Lower Back Pain in Field Hockey

Argentina’s Martin Ignacio Ferreiro, Nicholas Cicileo, and Hans Kei Kaeppeler of the U.S. in action. REUTERS/Susana Vera

Unlike many field-based sports, field hockey requires all players to compete right-handed, irrespective of hand dominance. This rule enforces repeated asymmetrical movement patterns and prolonged thoracolumbar flexion during high-intensity skills such as dribbling, passing, tackling, and striking^(1,2). These sport-specific demands expose the thoracolumbar region to substantial mechanical stress, contributing to the high prevalence of lower back pain (LBP) reported across ages, playing levels, and positions^(2,11,12). Prevalence rates range from roughly 33% to over 60%, highlighting LBP as a common issue in the sport⁽¹⁰⁾. Over time, these stresses may exceed tissue tolerance, particularly in younger athletes. 

Biomechanics

Prolonged adoption of a semi-crouched playing position is a defining feature of field hockey (see figure 1). Players frequently maintain thoracolumbar flexion to optimize stick–ball control, defensive reach, and visual tracking of play. During both training and competition, they have to sustain this posture for extended periods, often exceeding one hour during matches and up to two hours during training sessions⁽⁶⁾. Over time, this sustained flexed position may lead to postural adaptations, including flattening of the normal thoracolumbar curvature in the sagittal plane (see figure 2)^(5,6). Clinicians describe this phenomenon as the “hockey player’s back” and reflect chronic exposure to flexion-dominant spinal loading.

"Prolonged adoption of a semi-crouched playing position is a defining feature of field hockey..."