Low Back Assessment

Question 1

stability needs _____ and _____ to be equal

Answer 1

compression

tension forces

Question 2

what do muscles provide for stability?

Answer 2

force transference

Question 3

what does optimization of stabilization require?

Answer 3

adequate compression of joints

Question 4

tensegrity

Answer 4

a force pulling in one direction is equally opposed by a force pulling in the opposite direction

Question 5

compression is applied by?

Answer 5

gravity

Question 6

tension is absorbed and provided by?

Answer 6

muscle
tendon
ligament
bone

Question 7

what does spine stability depend on?

Answer 7

symmetry of muscle stiffness and forces all around the spine
no singl emuscle must exert too much force or too little, its activation level is in balance with all others
a neutral spine is required together with a broad base

Question 8

what muscles are shortened for lumbar hyperlordosis?

Answer 8

erector spinae

Question 9

anterior pelvic tilt has what weak muscles? tight?

Answer 9

weak gluteals, iliopsoas

tight quads, erector spinae

Question 10

protruding abdomen is caused by weak what?

Answer 10

abdominals

Question 11

foot flare is caused by?

Answer 11

tightness in external hip rotators

Question 12

pain over lateral knee is caused by?

Answer 12

shortened TFL

Question 13

hypolordosis is caused by weak what? tight?

Answer 13

weak: rectus abdominus, external oblique
tight: gluteals, hamstrings

Question 14

anterior pelvic tilt is caused by what?

Answer 14

tight: erector spinae, rectus femoris
weak: iliopsoas

Question 15

posterior pelvic tilt is caused by what?

Answer 15

tight: gluteus, hamstring, iliofemoral ligament
weak: rectus abdominis, external oblique

Question 16

what are some screening methods for lower cross syndrome?

Answer 16

prone instability test
hip extension pattern
hip abduction pattern
glute bridges

Question 17

what mobility tests are used for lumbar spine evaluation?

Answer 17

toe touch

prone instability test

Question 18

what motor control tests are used for lumbar spine?

Answer 18

hip extension pattern
hip abduction pattern
glute bridge

Question 19

what functional patterning tests are used for lumbar spine?

Answer 19

deadlift
lunge
deep squat

Question 20

P-A instability test (feet down)

Answer 20

patient is prone, with legs off the end of the table

impulse at each lumbar spinous process. pain occurs at unstable segments

Question 21

P-A instability test (feet up)

Answer 21

patient is prone on the table with the legs off the table
impulse at each lumbar spinous process. Pain lessens when legs raised as lumbar extensors are activated, stabilizing lumbar spinal segments

Question 22

hip extension proper motion pattern

Answer 22

ipsilateral hamstring
ipsilateral gluteals
contralateral spinal extensors
ipsilateral spinal extensors

Question 23

where are doctor’s hands on hip extension?

Answer 23

one hand on glutes

one hand on thoracolumbar paraspinals

Question 24

hip extension motion pattern, what happens if they can’t hold knee extension?

Answer 24

facilitated hamstrings

inhibited glutes

Question 25

hip extension motion pattern, what happens if there is forced lumbar extension?

Answer 25

facilitated thoraclolumbar extensors inhibited glutes hypermobile lumbar segments

Question 26

hip extension motion pattern, what happens if the thoracic spine activation first with trapezius activation?

Answer 26

evaluate contralateral latissimus dorsi

Question 27

what is the treatment for altered hip extension?

Answer 27

stretch tight muscles first | strengthen weak muscles

Question 28

what muscles do you stretch when your patient has altered hip extension pattern

Answer 28

psoas quads hamstrings

Question 29

what muscles do you strengthen in an altered hip extension pattern?

Answer 29

``` gluteals abdominals (curl up) ```

Question 30

what else can you do for altered hip extension pattern?

Answer 30

adjust thoracics lumbars SI

Question 31

what exercises can you use to help with hip extension?

Answer 31

quadruped leg reach | table top

Question 32

quadruped leg reach

Answer 32

get on all fours | lift one leg up without extending lumbars

Question 33

table top

Answer 33

lay top of back and head on exercise ball | lift hips up in air without extending lumbars

Question 34

proper hip abduction motor pattern

Answer 34

side lying with lower leg flexed slowly raise leg toward ceiling observe for normal motion hold position and observe for drift

Question 35

altered hip abduction pattern

Answer 35

``` decrease ROM hip flexion (forward drift) hip external rotation (foot flare) hip hiking (bending at waist) ```

Question 36

decreased ROM for hip abduction pattern

Answer 36

adductor tightness

Question 37

hip flexion altered hip abduction

Answer 37

TFL substitution

Question 38

hip external rotational altered hip abduction pattern

Answer 38

piriformis substitution

Question 39

hip hiking altered hip abduction pattern

Answer 39

QL substitution

Question 40

how do you treat altered hip abduction

Answer 40

stretch TFL, QL, piriformis strengthen gluteus medius adjust

Question 41

how can you strengthen gluteus medius?

Answer 41

side-lying hip abduction side plank wall press monster walk

Question 42

segmental stabilization of glutes

Answer 42

force closure of SI control and centralize femur in acetabulum co-contraction with psoas major provides pelvic stability segmental stabilizer through tensing TL fascia and triggering deep lumbar multifidus

Question 43

global stabilization of glutes

Answer 43

eccentric lengthening or isometric holding to control ROM

Question 44

how do the glutes provide eccentric lengthening or isometric holding to control ROM

Answer 44

sagittal plane stabilization of trunk during gait and standing controls trunk rotation during gait through conecction with lat frontal plane stabilizer during single leg (trendelenburg)

Question 45

global mobilizer of the glutes

Answer 45

produce high force or power

Question 46

how do the glutes produce high force or power?

Answer 46

``` hip extension external rotation superior fibers (abduction) lower fibers (adduction ```

Question 47

what are some lifting strategies to spare the spine?

Answer 47

``` avoid end range lumbar motion avoid lifting immediately after sitting flexed pre-stress the system for stability reduce the load moment direct force vector through the navel reduce the amount of weight lifted ```

Question 48

how do you avoid end range lumbar motion

Answer 48

neber flex the lumbar spine to full flexion under load

Question 49

how do you avoid pre-stressing the lumbar system for stability?

Answer 49

abdominal brace (increase intra-abdominal pressure)

Question 50

how do you reduce the load moment?

Answer 50

keep the weight in close | golfer's lift

Question 51

lifting mechanics

Answer 51

practice lifting avoid twisting rolling in bed