ORIGINAL ARTICLE

Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study

L O Mikkelsson¹, H Nupponen², J Kaprio³, H Kautiainen⁴, M Mikkelsson⁴ and U M Kujala⁵

¹ Pajulahti Sports Centre, Nastola, Finland
² University of Turku, Turku, Finland
³ Department of Public Health, University of Helsinki, Helsinki, Finland
⁴ Rheumatism Foundation Hospital, Heinola, Finland
⁵ University of Jyvaskyla, Jyvaskyla, Finland

Correspondence to:
Correspondence to:
L O Mikkelsson
Pajulahti Sports Center, Nastola, Finland; kesto{at}sci.fi

Objective: To examine whether adolescent flexibility, endurance strength, and physical activity can predict the later occurrence of recurrent low back pain, tension neck, or knee injury.

Methods: In 1976, 520 men and 605 women participated in a sit and reach test (flexibility) and a 30 second sit up test (endurance strength). In 1976 and 2001 (aged 37 and 42 years) they completed a questionnaire. Lifetime occurrence and risk of self reported low back pain and self reported, physician diagnosed tension neck and knee injury were calculated for subjects divided into tertiles by baseline results of strength and flexibility tests.

Results: Men from the highest baseline flexibility tertile were at lower risk of tension neck than those from the lowest tertile (odds ratio (OR) 0.51, 95% confidence interval (CI) 0.28 to 0.93). Women from the highest baseline endurance strength tertile were at lower risk of tension neck than those from the lowest tertile (OR 0.60, 95% CI 0.40 to 0.91). Men from the highest baseline endurance strength tertile were at higher risk of knee injury than those from the lowest tertile (OR 1.96, 95% CI 1.05 to 3.64). Men who at school age participated in physical activity were at lower risk of recurrent low back pain (OR 0.61; 95% CI 0.42 to 0.88) than those who did not.

Conclusions: Overall good flexibility in boys and good endurance strength in girls may contribute to a decreased risk of tension neck. High endurance strength in boys may indicate an increased risk of knee injury.

Keywords: exercise; flexibility; neck tension; low back pain; knee injury

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