Restoring spinal stability muscles Flashcards
Transversospinalis Group
Rotatores
Interspinales
Semispinalis
Intertransversarii
Multifidus
Poor mechanical advantage relative to movement production
Primarily Type I muscle fibers with high degree of muscle spindles (2-6x’s normal)
Designed for stabilization and proprioception
Provides intersegmental stabilization in all positions
multifidus
Primarily responsible for providing proprioceptive information to CNS
Segmental deceleration of flexion and rotation of spine during functional movements
Transversospinalis Group
Must be trained to allow dynamic stabilization
Long extension moment arm with minimal compression
Most efficient lumbar extensors
Thoracic longissimus and iliocostalis
Create posterior shear with lumbar flexion
lumbar longissimus and iliocostalis
Largest moment arm of all back muscles therefore great effect on LPHC
latissimus dorsi “bridge between upper and lower extremities”
Provide dynamic stabilization against rotational and translational stress
Provide optimal neuromuscular control to entire LPHC
Contraction precedes activation of other abdominal muscles regardless of direction of reactive forces
Important for dynamic stabilization during all trunk movements
With multifidus, active during all trunk movements
Transverse Abdominis (TrA)
Contributes to stability of lumbar spine during inspiration and expiration
Involved in the control of postural stability during sudden voluntary movement of the limbs
Normally in horizontal position in adults
Cephalad i.e., ‘‘inhalation’’ position is inhibitory of normal function
Diaphragm
Injury Mechanics in the Lumbar Spine
Too many repetitions of force and motion and/or prolonged postures/loads Cumulative loading (compression, shear or extensor moment) Axial torque with flexion or extension loading Cumulative exposure to unchanging work
Types of Muscle HypertonicityFrom Janda 1991
Limbic system dysfunction Interneuron dysfunction MTrPs Reflex spasm Muscle tightness
Caused by psychological stress
Increased muscle tone in cervico-thoracic-shoulder complex, low back, pelvic floor muscles
Headache, LBP, dysmenorrhea, dyspaneuria, urinary frequency
Limbic System Dysfunction
Caused by aberrant afferent information sent by spinal or peripheral joint dysfunction (subluxation)
Hypertonicity in segmentally-related muscles that can spread beyond involved segment(s)
Prone to form MTrPs
Prone to muscle imbalance including reciprocal inhibition, synergistic dominance
Faulty movement patterns established and perpetuated
interneuron dysfunction
Formed as a result of dysfunction
myofacial trigger points
Hyperirritable spot usually within taut band of skeletal muscle or in the muscle’s fascia, that is painful upon compression and can give rise to characteristic referred pain, tenderness
MTrPs
quadratus lumborus trigger point
SI
