Analysis of Posterior Chain Muscle Symmetry
in Junior Badminton Players of South Asia
Digpal Ranawat1,2, Manan Vora1,3*, Manit Arora1,3 and Apoorva Tiwari2
1Abhinav Bindra Targeting Performance, Mohali, India
2Abhinav Bindra Targeting Performance, Bangalore, India
3Fortis Hospital, Mohali, India
Submission: November 28, 2018; Published: December 06, 2017
*Corresponding author: Manan Vora, Fortis Hospital, Mohali, India
How to cite this article: Digpal R, Apoorva T, Manan V, Manit A. Analysis of Posterior Chain Muscle Symmetry in Junior Badminton Players of South Asia. J Phy Fit Treatment & Sports. 2018; 6(1): 555676. DOI: 10.19080/JPFMTS.2018.05.555676
Badminton is a physically demanding sport and it is not uncommon for players to have muscle imbalances. Detection and prevention of posterior muscle chain imbalances may help prevent injuries and result in overall improvement in performance. Accordingly, the study was proposed to analyse the posterior muscle chain symmetry in junior badminton players and understand the importance of prevention of muscle imbalance. A total of 100 players from South Asia between the ages of 8 and 15 years were analysed. Postural bench MF system of Tec nobody Italy was used. Variables measured were gender, height, age, body mass index, and experience in years, level at which they play, current pain, and clicks & catches in the past 1 year. Our study showed that there is a significant difference in the lumbar load between the right and left side in amateur and professional badminton players and in the pelvic load between the right and left side in players with an experience of less and more than 5 years. Rest of the variables did not prove to be significant with respect to difference in scapular, lumbar and pelvic load. There needs to be a greater focus on prevention of muscle imbalances with the help of specific training, strength & conditioning, and rehabilitation as part of the development of junior badminton players.
The intermittent nature of badminton makes it hard to determine exactly what is happening physiologically, because so much is dependent on standard of players, the type of game being played, the duration of the play, coordination, mental acuity and the environmental conditions encountered Mikkelsen . Great athletes make difficult moves look effortless with a combination of skill, strength, and balance and accordingly, train for smooth and fluid movement to help prevent muscle imbalances, mobility restrictions, stability problems, and injuries Cook . It has been previously established that the biomechanical rationale for achieving and maintaining optimal posture is to move efficiently, free of impairment and dysfunction Kritz & Cronin . Muscle imbalance occurs when muscles become constantly shortened or lengthened in relation to each other Norris . Various imbalance classifications have been suggested relating to muscles’ structure, function and response to injury. Muscles have been classified as both postural and phasic types, and stability and movement synergists Norris . It states that shortened muscle in a group shows a lowered irritability threshold and is recruited first in a movement, causing changes in motor programming. Few studies have taken place on muscle imbalance in sport. The relationship between hip muscle imbalance and occurrence of low back pain in athletes has been studied Nadler et al . Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes has been documented Page . Muscle imbalances of the lower extremities in competitive sports like basketball and volleyball have been analysed Sommer . Additionally, strength imbalances in professional soccer players has been discussed as well Croisier, Ganteaume, Binet, Genty, & Ferret .
Posterior chain muscle imbalance could either be a cause of or lead to potential postural problems. One recent study focused on the posture of badminton players. It analysed the reliability of postural measures in elite badminton players using Posture Pro 8 software which is used for photogrammetry assessment of posture Hébert-Losier & Rahman . The authors assessed the standing posture from anterior, lateral, and posterior photographs and extracted postural measures using visual landmarks as guide. Another study in the past did posture assessments from four photographs: anterior, posterior, lateral and oblique views Watson & Mac Donncha . There have been various other studies which have used certain methods to assess muscle imbalances and function. One such study used clinical movement analysis to identify muscle imbalances Padua & Hirth . Surface electromyography, a non-invasive technique for assessing muscle function and providing a basic understanding of the function of trunk muscles in both normal subjects and low back pain patients during specific postures and movements was done Oddsson & De Luca  while another preliminary alternative approach in an attempt to assess muscle function in relation to both- performance
& injury prevention and muscular recovery after injury has been
documented as well Schlumberger et al. 
A study on the epidemiology of injuries in elite badminton
athletes showed that the most common region of pain in the body
is the back Yung, Chan, Wong, Cheuk, & Fong . Goh, Mokhtar, &
R. Mohamad Ali,  Studies have shown that most sports injuries
are related to flexibility, posture, acceleration, clinical defects, and
previous injury Watson . A study was also conducted on the
sports injuries in footballers related to defects of posture and
body mechanics with the objective being to investigate possible
relationships between the incidence of sports injury and the
existence of body mechanics defect in players Watson .
Studies co-relating injuries to muscular imbalances have been
documented such as a relationship between shoulder mobility,
rotator muscles’ strength and scapular symmetry, and shoulder
injuries and/or pain in elite volleyball athletes Wang & Cochrane
 A prospective study of overuse knee injuries among female
athletes with muscle imbalances and structural abnormalities
has been conducted Devan, Pescatello, Faghri, & Anderson .
The purpose of this study was to identify the modifiable and
non-modifiable factors that contribute to posterior chain muscle
imbalances in badminton players, resulting in potential postural
problems, back pain and increased risk of injury. Non-modifiable
factors include gender, height, age and years of experience.
Modifiable factors include body mass index, level, current pains,
clicks and catches in the body.
One hundred junior badminton players under the aegis of
Badminton Association of India (BAI) were recruited for the study.
Informed consent from the players, legal guardians and coaches
was taken prior to participation. Approval from the BAI was
taken prior to initiation of the study. All players were screened
using a combination of a questionnaire and machine analysis.
The questionnaire consisted of a self-developed item set with
focus on demographics, injury history, treatment history, playing
career history and current injury state. The demographic data
included age, sex, height, weight, and dominant hand. The injury
history included questions regarding injuries in the past, their
severity, whether they occurred during competition, training or
daily activity, whether it prevented the player from taking part in
a competition and/or training and/or daily activity, and if the pain
was more during a particular badminton stroke. The treatment
history questioned the form of treatment taken for the injuries,
whether it was oral medication, physiotherapy, surgery, or any
Playing career history included information regarding the age
at which the player began playing badminton, whether the player
has a dedicated coach and/or trainer, age at which he/she began
playing badminton tournaments, and current professional level.
Current injury state involved questions regarding any current
pain faced by the player, and whether the player has experienced
any clicks, cracks or catches in the body in the last 12 months.
The machine analysis was done by conducting a biomechanical
assessment of posture. Postural bench MF system of Tecnobody
Italy (Figure 1) was used to assess the posture. The Postural
Bench system is equipped with two tilting flat surfaces (head
and trunk surface A and lower limbs surface B) which pivot on
the dock. The athlete is made to lie down flat on the bench. As
you tilt the system from either end (Figure 2), contraction of the
back muscle structure takes place, emphasizing the rotations and
muscular dissymmetry. The assessment module of the Postural
Bench system allows one to monitor, in real time, the symmetry of
the posterior chain in three fundamental points: scapular, lumbar,
and pelvic areas. At the end of the 2 minute test, the report (Figure
3) presents a clear picture about the muscular symmetry between
right and left sides, in which it shows in percentage terms the load
developed from the posterior chain.
*Significant difference level at (0.05).
*Significant difference level at (0.05).
*Significant difference level at (0.05).
We recorded the difference in scapular, lumbar, and pelvic
load (%) from each athlete’s report. The test was done using the
Tecnobody machine in Abhinav Bindra Targeting Performance at
Padukone-Dravid Centre for Sports Excellence in Bangalore. The
data was categorized into variables (Tables 1-3) and the resulting
categorical data was analysed by computing the Mean, Standard
Deviation and T-test to identify the level significance in kinematic
variables using Microsoft Excel and SPSS (16.0) software.
A total of 100 junior South Asian Badminton players
underwent the assessment. Out of the 100 players, 59 were male
players and 41 were female players. 90 of them were from India,
4 each from Nepal and Sri Lanka, while 2 players were from
Maldives. The age group was between 8 and 15 years. The data is
presented in Tables 1-3.
Table 1 shows difference in scapular load (%) between right
and left sides of a body among various groups. Gender, height,
age, BMI, experience in years, level at which they play, current
pain, and clicks & catches in the past 1 year were the variables.
However, none of the variables showed a significant difference
between the groups. As seen in Table 1, there is no significant
difference in Scapular load with the variables.
Table 2 highlights the difference in lumbar load (%) between
right and left sides among groups. We observed a significant
difference in terms of level at which they play (Graph 1). 34 players
were amateur and 66 were professional players. Mean lumbar
load difference in amateur players was 6.01 ± 4.90 % and in
professional players was 7.65 ± 7.29 %. The significant difference
was 0.05. There was no significant difference in terms of the other
groups. As seen in Table 2, there is a significant difference in the
level at which the players are playing.
Table 3 highlights the difference in in pelvic load (%) between
right and left sides among groups. We observed a significant
difference in terms of experience in years (Graph 2). 44 players
had playing experience of less than 5 years and a mean of 8.81 ±
7.45. 56 players had more than 5 years of playing experience and a
mean of 13.33 ± 23.04. The significant difference was 0.02. There
was no significant difference in terms of the other groups. As seen
in Table 3, there is significant difference with respect to years of
Badminton requires specific physical conditioning in terms of
action controls such as reaction time, foot stepping, and static or
dynamic balances, which are essential motor demands in the sport
Laffaye, Phomsoupha & Dor . In addition to moving back and
forth on the court, players conduct various movement patterns
during the game including twists, jumps, and swings to strike the
shuttle-cock Phomsoupha & Laffaye . Due to the high physical
demands of the game, it is not surprising that badminton players
may have posterior muscle chain asymmetry.
The results of our study have highlighted certain factors that
contribute to causing posterior muscle chain asymmetry, but it
also sheds light upon the lack of importance given by players and
coaches in including a training and conditioning program in an
athlete’s regimen that focuses on improving the muscle imbalance
and posture of an athlete. Based on our results, we found that there
is a significant difference in the lumbar load between the right
and left side in amateur and professional badminton players. We
also found a significant difference in the pelvic load between the
right and left side in players with an experience of less and more
than 5 years. Rest of the variables proved to be non-significant
with respect to difference in scapular, lumbar and pelvic load.
Non-modifiable factors include gender, height, age and years of
experience. Modifiable factors include body mass index, level,
current pains, clicks and catches in the body.
The factors in question here were gender, height, age and
years of experience There was a significant difference in the
pelvic load between the right and left side in players with an
experience of less and more than 5 years. The result showed that
the players with more experience had more difference in pelvic
load compared to the ones with less experience. This proves that
as players become more experienced after a number of years in
this gruelling sport, they are more prone to hip muscle imbalance.
The muscles around the pelvis may be imbalanced and lead
to reduced levels of stability, mobility, flexibility and strength,
eventually affecting a player’s performance. The importance of
pelvic stability has been well highlighted and the need for pelvic
stability training to be incorporated in a badminton player’s
regimen is necessary Manan, Digpal, Apoorva, & Manit .
This also shows that despite players having more than 5 years’
experience in the sport, they may not have access to strength and
conditioning specialists or specialised physiotherapists who can
help train them in improving their muscle imbalance and that it is
not being given the importance it needs. There was no significant
difference observed between any of the other groups in terms of
difference in scapular, lumbar, and pelvic load between the right
and left side of the body.
The factors being considered here were body mass index,
level, current pains, clicks and catches in the body. There was a
significant difference in the lumbar load between the right and
left side in amateur and professional badminton players. The
result showed that professional badminton players had more
difference in lumbar load compared to the amateur players. A
study conducted on football players showed that knee injuries
were found to be associated with lumbar lordosis and sway back.
Subjects who suffered from muscle strains had a higher incidence
of lumbar lordosis, sway back and abnormal knee inter-space. It
also stated that back injuries were associated with poor shoulder
symmetry, scapulae abduction, back asymmetry, kyphosis,
lordosis and scoliosis. In general, it was found that the incidence
of ankle, back, knee and muscle injuries was influenced by the
presence of defects of body mechanics and the results suggest that
intervention to improve body mechanics would be likely to reduce
the incidence of sports injuries in football Watson 
The importance of good posture and prevention of lumbar
muscle imbalance needs to be highlighted to players and their
coaches to help prevent injuries and maximise performance.
There was no significant difference observed between any of the
other groups in terms of difference in scapular, lumbar, and pelvic
load between the right and left side of the body. There are various
studies that have suggested methods to assess muscle function and
help prevent muscle imbalance. It has been previously stated that
muscle impairments contribute to postural abnormalities and are
associated with movement impairments. The authors suggested
that the additional information provided by a static standing
posture assessment may assist the strength and conditioning
professional in developing a strength programme that is more
specific to the athlete’s needs in order to enhance performance
and possibly reduce the incidence of injury. To optimise function,
an athlete should be suggested an integrated functional exercise
program for stretching of potentially overactive and tight muscles,
and for strengthening of underactive and weak musculature
Padua & Hirth .
The advantages of balance and stability training too have been
highlighted. The authors indicate balance and stability training
to be effective for gain in muscular strength and equalisation of
muscular imbalances Heitkamp, Horstmann, Mayer, Weller, &
Dickhuth  Manan et al . A few studies have also discussed
the co-relation between muscular imbalance and low back
pain and posture related problems. It has been observed that
improved objective techniques for early diagnosis, treatment, and
rehabilitation of patients with low back pain may help reduce costs
and prevent the development of a chronic disability. The authors
stated that the development of such techniques requires a detailed understanding of mechanisms controlling muscle activation in the
presence of low back pain as well as objective ways of measuring
and quantifying muscular function in the presence of low back
pain. Another study showed the concept of hip muscle imbalance
being associated with low back pain occurrence in female athletes.
Their research further supported the need for the assessment and
treatment of hip muscle imbalance in individuals with low back
pain. In a previous study, we assessed hip stability, helping us pinpoint
the exact region of muscle imbalance and treat it accordingly
Manan et al .
Importance should also be given to injury prevention.
Stretching before playing and cool down exercises after playing are
necessary. It is also suggested that injury prevention programmes
should concentrate on improving posture and the rehabilitation
from previous injury, rather than flexibility. There were some
limitations we faced in our study. Firstly, the participants included
players between the ages of 8 and 15 years only. Secondly, the
study could have included a wider geographical area including
players from more Asian countries. Thirdly, an assessment
after correction of muscle imbalance could have been done.
This study opens up new grounds for further research. Further
studies can address other variables not included in the present
study. Additionally, targeted interventions are needed to prevent
posterior muscle chain imbalance in athletes and the effect of
such improvements on performance need to be determined.
This study shows that there is a significant difference in
the lumbar load between the right and left side in amateur and
professional badminton players and a significant difference in
the pelvic load between the right and left side in players with an
experience of less and more than 5 years. Professional players had
more difference in lumbar load compared to amateur players and
players with more than 5 years’ experience had more difference
in pelvic load compared to less experienced players. However,
no significant difference in scapular, lumbar and pelvic load was
seen across other variables. Understanding the need of injury
prevention programmes, strength & conditioning, and sports
rehabilitation and its importance in overall improvement in
badminton performance is vital and may help take a badminton
player’s fitness and game performance to a whole new level.