Spinal Abnormalities Flashcards
Plumb line surface landmarks
- Ear lobe
- Shoulder joint
- Midway of the trunk
- Greater trochanter
- slightly ant to knee joint
- slightly ant to ankle joint
What are the structural changes in exagerrated lumbar lordosis
- Lordosis
- ANterior pelvic tilt
- hip flexion
What are the structural changes in sway back
- Pelvis shifted forward in relation to thorax
- Increased lumbar lordosis
- Thoracic kyphosis
- hip extension
What muscles are short and strong in sway back
Hamstrings
Upper fibers of IO
What muscles are strong but not short in sway back
lumbar erector spinae
What muscles are long and weak in sway back
- One joint hip flexors
- External oblique
- Upper back extensors
- Need flexors
What are potential sources of dysfunction in sway back
- Stretch iliofemoral lig
- hip joint dysfunction
- Lumbar lordosis/thoracic kyphosis/HFP
What are the structural changes in Flat back
Decreased lumbar lordosis + posterior pelvic tilt
What muscles are short and strong in flat back
Hamstrings and often abdominals
What muscles are long and weak in flat back
one joint hip flexors
Possible causes of flat back?
Poor postural habit, poor ergonomics
Possible sources of dysfunction for flat back
- short abdominals/hip extensors
- long and weak lumbar extensors
- loss of normal lumbar curve (reduced capacity for shock absorption)
- stretched PLL and lumbar erectors, compressed anterior disc
- altered respiration
What muscles are short and strong in HFP
Lev scap
SCM
Scalenes
Suboccipitals
What muscles are long and weak in HFP
- Deep neck flexors
- Erector spinae
Types of scoliosis
- idiopathic
- Congenital - vertebral deformities
- neuromuscular - second to other conditions
Scoliosis S&S
- Decreased nerve conduction - myo, demas, reflexes
- Decreased nerve mobility - SLR, slump
Scoliosis Ax
- Forward bend test
- muscle imbalance
- Decreased proprioception
Scoliosis Rx
- Posture
- Stretch and strengthen
- CV training (decreases pain)
- If severe - bracing + surgery
Postural back pain caused by ____
tissue creep
Postural dysfunction S&S
i. pain increases w/ sitting or prolonged postures
ii. poor posture/ergonomic set up
iii. pain not specifically caused by FLEX or EXT
iv. NO neurological s/s
v. better in AM, worse as the day goes on
vi. associated w/ decreased fitness
Postural dysfunction Rx
Correct!!! posture and ergonomics muscle imbalances fitness issues spinal supports (obus forme) education on posture + rest/activity/breaks
What are the general risk factors for MSK Injury due to workplace ergonomics
- Repetitive, labor intensive work
- Young ( < 30 yrs)
- First 5 years of practice
- Responding to unexpected movement
- Failure to take rest breaks
- Inadequate training re: injury prevention
What are the WorkSafe BC Ergonomic recommendations
o Forearms horizontal, elbows at 90° (or slightly greater) with shoulders/upper arms relaxed
o Wrists neutral (straight) with hands on keyboard or mouse
o Head upright over shoulders, eyes looking slightly downward (~30° with screen 64-75 cm from the floor)
Top of line of text should be at eye level
Arms length between your eyes and the screen
o Backrest supporting lower back, pelvis, and the natural curve of your spine (90-110° tilt, minimum 45 cm tall)
o Thighs resting horizontally with a 90-110° angle at the hips (seat height 38-51 cm)
o Feet fully supported by the floor or a footrest with an adjustable slope (10-20°)
What are the two components of a disc? Which has pain fibers?
Nucleus pulposis (inner) Annulus fibrosis (outer)
Annulus has pain fibers
What is the healing time for a disc lesion
3 months for ligaments to heal
Disc lesion S&S
- Central back pain +/- leg pain
- +/- lateral shift (name relative to shoulders)
- loss of normal lordosis - flat back - muscle supporting EXT
Disc lesions Rx
centralize pain, radiate correct shift support lordosis posture education avoid flexion postures with time traction (gentle!) correct: muscle balance, posture, ergonomics
Stenosis - Causes:
Swelling
Disc
Osteophyte
Bony change
Stenosis - S&S:
- Bilateral radiation: legs/feet
- X-ray changes: bony hypertrophy, DDD, spurs
Stenosis - Rx:
posture avoidance, correct muscle imbalances (core, hamstrings)
Spondylolisthesis S&S:
- central low back pain +/- referred pain
- weak abdominal muscles
- +/- tight hamstrings
- Agg: Ext
- Ease: Flex
Spondylolisthesis Rx:
- address lower quadrant muscle imbalance
- abdominal strengthening
- biomechanical counseling
- avoid HYPEREXT activities
