Transcript Slide 1
Paul Thawley BSc (Hons) MSc (sports med) Pg Dip Team GB Physiotherapist, Honorary clinical fellow, UCL The Spine, Dynamic control and Back pain Spinal Stability • Anatomy, Joint shapes and congruency • Passive, stability ligaments • Active stability • Tensegrity • Time in tension • Common patterns of back pain And first aid The Normal spine Huge variation in anatomy between individuals What is the anatomy of the Spine? Differing pelvic positions, all normal! These are postures and pelvic position can create problems, although normal What is pelvic neutral, why is it important Common problems The internal support system Transverse abdominus It’s a circle around the lumbar spine Inner stability! Its limited in what it can do due to its attachment Schematic view of muscles and control Tensegrity Very clever concept; restricted hamstrings can change pelvic attitude! Restricted hip flexors put pressure on low back Tensegrity We’ve Heard So Much of the ‘CORE’, What About the ‘SLINGS’? GOBAL MUSCLES SLINGS: All planes of movement provides support and power in ballistic / active movement Core stability alone is too simplistic a concept In Normal running gait how is the spine effected by the following Weak gluts Over active / weak adductors Tight hamstrings Poor quads Tight calf's Importance of Gluteus medius and adductor groups New Concepts in Stability and control related to function Think of elite athletes and progressive research as F1 to family car development • Supine core exs? Translation to daily function asp, as they have v low level carry over to anti gravity postures. • Must be challenging and adopt the SAID principle, but must be set at appropriate level of control • Must involve slings and anti rotation control • What about time in tension as a pose to sets and reps? Trunk Stiffness Advanced Pelvic Control Sumo squats 8 x 30secs Holds Core tight Sitting pushing through heels. Turnout feet to increase adductor work Abs long arms draw in with Abs Level pelvis 4 x 5reps of 15 secs. Also Diagonals Tuck hold in position 3 x 3 at 20secs control! Hold 15 secs x 10 Flat low back +++ ! Hold 30 secs x 10 reps Spiderman / walk back and forward alt arms and leg. Coffee table ! 6 x 30 secs work IF YOU GET TIRED AND LOOSE FORM STOP AND REST. FORM IS EVERYTHING! Common spinal problems and first aid Facet likes movement Disc ? Leg pain movement pain Ligaments Muscle spasm RX Active rest No NSAID for 48hrs Seek advise if symptoms are not settling in 48 – 72 hours Culture and psychology of LBP, all sensation is perceived as pain why?