Spine injuries in baseball players | cervical spine injuries | Colorado Spine Surgeon
Chapter 24 Rehabilitation of Injuries to the Spine.
-
Upload
darleen-french -
Category
Documents
-
view
223 -
download
2
Transcript of Chapter 24 Rehabilitation of Injuries to the Spine.
![Page 1: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/1.jpg)
Chapter 24
Rehabilitation of Injuries to the Spine
![Page 2: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/2.jpg)
Cervical Lateral Flexion with Flexion Stretch
Seated position 1 hand on contralateral
upper trapezius 1 hand on
temporal/occipital lobe Gently apply pressure to
laterally flex head & then move into slight flexion
Contraindication - cervical disc problems, osteoporosis of cervical spine
![Page 3: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/3.jpg)
Cervical Rotation Stretch Seated position 1 hand on
contralateral upper trapezius
1 hand on mandible
Gently apply pressure to rotate head
![Page 4: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/4.jpg)
Lower Extremity Assisted Stretching
Make sure client is warmed up, not wearing restrictive clothing, you are aware of any medical contraindications to stretches, have subject lie prone
Make sure client feels comfortable with hands on stretching
![Page 5: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/5.jpg)
Sequence of Lower Extremity Stretching
1. Single Knee to Chest2. Straight Leg Raise
a. knee slightly flexedb. knee extended
3. Gastrocnemius Stretch – knee extended4. Soleus Stretch – knee slightly flexed5. Adductor Stretch
6. IT Band Stretch7. External Rotation8. Internal Rotation9. Low Back Stretch10. Hip Flexor Stretch11. Quadriceps Stretch
![Page 6: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/6.jpg)
Single Knee to Chest– stretches
adductor, gluteus maximus, lumbar spine
![Page 7: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/7.jpg)
Straight Leg Raise– stretches hamstrings– tight hamstrings
posteriorly rotate pelvis causing straightening of lumbar spine
– this stress on discs contributing to low back pain
– tight hamstrings
![Page 8: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/8.jpg)
Gastrocnemuius Stretch– knees in extension
Soleus Stretch– knees slightly
flexed
![Page 9: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/9.jpg)
Adductor Stretch– risk of groin pulls
![Page 10: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/10.jpg)
IT Band Stretch– risk IT Band
syndrome, common in cyclists & runners moving only on sagital plane
– IT Band rubs over lateral condyle of femur creating inflammation
![Page 11: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/11.jpg)
External Rotation Stretch– to stretch the internal rotators
![Page 12: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/12.jpg)
Internal Rotation Stretch– to stretch the external
rotators– piriformis
sciatic nerve runs very close to this muscle
tightness in piriformis may contribute to sciatic pain
![Page 13: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/13.jpg)
Lumbar Rotation Stretch Lumbar Hyperextension
Stretch
![Page 14: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/14.jpg)
Hip Flexor Stretch– Stretches Iliopsoas– tight hip flexors
cause an anterior rotated pelvis
– this causes hyperextension of the lumbar spine and can contribute to low back pain pressure on facet
joints
![Page 15: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/15.jpg)
Quadriceps Stretch– keep pelvis posteriorly
rotated– risk of quadriceps pull
![Page 16: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/16.jpg)
![Page 17: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/17.jpg)
![Page 18: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/18.jpg)
Abdominal Exercises
Effective sit-ups emphasis lumbar flexion of the abdominal muscles
Hip flexor muscles (e.g. iliopsoas) can also perform lumbar flexion
![Page 19: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/19.jpg)
Abdominal Exercises
Flexing the knees neutralizes the hip flexor muscles
Stabilizing the feet increases the strength of the hip flexors
![Page 20: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/20.jpg)
Crunches1. Flex the knees and hip to 90 degrees2. Don’t stabilize the feet3. Arms at side; move them closer to the head to increase
difficulty4. If hands behind head, avoid over cervical flexion5. Slowly perform lumbar flexion6. Exhale during lumbar flexion7. Abdominal muscles active during first half of lumbar flexion8. Return until head touches the floor
9. Muscles: Upper rectus Abdominis (obliques, hip flexors)
![Page 21: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/21.jpg)
![Page 22: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/22.jpg)
Leg Pull or Reverse Crunch
Action? Lumbar flexion Muscles: Lower rectus abdominis, obliques, and hip
flexors
![Page 23: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/23.jpg)
Leg Raises
Muscles: First, hip flexors then as the hips are raised off the ground, the rectus abdominis is more involved
![Page 24: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/24.jpg)
Abdominal Exercises Rectus Abdominis and Obliques dynamically contract only if actual
waist flexion occurs. With no waist flexion, Rectus Abdominis and External Oblique will
only isometrically contract to stabilize the pelvis and waist during hip flexion.
It may be necessary to completely flex the hips before waist flexion is possible
ExRx
![Page 25: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/25.jpg)
Abdominal Exercises
Muscles: Obliques (rectus abdominis and hip flexors)
Notice her right external oblique - rotation to the opposite side
Her left internal oblique - rotation to the same side
![Page 26: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/26.jpg)
![Page 27: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/27.jpg)
Sit-Ups
Muscles: Rectus abdominis (obliques and hip flexors)
Note: Flexing or “curling” the lumbar region emphasizes the rectus abdominis
![Page 28: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/28.jpg)
Incline Sit-ups Increased resistance
![Page 29: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/29.jpg)
Leg Raise
Muscles: First, hip flexors. As the upper leg passes horizontal, rectus abdominis becomes more involved
![Page 30: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/30.jpg)
Side Bends
Action? Lateral Flexion Muscles: Quadratus Lumborum, Rectus Abdominis,
and Obliques
![Page 31: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/31.jpg)
![Page 32: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/32.jpg)
Transverse abdominis
![Page 33: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/33.jpg)
![Page 34: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/34.jpg)
![Page 35: Chapter 24 Rehabilitation of Injuries to the Spine.](https://reader030.fdocuments.in/reader030/viewer/2022032705/56649d845503460f94a6b43f/html5/thumbnails/35.jpg)
Abdominal Exercises No one type of abdominal exercise is best.