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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 - PowerPoint PPT Presentation
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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
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
Structure of the Spine
Structure of Vertebrae
Note: orientation of facets largely determines amount of movement possibleFacets and discs share load bearingQuestion #5, p 306
Facet Orientation – relatedTo movement capability
Segmental Movements
Question #1, P 305
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)
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 305)
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 (question #9, p 205)(4) Avoid rapid, jerking motion while lifting
Lifting recommendations
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
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.
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