Research Review: The "Ready Position" and Back Pain

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Hey guys!


I'm starting a free "research roundup" service for table tennis players. If you'd like to get an email once a month or so with a roundup of the latest research on table tennis, you can join here:


https://mailchi.mp/8daf7851fcd0/research-roundup-signup


The first issue comes out on the 13th of this month.


I try to keep each breakdown concise and provide some practical take-aways as well. See below for an example!


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Is your "ready position" the root of your back pain?


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7305769/


In this study, 22 competitive female table tennis players completed a questionnaire on spinal pain and were given a body postural assessment that compared their normal standing posture with their table tennis "ready position." Over half of the participants reported a medium level of back pain with 36% citing a level of pain that required them to stop training. The athletes were also tended towards a kyphotic (hunched forward) posture, and were asymmetrical in the alignment of their pelvis and spinous process.


The researchers concluded that due to the number of practice hours required to become competitive in table tennis, the risk for postural defects, asymmetries, and spinal pain may be higher than average. They recommended being wary of training volume, assessing technical form issues with a coach, and performing exercises that improve symmetry of the work of the upper limbs, body trunk muscles and the pelvis.


Key Takeaway:


Athletes displaying sport-specific asymmetries is nothing new. To some extent, this is unavoidable. If you are proactive, however, you may be able to counteract this to some degree.


Here are a few places to start:


- Incorporate things like Cat/camels, Wall slides, Bird dogs, and T-spine mobilizations as part of your warm-up
- Engage in full body strength training using unilateral movements
- Balance all that TT flexion with movements that work on extension and external rotation—Face pulls, Y-raises, External rotations, Supermans, etc.


Note: Most people are a little asymmetrical. And few have perfect posture. If you're not experiencing any pain or restrictions in movement, don't "WebMD" yourself into a crisis here.


A large part of posture is awareness. Simply strengthening certain muscles is unlikely to change your daily posture; you need to actively build an awareness and self-correct throughout the day (shoulders back, proud chest, etc.).
 
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Many problems with this study: It is small. Crucially, there is no control group ( age matched athletes in a different more symmetrical sport or non athletes). It is only women. None of the asymmetry parameters are considered in relationship to whether pain is present or not, or with dominant hand of the players. We are told nothing about the styles of play in different athletes in the study. Are defenders different from loopers or do they think everything comes from the ready position? Recommendations for therapeutic intervention are not even remotely evidence based.
 
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I agree the study has limitations. And perhaps I wasn't clear enough that I didn't intend this to be prescriptive as a "cure" for back pain or anything like that. This is why my recommendations based on this study were to do things that most should be doing anyway, i.e., work on mobility, strengthen the body as a whole, address neglected movement patterns, etc. These are things that the broader literature supports as a means of reducing injury risk.

I also specifically mentioned not to obsess over minor asymmetries or slightly poor posture in the absence of any pain or movement issues.

I'm still trying to nail down a format that is concise, yet thorough enough to properly contextualize the studies, so your feedback is appreciated!

Perhaps I'll add a "limitations" section to each breakdown.
 
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I have found a lot of pretty bad sports science and nutrition studies over the years. Sometimes its because the studies are hard to do, sometimes theyre just bad. This one has limitations that make it pretty much useless

TT is unquestionably hard on the back. I don't think it's because of the ready position though. I think the stresses come from all the other movements. Worse still with age, any extra wright, or bad luck.
 
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