Association between Body Composition Characteristics and Chronic Low Back Pain in High-School Baseball Players: A Retrospective Study

Int J Sports Phys Ther. 2025 Nov 2;20(11):1594-1601. doi: 10.26603/001c.146018. eCollection 2025.

Abstract

Background: Chronic low back pain (CLBP) is common among adolescent athletes, particularly baseball players; however, its association with body composition remains unclear.

Purpose: To investigate the relationship between body composition parameters and the presence of CLBP in high-school baseball players.

Study design: Retrospective cohort study.

Methods: Male high-school baseball players were recruited and divided into the CLBP and non-CLBP groups. CLBP was defined as low back pain rated ≥3 on the numerical rating scale (NRS) and lasting >12 weeks. Body composition was measured using bioelectrical impedance analysis in the first year of high school. Logistic regression was used to identify the factors associated with CLBP.

Results: Ninety male baseball players participated (mean age: 16.8±0.4 years, during second year). The CLBP group (n=31) showed significantly higher percentage body fat (PBF), body fat mass (BFM), BFM index, and trunk fat mass compared with the non-LBP group (n=59). Logistic regression analysis identified first-year NRS scores (odds ratio [OR]: 2.10; 95% confidence interval [CI]: 1.46-3.21) and PBF (OR: 1.26; 95% CI: 1.05-1.51) as significant predictors of CLBP.

Conclusion: Elevated body fat percentage and elevated pain intensity in early high-school years were associated with the development of CLBP among high-school baseball players. Regular monitoring of body composition and early intervention based on pain levels may effectively prevent CLBP in adolescent baseball players, thereby supporting better long-term athletic performance and health outcomes.

Level of evidence: 3b.

Keywords: adolescent athletes; baseball; body composition; chronic lower back pain; percentage bod fat.