Watching UFC, One FC, Boxing or any other combat sports programs, it's very clear that to fight at that level you need above average diligence, persistence, skill, reactions, and honestly pain tolerance. Yet 3/10 individuals who train in combat sports suffer from lower back pain (LBP) (Alves de França et al., 2025). While it's currently widely understood that any sort of participation in activities and sports decreases the likelihood of LBP (Kim and Yim, 2020), these athletes in these types of sports are still getting it, so what is going on?!
Lower Back Pain, Spinal Mobility and Hip Rotation in Combat Athletes
Some common saying around physio classrooms are "motion is lotion" and "use it or lose it"; well these athletes are usually quite active, and they are using large ranges of motion with great skill and technique. However, in combat athletes with LBP there is a significant decrease in spinal mobility — specifically, spinal range of motion and hip rotation (Tak, Weerink and Barendrecht, 2020; Almeida et al., 2012). While there is not a lot of information to say which one came first, the LBP or decreased movement in the spine or the hip, we can probably conclude that the excessive need for rotational movements in these types of sports would cause the LBP. So what is there to do to address this? I mean at the end of the day it's not like we're seeing Justin Gaethje complaining of his back when he's back flipping off the fighting ring.
Recovery and Rehab: Restoring Hip Mobility and Lower Back Mobility
First thing is first, we need to try and alleviate the LBP to then start rehabbing; so taking a week off the sport or stopping aggravating movements (Lindsay and Vandervoort, 2014). But that doesn't just mean sitting and sipping margaritas, there then comes the rehabilitation portion. When improving hip mobility — hip internal rotation, spinal flexion and extension — becomes the most important factor for returning to performance and decreasing the chances of recurrence (Kim, Jung and Bae, 2024). Moreover, when rehabilitation exercises for core, hips, legs and back — lower back rehab that also restores lower back mobility — are combined with mobilizations with a practitioner, there is a significant increase in positive outcomes and sped up the improvement in lower back pain (Zago et al., 2025).
Sports Injury Recovery and Returning to Combat Sports
So as it seems like a lot of other conditions a proper recovery and rehabilitation program should have you on your way back into your sport. Either way combat athletes are not ones for quitting, which seems to be serving them well in recovery (Alves de França et al., 2025). But if you think you might need some outside support you can book for a session at TandemBalance here.
Stay Nerdy!
Mariam Aziz, Chartered Physiotherapist
References:
Almeida, G. P. L., de Souza, V. L., Sano, S. S., Saccol, M. F. and Cohen, M. (2012) 'Comparison of hip rotation range of motion in judo athletes with and without history of low back pain', Manual Therapy, 17(3), pp. 231-235. Available at: https://doi.org/10.1016/j.math.2012.01.004
Alves de França, M., Batista Lima, V., Medeiros Silva, C. A., de Costa Assis, S. J., Freitas de Lucena, E. M. and Gabriel de Souza, C. (2025) 'Analysis of the relationship between low back pain and jiu-jitsu: A cross-sectional study', Fisioterapia em Movimento, 38, pp. 1-8. Available at: https://doi.org/10.1590/fm.2025.38120
Kim, B. and Yim, J. (2020) 'Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial', Tohoku J Exp Med, 251(3), pp. 193-206. Available at: https://doi.org/10.1620/tjem.251.193
Kim, H.-g., Jung, J.-h. and Bae, S.-u. (2024) 'Effects of the Three-Direction Movement Control Focus Complex Pain Program and Neurodynamic Focus Complex Pain Program on Pain, Mechanosensitivity, and Body Function in Taekwondo Athletes with Non-Specific Low Back Pain: A Preliminary Study', Healthcare (2227-9032), 12(4), pp. 422. Available at: https://doi.org/10.3390/healthcare12040422
Lindsay, D. M. and Vandervoort, A. A. (2014) 'Golf-related low back pain: a review of causative factors and prevention strategies', Asian J Sports Med, 5(4), pp. e24289. Available at: https://doi.org/10.5812/asjsm.24289
Tak, I. J. R., Weerink, M. and Barendrecht, M. (2020) 'Judokas with low back pain have lower flexibility of the hip-spine complex: A case-control study', Physical Therapy in Sport, 45, pp. 30-37. Available at: https://doi.org/10.1016/j.ptsp.2020.06.003
Zago, J., Araújo, R., Marques, E., Gomes, A., Drummond, A., Rondinel, T., Nascimento, L., Queiroz, R., Amatuzzi, F., Pivetta, R. and Chiappa, G. R. (2025) 'Comparison of Maitland mobilizations and exercise programs for non-specific low back pain in karate fighters: A randomized clinical trial', Journal of Bodywork & Movement Therapies, 43, pp. 108-113. Available at: https://doi.org/10.1016/j.jbmt.2025.04.013
