Spinal Manipulative Therapy and Sports Performance Enhancement: A Systematic Review

J Manipulative Physiol Ther. 2017 Sep;40(7):535-543. doi: 10.1016/j.jmpt.2017.03.014.


Objective: The purpose of this study was to review the literature regarding the relationship between spinal manipulative therapy (SMT) and sports performance.

Methods: PubMed and Embase databases were searched for original studies published up to July 2016. Inclusion criteria were if SMT has been applied to athletes and if any sports performance-related outcome was measured.

Results: Of the 581 potential studies, 7 clinical trials were selected. Most studies had adequate quality (≥6/11) when assessed by the PEDro scale. None of those studies assessed performance at an event or competition. Four studies revealed improvement in a sports performance test after SMT. Meta-analysis could not be performed because of the wide differences in methodologies, design, and outcomes measured. Spinal manipulative therapy influences a wide range of neurophysiological parameters that could be associated with sports performance. Of the 3 studies where SMT did not improve test performance, 2 used SMT not for therapeutic correction of a dysfunctional vertebral joint but to an arbitrary previously set joint.

Conclusions: Although 4 of 7 studies showed that SMT improved sports performance tests, the evidence is still weak to support its use. Spinal manipulative therapy may be a promising approach for performance enhancement that should be investigated with more consistent methodologic designs.

Keywords: Athletes; Athletic Performance; Musculoskeletal Manipulations; Spine; Sports.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adult
  • Athletes / statistics & numerical data*
  • Athletic Injuries / prevention & control
  • Athletic Performance*
  • Female
  • Humans
  • Male
  • Manipulation, Spinal / methods*
  • Middle Aged
  • Young Adult