of low back pain. Man Ther. 2012;17(3):231–235.
  3. Dillen LRV, Bloom NJ, Gombatto SP, Susco TM. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Phys Ther Sport. 2008 May 1;9(2):72–81.

About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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By Sam Gilbert