The current study is a randomized controlled trial aims to compare the effectiveness of the Mezieres Method combined with core stabilization versus routine physiotherapy involving core stabilization on muscle imbalance, body awareness, and postural alignment in athletes with lower back pain. Eligible participants will be randomly allocated into two groups: an experimental group receiving the Mezieres Method plus core stabilization exercises and a control group receiving routine physiotherapy treatment involving core stabilization alone. Outcomes related to muscle imbalance, body awareness, postural alignment, and pain/function will be assessed before and after the intervention period. The study seeks to determine whether the Mezieres Method combined with core stabilization provides additional benefits in athletes with lower back pain.

Low back pain (LBP) is the type of musculoskeletal problems affecting athletes in many sports, and it is approximately about 80% of them experience at least one episode during their career and many of them later develops long duration or recurrent pain that definitely impact performance, training routine and also day-today quality of life . Lower back pain is one of the most common musculoskeletal conditions worldwide, particularly among athletes because of repetitive strain, poor biomechanics, and muscle imbalances. In the world wide, studies estimate that nearly 60-80% of individuals experience low back pain at some point in their lives, with a point prevalence of about 7-12% in the total population and even higher rates reported in athletic populations due to intensive physical demands. In sports communities, the prevalence can range from 20% to 50%, depending on the type of sport, training intensity, and postural habits. Locally, in countries like Pakistan, the burden of low back pain is also significantly high, although underreported; hospital-based and regional studies suggest prevalence rates ranging from 30% to 70% among adults, with athletes and physically active individuals being at increased risk due to inadequate conditioning, poor posture, and lack of body awareness. These rising trends focused the importance of effective rehabilitation approaches such as the Mezieres method, which mostly focuses on correcting muscle imbalance, improving body awareness, and restore the good postural alignment. In early morning many athletes often complain more stiffness and they are type of more predisposed to LBP because of routine mechanical loading, postural strains, asymmetric movements and high demands on spinal flexibility and strength. Sports like gymnastics, soccer and dance place unusual stress on the lumbar region through repeated hyperextension, twisting and high-impact movements, which sort of increase the risk even more. These biomechanical stresses can lead to muscle imbalance, postural changes and sometimes impaired neuromuscular control, and all of this basically keep the pain going with functional limitation. The pathophysiology of LBP in athletes sometimes includes multifactorial origins including poor lumbopelvic stability, weak core muscles and asymmetrical tension in posterior muscular chains. This muscular imbalance can disrupt spinal alignment and even change the proprioceptive control so athletes start using compensatory movement patterns and recurrent injury kind of occurred again. Traditional physical therapy usually emphasis on strengthening the core, better flexibility and decrease pain with therapeutic exercises and manual therapy. Core stabilization exercises in especially have shown good efficacy on patients in improving spinal stability, posture and reducing LBP intensity. So the present study is purpose to compare effects of Mezieres Method combined with core stabilization exercises to routine physiotherapy (core stabilization exercises alone) on muscle imbalance, body awareness and postural alignment in athletes with lower back pain. And by doing so it seeks to determine whether integration of global postural re-education offers additional benefits over conventional therapeutic practices and whether difference between groups is clinically meaningful for athletes who receive these treatments.

Inclusion Criteria:

• Diagnosed with non-specific LBP lasting at least three months with following test (Straight Leg Raise Test, Slump Test, Schober's Test )
• Athletes aged 18-35 years of either gender
• Athletes should exhibit signs of postural imbalance or muscular chain dysfunction
• Functional limitation related to posture or movement.
• Patient undergoing physiotherapy intervention for musculoskeletal disorders.
• Reduced trunk mobility, impaired postural alignment, or functional defects.

Exclusion Criteria:

• History of spinal surgery, fracture, or structural deformity (e.g., scoliosis, spondylolisthesis).
• Neurological or systemic disorders affecting balance or muscle control
• Current use of medications that may effect musculoskeletal performance (e.g., corticosteroids, muscle relaxants)
• Pregnancy or any contraindication to physical activity

Individual participant data will not be publicly shared to maintain participant confidentiality and privacy. The study data are intended for academic and research purposes only and are subject to institutional ethical guidelines and consent limitations.

The outcome assessor will be blinded to group allocation to minimize assessment bias. Due to the nature of physiotherapy interventions( Mezieres method and core stabilization exercise), participants and treating therapists cannot be blinded.