Introduction. Weightlifting (WL) and Powerlifting (PL) are popular strength-based sports, which are associated with large spinal tissue loads (1,2). Low back pain (LBP) is one of the most common disorders incurred by WL and PL (3). Fear of movement has been thought to be a risk factor for the onset and persistence of LBP (4), but this has only been investigated in the general population. Whether similar levels of fear exist in a cohort of athletes who frequently expose themselves to high and repetitive spinal loads is uncertain. In addition, the predictors of fear in people who perform WL and PL are unknown. Methods. Fear of movement was quantified using the Photograph Series of Daily Activities Short Electronic Version (PHODA-SeV) (scored from 0 = `Not harmful at all` - 100 = `Extremely harmful`) in a cohort of 70 WL and PL athletes (Age = 28 ± 8, Mass (kg) = 74 ± 12, Back squat (kg) = 129 ± 49). Pain intensity in the cohort was measured using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSLO) (5). 13 variables were measured and included in the stepwise regression to predict fear. Independent t-test were used to compare the cohort mean PHODA-SeV score with the mean population score (PHODA-SeV = 40). A stepwise regression model was used to determine the strongest predictors of PHODA-SeV score. Results. PHODA-SeV scores were 19.8 (p<.001) lower than the general population score of 40. The top three predictors in the regression model were back squat (ß = -.57, p<.001), age (ß = -.22, p = .037), and Oslo Q4 (To what extent have you experienced LBP related to your sport in the past 7 days?) (ß = 2.0, p <.001). Discussion. Athletes who train in WL and PL had lower fear levels compared to the general population. Similar findings have been seen within ACL recoverees (6), where modified PHODA scores were reduced in athlete`s ACL recovery group compared to the sham group (6). This would suggest that regular exposure to movements deemed dangerous reduces fear of movement. Our findings were supported by our regression analysis which found greater back squat load was associated with reduced pain score. This supports previous research (6) and the suggestion that with exposure to heavier weights and dangerous movements, WL and PL athletes have reduced fear even when LBP prevalence is high (6). Our findings suggest that repeated exposure to activities that incur high spinal load may help pain-related fear in a cohort of largely asymptomatic athletes. Whether WL and PL can be used to manage pain-free episodes to reduce risk of LBP remains to be investigated.
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