Ch. 14 Exercise Prescription Low Back
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The fundamental unit of the lumbar spine is " ", which consists of two vertebrae and their intervening disc
- The posterior elements of the vertebrae include the superior and inferior articular processes, and each of their junctions is referred to as a zygapophyseal joint, or " "
- In addition to assisting in supporting loads on the spine, the facet joints control the amount and direction of vertebral movement
- Consists of a centrally placed nucleus (nucleus pulposus) surrounded by a sheath of connective-tissue fibers (annulus fibrosis)
- Acts as spacers and shock absorbers, and when a person carries a load, the nucleus of the disc exerts pressure in all directions to help absorb the force
1st and 2nd most vulnerable intervertebral disc to injury in the low back?
- 1st is the one between the fifth lumbar vertebra and the sacrum (L5-S1 disc); its load is greater than that of any other disc
- 2nd is the one between L4 and L5; except for their periphery, the discs do not have pain receptors
The intervertebral disc is avascular (1), and its nutrition is enhanced (2)________. Long term (3)________ and ___________ both decrease nutrition to the disc
- (1) without blood supply
- (2) motion in the spine, motion enables the disc to absorb nutrients through the vertebral end plates
- (3) bed rest, smoking
Why is stretching important before and after sleep?
- when we sleep, discs imbibe fluid and actually become tighter than they were at the end of the day
- back injuries often occur in the morning, when these fuller disc permit less movement
Lordotic and Kyphotic
- Lordotic = concave
- Kyphotic = convex
- A small lumbar lordotic curve is natural and, along with cervical lordosis and thoracic kyphosis, assists the discs in cushioning compressive forces occuring in the spine during ADLs
Functional and Structural spinal curves
- Spinal curves are functional if the curve can be removed by assuming a posture that takes away the force responsible for the curve
- Structural curves can result from assuming an unhealthy posture over several years
- Structural lumbar lordosis = hard to do crunches due to lack of mobility in the lumbosacral area
- Although this person might be able to do sit-ups by using the hip flexors while the feet are held down, this motion could exacerbate the problem
The sacrum (in the pelvis) is the (1)_______ for the (2)________, pelvic positioning is important to the integrity of the spine
- (1) foundation
- (2) 24 vertebrae stacked on it
- Energy expenditure is minimal when body segments are balanced
Low back pain in adults
- most cases are caused by damage to the intervertebral discs
- low-back pain such as discs injury typically is caused by a succession of inappropriate movements occurring over time
- also called repetitive microtrauma condition or a repetitive motion injury
(1) Low Back Problems in Youth
(2) Pars interarticularis?
- (1) Are typically seen in the part of the vertebrae posterior to the spinal cord, including the superior and inferior articular processes
- (2) the part of a vertebrae between the superior and inferior articular processes
(1) The large muscles of the spine that contribute to CS include:
(2) The other trunk muscles that contribute to CS:
- (1) the erector spinae, multifidus, and quadratus lumborum
- (2) rectus abdominus, internal and external obliques, transversus abdominis, and quadratus lumborum
Lack of (1)______ in the back musculature is often seen in people with (2)_______
- (1) Strength and Endurance
- (2) low-back pain
- Abs are usually stronger than back because of the lack of extensor muscle training
Many people believe that (1)_______ reduces the role of the (2)______ muscles, but this is not so, particularly if the feet are supported (held by another person) the (3)_____....
- (1) bending the knees
- (2) psoas
- (3) psoas muscles put extreme compressive forces on the discs of the lumbar-motion segments of the vertebral column
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