Rehabilitation management for a dysfunctional/non-painful (DN) joint causing low back disorder in an elite athlete: A case report.

Abstract

Low back pain in athletes can arise from asymptomatic dysfunctional/non-painful (DN) joints, which cause compensatory stress on adjacent regions. This report highlights the clinical importance of identifying and correcting these underlying 'DN joints,' integrating concepts from the Selective Functional Movement Assessment and the joint-by-joint approach to prevent recurrence. A 25-year-old female professional volleyball player underwent surgery for L5 radiculopathy due to disc herniation. Postoperatively, a functional assessment revealed DN joints:restricted mobility in her right glenohumeral joint and thoracic spine. This dysfunction led to compensatory lumbar lateral flexion during spiking motions and unilateral landing on the left foot after spiking, increasing mechanical stress on her lower back. A rehabilitation program successfully corrected these DN joints. Consequently, the compensatory movement pattern resolved. The patient returned to competition six months post-surgery and remained pain-free at a two-year follow-up, competing at her pre-injury level. This case demonstrates that addressing asymptomatic DN joints as the root cause of symptomatic lumbar disorders is crucial for athletes. This comprehensive approach, which looks beyond the site of pain, is essential for a durable recovery and the prevention of injury recurrence. J. Med. Invest. 73 : 274-280, February, 2026.