Pilates and Low Back Pain

Question 1

If you are working with a client who occasionally gets nerve symptoms your goal is to ____.

Answer 1

Do your best never to exacerbate them.

Question 2

Nerve symptoms are most commonly caused by: (3)

Answer 2

disc injuries, spinal stenosis or muscle spasms

Question 3

Disc injuries most commonly cause pain when they________.

Answer 3

protrude toward the back of the spine and put pressure on the nerves that run through the spinal canal.

Question 4

Spinal flexion _______ disc pressure.

Answer 4

increases

Question 5

Neutral spine or spinal extension ________ disc pressure.

Answer 5

decreases

Question 6

Best postures for clients with disc injuries and degenerative disc disease (DDD) to start with.

Answer 6

supported neutral and neutral

Question 7

Condition where one vertebra slides forward on the vertebra below it.

Answer 7

Spondylolisthesis

Question 8

Condition where a vertebra fractures and becomes unstable.

Answer 8

spondylolysis

Question 9

In both spondylolisthesis and spondylolysis the vertebrae are at risk for sliding ______ and pinching the spinal cord in the process.

Answer 9

anteriorly

Question 10

When working with clients with spondylolisthesis and spondylolysis, you should work in neutral or with a slight _____ tilt, avoid spinal ________, and avoid loading the front of the spine with the psoas in hip flexion

Answer 10

posterior, extension

Question 11

Conditions that involve deterioration of the joints of the spine either through the development of bone spurs in the canals that the nerves go through bone spurring on the body of the vertebra. (3)

Answer 11

Spinal stenosis
Arthritis
Degenerative joint disease

Question 12

When working with clients with spinal stenosis, arthritis and degenerative joint disease work in _______ or with a slight _______ tilt and avoid spinal __________.

Answer 12

neutral, posterior, extension

Question 13

The exercises that create the greatest challenge to the stability of the back include any _______.

Answer 13

supine exercise where the legs move away from the torso

Question 14

_______ pelvic tilt leads to shortness in the muscles that support the spine and hips, particularly the psoas, hip flexors, spinal extensors, latissimus dorsi and quadratus lumborum.

Answer 14

Anterior

Question 15

__________ pelvic tilt is often accompanied by tight abdominals, hamstrings, long hip flexors and back extensors

Answer 15

posterior

Question 16

Spasms in any of these muscles are common causes of acute and chronic low back pain (3)

Answer 16

Quadratus lumborum, iliopsoas, deep hip rotators

Question 17

___________ are much more effective than ______ when relieving spasms.

Answer 17

roller, ball or manual release techniques, simple stretching

Question 18

If a client can’t tolerate compression don’t use any ______ and use _____ and _____ instead.

Answer 18

closed chain leg and foot work, trap and chair instead

Question 19

Pain described as sharp, localized and usually unilateral that typically limits their movement in certain positions.

Answer 19

Acute muscle spasms

Question 20

Muscles most commonly involved in acute muscle spasms include (4)

Answer 20

Quadtratus lumborum
erector spinae
psoas and piriformis muscles

Question 21

_______ involve damage to the ligaments that hold the vertebra together.

Answer 21

Lumbar Sprains

Question 22

_________ involve damage to the muscles of the back.

Answer 22

Lumbar strains

Question 23

_______ when adjacent facet joints become stuck to each other or develop dysfunctional movement patterns.

Answer 23

Facet joint symdrome

Question 24

With facet syndrome _____ is typically the most uncomfortable position.

Answer 24

Extension

Question 25

First symptom of ___________ are stiffness or soreness in the joint which is worse with inactivity but gets better with movement.

Answer 25

Degenerative joint disease

Question 26

Characterized by degenerative boy changes on x-ray consisting of bone spurring between the vertebra, narrowing of the nerve outlets called spinal stenosis or fusion of the vertebra

Answer 26

Degenerative joint disease

Question 27

Spondylosis, osteoarthritis and bone spurs are other names for….

Answer 27

degenerative changes

Question 28

When nerve pain accomanies degenerative joint disorder, treat as for_____ or _______.

Answer 28

disc injuries or radiculopathy

Question 29

Avoid ____ in the affected area and be cautious with _____ when working with degenerative joint disease, osteoarthritis, and spinal stenosis.

Answer 29

compression, end range of motion

Question 30

Scoliosis usually develops in______.

Answer 30

early adolescence.

Question 31

Avoid _______ in the spine in scoliosis.

Answer 31

compression

Question 32

Common symptoms of disc and nerve pathologies (3)

Answer 32

chronic inflammation
radiating pain on one side of the body
significant muscular compensations

Question 33

A client with _________ will typically feel worse with sitting and will often feel best when lying down or standing.

Answer 33

disc and nerve pathologies

Question 34

The mildest form of disc pathologies is a _________ where the wall of the disc weakens and the disc becomes distorted.

Answer 34

Bulge or protrusion

Question 35

A ______ occurs when the protrusion becomes a permanent distortion in the disc.

Answer 35

prolapse

Question 36

An _____ occurs when the material inside the disc leaks out but does not move beyond the immediate area of the disc.

Answer 36

extrusion

Question 37

__________ occurs when the disc ruptures and the contents float away from the disc and enter the spinal canal.

Answer 37

Free sequestration (or leaky disc, degenerative disc disease)

Question 38

Indicates that a nerve root is being irritated with symptoms of tingling, numbness and radiating pain.

Answer 38

Sciatica and radiculopathy

Question 39

The most common discs affected in the lumbar areas:

Answer 39

L4 L5 and L5 S1 because these joints are where most of the movement in the back are

Question 40

A client suffering from pain unilaterally located at the SI joint that spreads into the low back and buttocks on the affected side is suffering from

Answer 40

Sacroiliac (SI) joint dysfunction

Question 41

Characterized by either instability or immobility in one or both sacroiliac joints.

Answer 41

Sacroiliac (SI) joint dysfunction

Question 42

______ hip rotation increases pressure on the joint which can stabilize a hypermobile joint.

Answer 42

External

Question 43

_______ hip rotation decreases pressure on the joint which can decrease discomfort if the joint is inflamed or arthritic.

Answer 43

Internal

Question 44

With sacroiliac joint inflamation, arthritis and joint pain, be cautious with _____ rotation, excessive ______ tension, and _____ initially.

Answer 44

external, gluteal, back extension

Question 45

With instability and hypermobility in the sacroiliac joint be cautious with ______ rotation and with lateral spinal flexion as aggressive side stretches can pull an unstable joint out of position.

Answer 45

internal

Question 46

A version of sciatica that doesn’t involve teh disc or nerve root but instead is caused by the piriformis muscle being so tight that it compresses the sciatic nerve and causes pain in the gluteal region and down the leg.

Answer 46

piriformis syndrome

Question 47

piriformis syndrome typically occurs because the support structor around the hip is _____.

Answer 47

not balanced

Question 48

When working with a client with piriformis syndrome be careful of excessive pressure on the ________ and be careful with ______ rotation work.

Answer 48

sits bones, external

Question 49

Most common symptom of _________ is unilateral pain with lumbar hyperextension.

Answer 49

spondylolysis and spondylolysthesis

Question 50

Indicates a fracture or stress fracture of a vertebra, typically in the lumbar region.

Answer 50

spondylolysis

Question 51

Important to avoid overusing the ____ during exercise with a spondylolysis to make sure it does not pull the vertebra anteriorly.

Answer 51

psoas

Question 52

When working with someone with spondylolsysis and spondylolysthesis be cautious with _____ stretching, rotation, and ______ until the client is pain free.

Answer 52

psoas, lateral flexion

Question 53

Indicates a vertebra that has slid forward on the vertebra below it or on the sacrum.

Answer 53

spondylolysthesis

Question 54

Indicates the surgical removal of the lamina which surrounds the nerve root as it exits from the spinal cord and typically performed with a ____.

Answer 54

laminectormy, discectomy

Question 55

Indicates the removal of some or all of the intervertebral disc material

Answer 55

discectomy

Question 56

Indicates that one or more vertebral levels have been fused through the use of bony implants or plates.

Answer 56

Spinal fusion