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Biomechanics of the Spine & Hip

Biomechanics of the Spine & Hip. Movements of Spine Flexion, Rotation, Extension, Abd, Add. Hip Movements Elevation, Anterior & Posterior Tilt, Flexion, Extension, Abd, Add, Hyperext, Hyperflex. Spinal Deviations. Lordosis Kyphosis Scoliosis. Forces Acting On The Spine.

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Biomechanics of the Spine & Hip

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  1. Biomechanics of the Spine & Hip • Movements of Spine • Flexion, Rotation, Extension, Abd, Add. • Hip Movements • Elevation, Anterior & Posterior Tilt, Flexion, Extension, Abd, Add, Hyperext, Hyperflex

  2. Spinal Deviations • Lordosis • Kyphosis • Scoliosis

  3. Forces Acting On The Spine • Forces Acting On The Spine Include: • Body Weight • Tension In The Spinal Ligaments • Tension In The Surrounding Muscles • Intraabdominal Pressure • The Major Form Of Loading On The Spine Is: • Axial

  4. Upright Position • Spinal Compression • Resulting From: • Body Weight + Weight Held by Arms and Hands • When Standing Upright • Total Body Center of Gravity Is Anterior to the Spinal Column. • Spine Is Placed Under Constant Forward Bending Moment.

  5. Torque • Defined: The Rotary Effect of a Force About An Axis of Rotation, Measured as the Producer of the Force and the Perpendicular Distance Between the Force’s Line of Action And The Axis • To Maintain An Upright Position • Torque Is Counteracted by Tension in the Back Extensor Muscles.

  6. Spinal Muscles Role In Lifting • Spinal Muscles Have Small Moment Arms With Respect To the Vertebral Joints. • Have To Generate Large Forces To Counteract the Torque Produced About the Spine by Body Weight and Objects Being Lifted. Erector Spinae Muscles

  7. Why Lift With The Legs? • Back Muscles, With a Moment Arm of Approximately 6 cm, Must Counter The Torque Produced by the Weights of the Body Plus Any External Loads.

  8. Question: How Much Torque Is Developed By The Erector Spinae Muscles With a Fm 6 cm? • 1 lb. = 4.448 Newtons • Segment Weight Moment Arm • Head 13 lbs. (58N) 25 cm • Trunk 73.75 lbs. (328N) 10 cm • Arms 18.2 lbs. (81N) 20 cm • Box 24.95 lbs. (111N) 40 cm • Torque at L5-S1= • (328N)(10cm) + (81N)(20cm) + (58N)(25cm) + (111N)(40cm) • = ? • 10,790 Ncm • Force? • 0 = (Fm)(6cm) - 10,790 In static position, sum • of the torques acting at any point is zero. • Fm = 1798.33 N or (404.30 lbs.)

  9. Problem for a 135 lb. Person • How much force must be developed by the erector spinae with a moment arm of 6 cm. From the L5-S1 joint center to maintain the body in a lifting position with segment moment arms as Specified? • Segment Weight Moment Arm • Head 50 N 22 cm. • Trunk 280 N 12 cm. • Arms 65 N 25 cm. • Box Lifted 100 N 42 cm. • Torque ? • 10,285 Ncm • Fm = 1714 N or (393 lbs. Force)

  10. What Does The Research Show? • % Load Compression On L3 During the Upright Standing, Lying Down, and Sitting. • Compression Increases More with Spinal Flexion, and Increases Still Further with a Slouched Sitting Position.

  11. Common Injuries Of The Back • Low Back Pain • Soft Tissue Injuries • Acute Fractures • Stress Fractures • Disc Hernia ions • Whiplash Injuries

  12. Low Back Pain 75%-80% of Americans Experience Low Back Pain Sometime During Life. Second Only to the Common Cold In Causing Absence In The Workplace. Mechanical Stress & Psychosocial.

  13. BACK, SPINAL COLLUMN, NECK • VERTEBRAL COLLUMN • RIBS & STERNUM

  14. SPINAL COLLUMN • 7 CERVICAL VERTEBRAE • 12 THORACIC • 5 LUMBAR • 1 SACRUM - FUSED • 1 COXCYC - 2 FUSED

  15. JOINTS OF THE VERTEBRAL COLLUMN • VERTEBRAL JOINTS • GLIDING JOINTS - SLIGHTLY MOVABLE • SEPARATED BY INTERVERTEBRAL DISKS

  16. THORACIC COMPLEX - RIBS • 12 SETS OF RIBS • ARTICULATE WITH THE THORACIC VERTEBRAE AND STERNUM • 7 PAIRS OF TRUE RIBS - ATTACH DIRECTLY TO STERNUM • 5 PAIRS OF FALSE RIBS • 2 PAIRS OF FLOATING RIBS • 3 PAIRS ATTACH TO STERNUM VIA COSTOCHONDRAL CARTLILAGE

  17. STERNUM • MANUBRIUM • BODY • XIPHOID PROCESS

  18. MUSCLES OF THE BACK, NECK & ABDOMEN • DEEP POSTERIORS • ABDOMINALS • VERTEBRALS • SUPERFICIAL NECK MUSCLES

  19. DEEP POSTERIORS • MOVEMENT - ROTATION, EXTENSION OF SPINAL COLLUMN

  20. ABDOMINALS • TRANSVERSE ABDOMINUS - DEPRESSION OF ABDOMEN • RECTUS ABDOMINUS - SPINAL FEXION • INTERNAL / EXTERNAL OBLIQUES - ROTATION, LATERAL FLEXION (ABDUCTION - ADDUCTION)

  21. MUSCLES OF THE THORAX • DIAPHRAM • INTERNAL INTERCOSTALS • EXTERNAL INTERCOSTALS

  22. INJURIES TO LOWER SPINE, PELVIS, HIP - CAUSES • DISK DEGENERATION - Herniation or General Degeneration • JOINT DISFUNCTION - Primarily @ Sacroiliac • Usual Cause - Lack of Normal Movement - Often Disputed • STRETCHED OR STRAINED LIGAMENTS - ie: Supraspinous Ligaments • LACK OF STRENGTH • Hamstrings, Erector Spinae, Abdominals, Hip Flexors

  23. PREVENTION OF INJURIES TO BACK • POSTURE - STANDING • HYPERLORDOSIS • KYPHOSIS • POSTURE - SITTING • CAUSING PAIN TO LUMBO/SACRAL AREA

  24. PROPER SITTING TECHNIQUE - Should Not Be Done Over Long Periods Of Time • HIPS SHOULD BE FLEXED • LEGS SHOULD NOT BE EXTENDED • BACK SHOULD NOT BE OVERLY ARCHED

  25. LIFTING WITH PROPER TECHNIQUE • BACK KEPT ERECT • KNEES BENT • WEIGHT CLOSE TO BODY

  26. STRENGTHENING EXERCISES • MANY BACK PROBLEMS ARE CAUSED BY WEAK MUSCLES ABOUT THE HIP AND ABDOMINALS • WEAK MUSCLES PREDISPOSE BACK TO HYPERLORDOSIS • INCORRECT SIT-UPS MAY CAUSE HYPERLORDOSIS - CAUSED BY SHORTENED ILIOPSOAS • STRETCHING - HAMSTRINGS - ILIOPSOAS - QUADRICEPS

  27. LUMBAR SPINE EVALUATIONS • STANDING EVALUATION • FLEX FORWARD - PALPATING SPINOUS PROCESSES & TRANVERSE PROCESSES • SITTING ALIGNMENT • PATELLULAR REFLEX - LUMBAR 4 INVOLVEMENT • ACHILLES REFLEX - SACRAL 1 INVOLVEMENT

  28. LYING ON BACK • TEST ABDOMINALS - RECTUS ABDOMINUS , ILIOPSOAS (HIP FLEXORS) • (STATIC W/ STABILIZED THIGHS - HIP FLEX AT 45 DEGREES • STRAIGHT LEG RAISE • PAIN WHEN TESTING UNAFFECTED SIDE - POSSIBLE HERNIATED DISK • PAIN WHEN TESTING AFFECTED SIDE - POSSIBLE SCIATIC NERVE STRETCHED

  29. LYING ON BACK (CONTINUED) • BOWSTRING SIGN • TO TEST FOR SCIATIC NERVE - USE PRESSURE TO POPLITEAL (BACK OF KNEE) • GAINSLENS SIGN • TO TEST SACRO-ILIAC LESSIONS (SWITCHBLADE LEGS WHILE ON SIDE)

  30. OTHER PROBLEMS OCCURING WITH THE SPINE • SOFT TISSUE TRAUMA - CONTUSIONS • NERVE INFLAMATION OR COMPRESSIONS - FROM DISK PROTRUSIONS • FRACTURES TO THE SPINOUS OR TRANSVERSE PROCESSES • SPONDYLOLYSIS (FRACTURE TO INTERARTICULAR PROCESS • SPONDYLOLISTHESIS (FORWARD SLIPPAGE OF THE VERTEBRA

  31. OTHER PROBLEMS OCCURING WITH THE SPINE (CONTINUED) • GROIN STRAINS • HIP POINTE.RS • HIP DISLOCATIONS

  32. REHABILITATION OF BACK AND HIP INJURY • ICE MESSAGE • MOVEMENT TO REGAIN FLEXIBILITY & RANGE • STRENGTHENING EXERCISES • SIT UPS & CRUNCHES (WORK OBLIQUES AS WELL) • PELVIC TILTS - (FLATTENING OF BACK AGAINST FLOOR) • HIP LIFTS - (FROM LYING ON BACK POSITION) • BACK EXTENTIONS - TO 90 DEGREES • PSOAS & HAMSTRING STRETCH - (KNEES TO CHEST)

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