Chapter 9 The spine: Objectives Explain how anatomical structure affects movement capabilities of...
-
date post
18-Dec-2015 -
Category
Documents
-
view
220 -
download
2
Transcript of Chapter 9 The spine: Objectives Explain how anatomical structure affects movement capabilities of...
Chapter 9 The spine: Objectives
• Explain how anatomical structure affects movement capabilities of the spine
• Identify factors influencing relative mobility and stability of different regions of the spine
• Explain the ways in which spine is adapted to carry out its biomechanical functions
• Explain the relationship between muscle location and the nature and effectiveness of muscle action in the trunk
• Describe the biomechanical contributions to common injuries of the spine
The Spine: Outline
• Structure • Muscles and movements • Low Back Pain • Strengthening exercises• Lifting guidelines• Common low pack problems• WebSite for spine and spinal problems:
MMG - Patient Education back TOC
• Introductory problems, p 305: 1,6,7,9,10• Additional problems, p 306: 1,2,3,5,8
Structure of the Spine
Structure of Vertebrae
Note: orientation of facets largely determines amount of movement possibleFacets and discs share load bearingQuestion #9, p 305
Facet Orientation – relatedTo movement capability
Segmental Movements
Question #1, P 305
The Spine: Muscles• Abdominal muscles (flexors)
– Rectus abdominis– External and internal obliques
• Spinal extensors– Splenius cervicis and capitis (cervical)– Erector spinae (lumbar and thoracic)– Quadratus lumborum (lumbar)
Muscle force vectors
Flexion Exercises
• Effect of– Anchoring feet?– Bending knees?– Placement of hands and
arms?– Inclined board?
Back Extension Exercises to Avoid:
Good morning exercise:Hyperextended back:
Recommended Extension Exercise
Loads on the spine:Line of gravity for upper body passes anterior to vertebral column, creating a forward torque
It is important to keep pelvicgirdle balanced! (Question # 6, 7 p 319)
Effect of posture on lumbar compression force:
Torque while lifting
Lifting recommendations
(1)bend knees , (2) keep weight close to hips
(3) Avoid lifting while twisting and asymmetrical frontal plane loading of the trunk– it places 3 times more stress on the spine
(4) Avoid rapid, jerking motion while lifting
Lifting recommendations
Stress Fractures
• Most common type of vertebral fracture is in pars interarticularis– Spondylolysis– Spondylolisthesis
• Spondylolysis and spondylolisthesis don’t tend to heal with time– Common with sports involving repeated
hyperextension of the lumbar spine.
Common low back problems
Disc degeneration
Spondylolisis – separation of vertebraSpondylolisthesis – forward movement of vertebral body
Disc Herniations
• Cause of 1-5% back pain cases• Protrusion of part of nucleus pulposus from the
annulus.• Traumatic or stress related.• Common sites: between 5th-6th and 6th-7th cervical
vertebrae and 4th-5th lumbar and 5th lumbar and 1st sacral.
• Sensory nerves supplying anterior and posterior longitudinal ligaments generate pain signals.
Whiplash Injuries
• Relatively common injury to cervical region.• Usually from automobile collisions, where neck
undergoes sudden acceleration and deceleration.• Symptoms:
– Neck pain, muscle pain, pain or numbness radiating from neck to shoulders, arms, hands and a headache (present in 50-60% of most cases)
Low Back Pain
• 75-80% of population will experience it at some time in their life
• Mechanical stress plays a significant role
• Children
• Relative Stability of Spine
• 60% of cases is idiopathic (unknown origin)
• Abdominal exercises help in treatment
Two common causes of low back pain
Compressive, or neurogenic:Symptoms are referred due to Spinal nerve compression
Mechanical - localized pain due toDamage to facets, discs, and/or softtissue
•Illustrations below are from: MMG - Patient Education back TOC