Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Physical Therapy (Medicine)

Date of Defense


First Committee Member

Kathryn E. Roach

Second Committee Member

Ira M. Fiebert

Third Committee Member

Lawrence P. Cahalin

Fourth Committee Member

Thomas H. Champney


This dissertation determined the effect of known and theoretical risk factors for LBP in the Olympic class sailors utilizing a cohort design. A secondary goal was to determine if any factors related to sailors or sailing would provide a protective effect, lowering the risk of LBP. Sailors exposed to hiking (a sailing-specific activity) and non-hiking sailing classes were analyzed for the effect of hiking activity as a risk factor for LBP. Hiking exposure increases risk of LBP. Exposure to more than two hours of unloading the sailors’ boats and equipment prior to a regatta was a second unique risk factor for LBP, and worked as an effect modifier on the hiking risk of developing LBP. Hikers also exposed to greater than two hours of unloading time were found to have eight times greater risk of developing LBP than non-hikers. A previous case of LBP in the past 6 months doubled the hiking sailor’s risk of developing LBP. An age of 22 years or less increased risk by roughly 2.5 times. Regular training program exposure over the previous 12 months reduced risk of developing LBP by nearly two-thirds. Programs consisting of traditional aerobic and strength training components, along with the addition of sailing-specific training methods were most effective in reducing risk of LBP. A 65% reduction in risk of developing LBP was found by being a National Team member. Comparisons were made between the characteristics and behaviors of the National Team versus non-team affiliated sailors to possibly explain this effect.


spine; prevention; sport