mod 2- low back

Question 1

what are some ill advised back rehab recomendations

Answer 1

1. strengthen muscles in torso to protect back
2. Bend knees when performing sit ups
3. Perform sit up to prtect back
4. To avoid back injury bend whith the knees
5. tight hams and unequal leg lengths cause back troubles
6. a single exercise program is adequate for all cases

Question 2

what part of the Vb fails first in compression

Answer 2

endplates buldge inward due to vertical trabelcule compresssion and transverse ties break under the tension

Question 3

how does osteoporosis affect the VBs

Answer 3

transverse trabecular are affected the greatest amount
-compression causes the verticals to buckle w/o transverse support allows canceous bone to collapse forming wedge shaped VBs

Question 4

if u load a VB quick vs slow what will fail

Answer 4

quick- vert body

slow- endplate (looks like a starfish)

Question 5

what do repeated cycles of flex and extension result in

Answer 5

fatigue

eventually spondylolithesis, facet fracture etc

Question 6

what does posterior shear injur affect in slow and fast load

Answer 6

slow- soft tissue injury and VB fx

fast- wedge shaped fractures

Question 7

what do ant shear injury affect in slow and fast load

Answer 7

slow- soft tissue

fast- pars, facet fx, vb fx

Question 8

what is kissing spines

Answer 8

damage to interspinous lig occur when repeatedly crushed bw SP in full extension

Question 9

can disks be a pain generator

Answer 9

only after end plate damage occurs and new tissues (nerves) grow into place

Question 10

Rules of a disk herniation

Answer 10

1. must be bent to full ROM
2. repeated loading
3. linked to sedentary occupations
4. younger spines

Full flexion and compression

Question 11

what is the flexion/relaxiation phenomenon and what happens in non healthy people

Answer 11

when bending forward to end range extensor muscles become silent due to either relfex activity or passive tissues taking the load

unhealthy- extensor muscles never turn off

Question 12

effect of distance, speed, fatigue on lifting in lower back

Answer 12

distance- increase distance increases moment

speed- fast lifts increase moment 60% and lat bending, rot

Fatigue- change lifting patterns over time which increases compression and ant post shear

Question 13

one even and unever ground where should the load be in a backpack

Answer 13

even- higher up in the back

uneven- lower down to decrease moment arm

Question 14

what should be done with walking and lbp

Answer 14

fast walking with arm swinging

-allows for cyclic loading of tissues lowering lumbar spine torque, muscle activity and loading forces

Question 15

does running cause lbp

Answer 15

little risk for low back injury + can actually protect spine

Question 16

Problem with eliptical trainers

Answer 16

-requires more hip motion then walking so those with a restricted ROM tend to compensate thru the lumbar spone which can cause issues

Question 17

stats to avoid LBP from sitting

Answer 17

• vary posture frequently, avoid static loading, fixed pos
• seated posture leads to inactivity which increases metabolites and accelerates DDD
• include walking breaks

Question 18

how should you target obliques

Answer 18

side bridge

Question 19

loads of extension exercises (roman chair, superman, prone leg and trunk ext, birdog)

Answer 19

roman- activates all 4 (4000n)
superman- activates all 4 (6000n)
prone leg- both lumbar (2000n)
birddog- both lumbar and thocacic on one side (3000n)

Question 20

how does intra abdominal pressure contribute to stability

Answer 20

Aip doesnt contribute to stability directly but activating all the musculature that increases IAP creates the stability by creating a stiffer torso

Question 21

is it adivisable to do spine flexion exercises in AM

Answer 21

no becuase ligament stresses and disk bending forces are greater in AM

Question 22

what is spinal memory and what is the risk

Answer 22

function of spine modulated by prev activity which in turn determines ligament rest length

ex. post spinal flex the lig remains lax up to 30 mins after increasing risk of injury

Question 23

how to reduce risk of tissue injury in LB

Answer 23

1. reduce peak compressive loads
2. reduce repeated spinal motion
3. reduce full range flex/ext
4. reduce peak and cumulative shear forces
5. reduce slips and falls
6. reduce length of time sitting
7. increase appropriate loads
8. allow sufficient recovery

Question 24

why is keeping a neutral spine good

Answer 24

increases erector force but lowers shear forces

Question 25

why is bedrest bad for back pain

Answer 25

reduces hydrostatic load below disk osmotic pressure resulting in an inflow of fluid to disk

Question 26

what bone densities increase in space

Answer 26

Vert and skull due to swollen disks and brain swelling

Question 27

when is twisting dangerous

Answer 27

when there is a large twist moment on the spine due to a large load and coactivation of muscles

Question 28

how are nociceptors affected after injury

Answer 28

over time magnitude of response, sensitivity to stim and size of region increase (sensitization)

Question 29

what comes first disk damage or facet arthritis

Answer 29

disk damage

Question 30

back trouble risk factors (5)

Answer 30

1. large waist girth
2. chronicity (>3m)
3. bad flex and ext strength ratios
4. lack of muscular endurance
5. diminished hip extension and internal rot