Low Back Pain Flashcards
tight/overactive lower extremity dysfunction
fibularis lateral gastroc soleus IT BAND LATERAL HAMSTRING adductor PSOAS
weak/underactive lower extremity dysfunction
posterior tibialis flexor digitorum lateralis flexor hallucis lateralis anterior tibialis vastus medialis pes anserine gracilis sartorius semisendonosus GLUTEUS MEDIUS hip external rotators GLUTEUS MAXIMUS local lumbo-pelvic-hip stabilizers
common joint dysfunction for lower extremity
1st MTP joint subtalar joint talocrural joint proximal tibial/fibular joint SI joint lumbar facet joints
possible injuries with lower extremity dysfunction
plantar fasciitis
posterior tibial tendonitis
anterior knee pain
tight or overactive muscles in upper cross syndrome
pec major/minor anterior deltoid subscapularis latissimus dorsi levator scapulae upper trap teres major SCM scalenes rectus capitis
weak or underactive muscles in upper cross syndrome
rhomboids lower traps posterior deltoid teres minor infraspinatus serratus anterior longus coli and longus capitis
common joint dyfunction for upper cross syndrome
sternoclavicular joint
AC joint
throacic and cervical facet syndromes
possible injuries associated with upper cross syndrome
rotator cuff shoulder instability bicep tendonitis TOS headaches
when is there excessive neutral zone motion
after high-speed trauma the spinal segment’s neutral zone is increased
what is the first indicator of onset of injury?
excessive neutral zone motion
where is the biomechanically most stable position for stress on the spine?
neutral zone
what influences the neutral zone?
passive system
neural system
active system
what is the passive system?
vertebrae
IVD
zygapophyseal joints
ligaments
what is the neural system?
central and peripheral nervous system
what is teh active system?
muscles (local and global)
tendons
describe the global system of neutral zone control?
larger torque producing muscles
anatomically more superficial
control spinal orientation and balance of external loads
describe the local system of neutral zone control?
anatomically deep muscles
provide stability through increasing spinal segmental stiffness
play a role in anticipation of motion
local control fo the neutral zone
core stabilizers work at all times
increase their action before any further loading or motion occurs
includes transversus abdominis, pelvic floor, diaphragm, multifidis
what produces the most force?
eccentric contraction
what increases force?
lengthening slightly beyond resting length
non-contractile tisssue elasticity adds to force
what type of contraction causes more force?
faster ECCENTRIC contraction
rotators and intertransversarii
usually described as causing twisting and lateral flexion
small cross section
can produce only a few newtons of force
small moment arm
minimal contribution to bending and twisting
what is the function of rotators and intertransversarii?
length transducers and position sensors at every thoracic and lumbar joint
internal and external oblique abs actions
twisting and lateral flexion
accessory muscles of resporation
describe the internal and external oblique abs
forms a hoop around abdomen to increase core stability
thoracolumbar fasica in posterior
abdominal fasical inanterior
“layers of plywood”
rectus abdominis
contained within the abdominal fasica
connects laterally through the aponeurosis to the abdominal wall
also connects to pec major
action of rectus abdominis
trunk flexion
why is the rectus abdominis sectioned off?
prevents bulking upon shortening
allows greater trunk flexibility when contracted
multiple tendons allow forces from obliques to transmitted across the midline without pulling the fibers of the rectus apart
completes the abdominal hoop
psoas
attaches to the spine (T12-L5)
action is hip flexion
also causes substantial spine compression
describe psoas in lower cross syndrome
facilitated (tight)
puts chronic compression on the spine
needs to be stretch
strength
maximum force that a muscle can exert
anaerobic primarily
low repititions
high intensity
endurance
ability of a muscle to perform repeated contractions against less than maximal load high repititions low intensity type I fibers cardiovascular health energy state
quadratus lumborum
attach to each lumbar vertebrae, the pelvis and rib cage
buttressing against lateral buckling
strong stabilizer of the spine
hardly changes length during any spine motion
transversus abdominis
deepest of the abdominals
arises from the thoracolumbar fasical between the iliac crest and the 12th rib
attaches to the inguinal ligament, iliac crest and lower six ribs
attaches anteriorly to the abdominal aponeurosis
what does the transversus abdominus muscle do?
fibers are horizontally orientated
contraction increases intra-abdominal pressure
causes core stiffening
stiffens the lumbar spine
provides compression to the SI
during movement of the upper and lower etremity, it is recruited before any limb movement occurs
what kind of activity does the transversusu abdominis do?
tonic
compression of the SI joints that caues force closure of the SI joint
form closure
the shape of the joint compresses/closes the joint
normal loads stabilize the SI joint
“keystone” of an arch
force from contraction of the transversusu abdominis compresse of closes the SI joint space
stabilizes the joint
muscles of the pelvic floor
coccygeus
levator ani
iliococcygeus
pubococcygeus
kegel exercises
muscles used to stop the flow of urine
activation techniques for the kegels
stop lights
elevator
200x per day
