Chapter 9 The spine: Objectives
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Transcript of Chapter 9 The spine: Objectives
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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
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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
• Study questions for exam:– Introductory problems, p 305: 1,6,7,9,10– Additional problems, p 306: 1,5,8
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Structure of the Spine
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Structure of Vertebrae
Note: orientation of facets largely determines amount of movement possibleFacets and discs share load bearingQuestion #5, p 306
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Facet Orientation – relatedTo movement capability
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Segmental Movements
Question #1, P 305
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The Spine: Muscles• Spinal flexors – abdominal muscles
– Rectus abdominis– External and internal obliques
• Spinal extensors– Splenius cervicis and capitis (cervical)– Erector spinae (lumbar and thoracic)– Quadratus lumborum (lumbar)
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Muscle force vectors
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Flexion Exercises
• Effect of– Anchoring feet?– Bending knees?– Placement of hands and
arms?– Inclined board?
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Back Extension Exercises to Avoid:
Good morning exercise:Hyperextended back:
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Recommended Extension Exercise
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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 305)
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Effect of posture on lumbar compression force:
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Torque while lifting
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Lifting recommendations
(1)bend knees , (2) keep weight close to hips
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(3) Avoid lifting while twisting and asymmetrical frontal plane loading of the trunk– it places 3 times more stress on the spine (question #9, p 205)(4) Avoid rapid, jerking motion while lifting
Lifting recommendations
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Common Spinal Injuries
• Lumbar spinal injury is by far the most prevalent of all areas of the spine
• Low back pain is most common and most expensive injury in work place
• Low back pain is usually related to mechanical stress• 60% of cases are ideopathic
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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.
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Common low back problems
Disc degeneration
Spondylolisis – separation of vertebraSpondylolisthesis – forward movement of vertebral body
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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.
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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