Lumbopelvic Flashcards
line of gravity
- mastoid
- anterior to S2
- posterior to hip joint
- anterior to knee and ankle
lumbar vertebrae facet joint orientation
sagittal plane to permit flexion/ extension
lumbar vertebrae osteology
5
spinous process extend posteriorly
sacral vertebrae osteology
5
spinous process extend posteriorly
sacral transverse process and facet joint orientation
none
Ferguson’s angle
angle between the horizontal plane and superior surface of the base of the sacrm
What does an increase in ferguson angle result in?
increase in the anterior shear force (due to body weight)
spondylosis
age-related degenerative changes that occur in the spine
spondylolysis
defect of portion of vertebrae between superior and inferior articular process (pars interarticularis)
spondylolisthesis
anterior slippage of one vertebral body on another
protrusion
displaced NP within AF, may put pressure on SC
prolapse
displaced NP on posterior edge of disc but within AF
Extrusion
AF rupture,NP escapes to epidural space
Sequestration
NP and fragments of AF become lodges within epidural space
Flexion Arthrokinematics
superior and anterior sliding of the inferior facet on the superior facet
Extension Arthrokinematics
inferior and posterior sliding of the inferior facet on the superior facet
Lateral Flexion Arthrokinematics
ipsilateral: inferior slide
contralateral side: superior slide
Rotation Arthrokinematics
ipsilateral: facet separation
Contralateral: facet approximation
side bending and rotation of facet occurs in opposite directions when….
performed from neutral position
side bending and rotation of facet occurs in the same direction when…
performed from flexed or extended position
Lumbopelvic rhythm
coordination of movement between lumbar spine and hip to complete sagittal flexion and extension in standing w/ knees locked
Lumbopelvic rhythm - flexion
lumbar flexion 40-70 degrees
anterior pelvic rotation
hip flexion - 70 degrees
Lumbopelvic rhythm - extension
initially driven by hip extension, posterior pelvic rotation and lumbar spine extension
What motions should be noted during lumbar sagital motion
out of phase movement
aberrant movement
reversal of lumbopelvic rhythm
lumbar contribution is small and large in what populations?
small - patients with LBP, edelery & females
large - greater external load and back muscle fatigue
nutation
how does the pelvis move?
relative anterior tilt of the top of sacrum on illium
- anterior sacral on iliac rotation
- posterior ilium on sacral rotation
counternutation
posterior tilt of the top of sacrum on illium
- posterior sacral on iliac rotation
- anterior ilium on sacral rotation
sacroiliac joint
stable load transfer between axial skeleton and lower limbs
How does SIJ contribute to stress relief within the pelvic ring?
- dissipates intrapelvic torsion during gate
- modified movement during delivery
Form Closure
passive stabilization of SIJ by interlocking ridges & grooves on the joint surfaces and ligamentous stabilization
Force Closure
active stabilization provided by isolated contraction of skeletal muscle groups
treatment for pelvic girdle pain
- thigh thrust
- distraction test
- compression test
- sacral thrust
- Ganslens test
common impairments of pelvic floor
hypo or hypertonicity , volitional control and pain
Latissimus dorsi
- Ext, ADD & IR
2. B: trunk extension & U : lateral flexion
transversospinal
stabilization components - may function as organs of proprioception
External Obliques
Flexion , posterior pelvic tilt
B: lateral flexion & contralateral rotation
U: ipsilateral rotation
Internal Oblique
Flexion, posterior pelvic tilt, increase TLF tension
B: lateral flexion
U: ipsilateral rotation
Transversus abdominis
compression of abdominal cavity and tension on TLF
Rectus Abdominis
Trunk flexion, compression of abdominal cavity
illiopsoas
hip flexion & initiates flexion of trunk with fixed thigh
- decreases lumbar lordosis
Quadratus lumorum
b: extension of l/s
u: lateral flexion of lumbar spine and pelvic hiking
Gower’s sign
reversal of lumbopelvic rhythm during flexion and/or extension of the lumbar spine in standing
Lifting technique
- keep external load close to the body
- avoid extreme flexion/extension
- utilize hip and knee
- avoid twisting
- minimize vertical and horizontal distance the load must be lifted
- wide BOS
Core control is an element of
- neuromuscular control during upright posture
- component of optimal ventilation
- conservative management for spine and LE conditions
