EFFECTS OF MEZIERES METHOD ON MUSCLE IMBALANCE, BODY AWARENESS AND POSTURAL ALIGNMENT IN ATHLETES WITH LOWER BACK PAIN

Background: Low back pain is a frequent musculoskeletal complaint among athletes and may interfere with training, performance, posture, and daily function. Repeated loading, poor movement control, muscle imbalance, and altered postural awareness are common contributing factors. Conventional physiotherapy often focuses on core stabilization; however, global postural re-education approaches such as the Mezieres Method may offer additional benefits by addressing muscle-chain tightness, postural deviation, and body awareness together. Objective: To compare the effectiveness of the Mezieres Method combined with core stabilization versus routine physiotherapy on muscle imbalance, body awareness, and postural alignment in athletes with lower back pain. Methods: This randomized controlled trial was conducted at the Physiotherapy and Sports Unit, Pakistan Rugby Academy, Lahore, over nine months after synopsis approval. A total of 36 athletes with lower back pain were included and equally allocated into Group A and Group B, with 18 participants in each group. Group A received the Mezieres Method with core stabilization exercises, while Group B received routine physiotherapy based on core stabilization exercises. Pain, muscle imbalance, body awareness, and postural alignment were assessed before and after intervention. Data were analyzed using Shapiro–Wilk normality testing, paired-samples t-test, and independent-samples t-test. Results: Both groups were comparable at baseline for muscle imbalance, body awareness, and posture, while baseline pain was higher in Group A (p < 0.001). Overall, pain decreased from 6.42 ± 1.811 to 2.72 ± 1.386 (p = 0.002), muscle imbalance decreased from 5.67 ± 4.523 to 2.25 ± 3.148 (p = 0.008), body awareness improved from 48.67 ± 5.456 to 61.92 ± 8.449 (p = 0.002), and postural alignment improved from 57.75 ± 3.865 to 71.53 ± 6.914 (p = 0.011). Post-intervention scores favored Group A for pain (1.67 ± 0.970 vs. 3.78 ± 0.808, p < 0.001), muscle imbalance (1.17 ± 2.176 vs. 3.33 ± 3.630, p = 0.037), body awareness (68.44 ± 5.490 vs. 55.39 ± 5.158, p < 0.001), and postural alignment (76.89 ± 4.764 vs. 66.17 ± 3.854, p < 0.001), with reported large effect sizes. Conclusion: The Mezieres Method combined with core stabilization was more effective than routine physiotherapy in reducing pain and improving muscle imbalance, body awareness, and postural alignment in athletes with lower back pain. Keywords: Athletes; Exercise Therapy; Low Back Pain; Muscle Stretching Exercises; Physical Therapy Modalities; Postural Balance; Proprioception.