title: 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.
abstract: 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.
authors.affiliation: Pajulahti Sports Center, Nastola, Finland. kesto@sci.fi
authors.forename: L O
authors.initials: LO
authors.lastname: Mikkelsson
authors.forename: H
authors.initials: H
authors.lastname: Nupponen
authors.forename: J
authors.initials: J
authors.lastname: Kaprio
authors.forename: H
authors.initials: H
authors.lastname: Kautiainen
authors.forename: M
authors.initials: M
authors.lastname: Mikkelsson
authors.forename: U M
authors.initials: UM
authors.lastname: Kujala
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D002648:Child; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000209:etiology*; D017116:Low Back Pain / Q000209:etiology*; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009119:Muscle Contraction / Q000502:physiology; D019547:Neck Pain / Q000209:etiology*; D016017:Odds Ratio; D010807:Physical Endurance / Q000502:physiology*; D018583:Pliability; D012008:Recurrence; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires