脊柱及下腰疼治疗

SpineandSacroiliacRehabilitationTherapeuticExerciseRehabProjectByJackyAndreattaAnatomyoftheSpineandSacroiliacAnatomyoftheSpineandSacroiliacRehabilitationGoalsRehabilitationbeginsimmediatelyafteraninjuryhasoccurred.Onceaspecificinjuryhasbeenassessed,andrehabilitationprogramshouldbeimplemented.Eachrehabprogramshouldaddressseveralcomponentsforbothshortandlongtermgoals.Therehabprogramshouldinclude:(1)providingcorrectandimmediatefirstandandcontrolswelling.(2)reduceorminimizeswelling.(3)restorefullrangeofmotion.(4)restoreandincreasemuscularstrength,endurance,andpower.(5)reestablishneuromuscularcontrol.(6)improvebalance.(7)maintaincardiovascularendurance.(8)incorporatetheappropriatefunctionalprogressions.RehabilitationGoals Threephasesshouldbefollowedtoincorporatetheproperprogressions.Theimmediatecarephase.Restorationofmotionandstrength.Thereturntoactivityphase.CommonInjuriestotheSpineandSacroiliacHerniatedDisk:adisplacementofthedisc’scenter(calledaherniatedorruptureddisc)throughacrackintheouterlayer.SpinalStenosis:conditioncharacterizedbyanabnormallynarrowspinalcolumn,whichinturnpinchesthespinalcordandassociatednerves.Spondyloisthesis:adevelopmentalcrackinoneofthevertebrae,usuallyatthepointatwhichthelower(lumbar)partofthespinejoinsthetailbone(sacrum).crackedvertebradoesslipforwardoverthevertebrabelowit.Thisisknownasadultisthmicspondylolisthesis.Spondylolysis:astressfracture,duetotheconstantforcesthelowbackexperiences,thisfracturedoesnotusuallyhealasnormalbone.ThistypeoffractureissimplyacrackinpartofthevertebraSacroiliacJointDysfunction:canbecomeirritatedisthroughabnormalmovementoccurringonarepetitivebasis. Examplesofthisaresport-relatedactivitieswhereheavyimpactoccursthroughjumpingandtwisting.CommonInjuriestotheSpineandSacroiliacSprainsandStrainsoftheSpineandSacroiliac:areamongthemostcommonofinjuriestotheareaandcanbecomesomeofthemostfrustratingandaggravatinginjuriesduetotheirtendencytolingerandcauselastingdisability.Sprains:overstretchingoneormoreoftheligamentsintheback.Strains:ariportearinthemusclecausedbysuddenforce.Bothoftheseinjuriescanhappenfromaninjury,poorposture,orimproperlifting.PicturesofCommonInjuriesSpondylolysisChangesinSpineandSacroiliacRehabilitationOverthepastcoupleofyearstreatmentofspineinjurieshaschangedgreatly.About10yearsagospinetreatmentswereveryconservativeandcalledformanydaystoweeksofbedrest.Todayithasbeenlearnedthattreatmentapplicationsshouldincludeminimalrestandprogressionintoactivityasquicklyasisappropriatefortheindividualandtheinjury.ACompleteRehabilitationfortheSpinIncludes:Modalities:Ice,Heat,Whirlpool,TENS/Stem,Ultrasound, ect.ManualTechniques:soft-tissueandjointmobilization,TherapeuticExercise:spinalstabilityinstruction, posturecorrection,body mechanics,ect.CardiovascularExercise.RehabilitationTechniquesSoftTissueMobilizationCervicalSpine: Themostcommontechniquesusedforsofttissuemobilizationareicemassagedirectlytothetriggerpointsofthemusclesincorporatedwiththecervicalspine. Themusclesinvolvedinthismethodincludethetrapezius,levatorscapulae,sternocleidomastoid,scalenes,splieni,andposteriorcervicalmuscles.RehabilitationTechniquesSoftTissueMobilizationMassageTechniquesFortheNeckandSpineRehabilitationTechniquesFlexibilityExercisesCervicalSpineandNeck:Stretchingofthecervicalspinecanalsobeachievedby:AxialExtensionCervicalRetractionCervicalextensionScalenestretchPectoralstretchTrapeziusStretchLongitudinalMovementRehabilitationTechniquesFlexibilityExercisesLowBack:stretchingthelowbackcanbeachievedthroughmanydifferenttechniques.Forexample:SpinalTwistProlongedSide-BendingLumbarRockStraightLegRaiseHamstringStretchGlutStretchTFLStretchHamstringStretchPriformissStretchRehabilitationTechniquesFlexibilityExercisesMcKenzieExtensionExercises:ProneLying:lieonstomachwitharmsalongsidesandheadturnedtoonesidePronelyingonelbows:lieonyourstomachwithweightonelbowsandforearmsandhipstouchingtheground.PronePress-up:onstomachhandsnearshoulders,slowlypushupkeepinghipsonthegroundProgressiveextensionwithpillows:Lieonstomachandplaceapillowunderchest.Addpillowifpaintolerancewillallow.StandingExtension:Whilestandingplacehandsosmallofback,andleanbackwardandhold.RehabilitationTechniquesFlexibilityExercisesWilliams’FlexionExercises:PelvicTilt:lieonbackwithkneesbentandfeetflat.Flattensmallofbackagainstfloor.SingleandDoubleKneetoChest:lieonbackwithkneesbent,slowlypullkneesorkneetowardthechest.Partialsit-up:dopelvictiltandslowlycurlheadanshouldersoffthefloor.HamstringStretch:sittingwithlegsandtoesforward,slowlylowertrunkforwardandoverthelegs.Hipflexorstretch:placeonefootinfrontoftheotherwithkneeflexed.Flexforwardthroughthetrunkuntiltheoppositekneecontractstheauxiliaryfold.Squat:standwithfeetparallelmaintainingtrunkstabilization,lowerthebodybyflexingtheknees.RehabilitationTechniquesPostureandCoreStabilizationAnypatientwithaninjuryshouldbeassessedforposture.IfapatienthaspoorpostureanditisnotcorrectedIwillexacerbatetheinjuryandmaketherecoverydifficult.Inordertocorrectanydeficienciesinpostureanathletictrainercanuseexercisestoimprovepostureandaidintherehabilitationprogression.Foranpatienttomaintainagoodposturetheymusthavewellmaintainedcoreinordertoholdthebodyinauprightandstableposition.RehabilitationTechniquesPostureandCoreStabilizationDefinitionsCore:(thetorso,extendingfromtheshoulderstothepelvis)thecentralorinnermostpartofanything,thecentralormostimportantpartStability:thestateorqualityofbeingstable,orfixed;steadiness,thecapacityofanobjecttoreturntoequilibriumoritsoriginalpositionafterbeingdisplaced.CoreStabilization:theintrinsicmuscleswhichlyewithinthetorso,whichareabletomaintainstabilitywhileanathleteisinmotionorifthebodyisstationary.RehabilitationTechniquesPostureandCoreStabilizationWhatMusculatureMakesUptheCore?TransverseAbdominalLumbarMultifidusGlutealsDiaphragmPelvicFloorRehabilitationTechniquesPostureandCoreStabilizationPostureandCoreStabilizationExercises:            Gentlyrotatepelvisforwardandbackward                   Lyingonside,tightenmuscleonfrontofthigh,thenliftleg8-10inchesawayfromfloor.                        Slowlyraisebuttocksfromfloor.keepingstomachtight.                          Bridgingwithballundershoulders.raiseonebentknee.Maintainbalance.Repeattootherside.               Withtubingaroundwaist.pushoffwithonefootandlungeforwardontoother.Return.Alternatelegs.                       Onhandsandtoesoverball,raiseonearmandoppositelegsimultaneously. DonotarchbackRehabilitationTechniqueStrengtheningExercisesRehabilitationTechniqueStrengtheningExercisesAlternativeTreatmentsforSpineandSacroiliacYoga:canprovideanothertoolforathletictrainerstouseinrehabilitation.Examplesofyogapositionswhichcanhelptorehabthelowerback:PlankPosePlankPoseisagoodprecursortomorechallengingarmbalances.BenefitsStrengthensthearms,wrists,andspineTonestheabdomenMatsyasana(FishPose)Unlikemanyoftheposesthatmimicthecreaturesthey’renamedafter,FishPosedoesn’tactuallylooklikeafish.Instead,it’ssaidthatifyouperformthisposeinwater,youwillbeabletofloatlikeafish.TraditionallyFishPoseisperformedwiththelegsinPadmasana.SincePadmasanaisbeyondthecapacityofmostbeginningstudents,herewe’llworkeitherwiththekneesbent,feetonthefloor,orwiththelegsstraightpressedagainstthefloor.(mot-see-AHS-anna) BenefitsAtraditionaltextthatMatsyasanaisthe“destroyerofalldiseases.”Stretchesthedeephipflexors(psoas)andthemuscles(intercostals)betweentheribsStretchesandstimulatesthemusclesofthebellyandfrontoftheneckStretchesandstimulatestheorgansofthebellyandthroatStrengthensthemusclesoftheupperbackandbackoftheneckImprovespostureAlternativeTreatmentsforSpineandSacroiliacAcupuncture:Theuseofthin,pre-sterilized,disposableneedlestore-establishtheproperflowofQiandbloodthroughthechannel(s)oftheback.Thisflowincreasescirculationallowingforoxygen,bloodandlymphtosupportthebodieshealingprocess.Ifthechannelshavebeenblockedforalongperiodoftime,orifthereispronounceddeficiencyofQiandblood,itisnecessarytohaveacupunctureforalongerperiodoftimetoassistthebodyinregainingit’snormalfunction.Researchhasshownacupuncturetocausethereleaseofneuro-chemicalssuchas:endorphins,enkephalins,serotoninandcorticosteroidsallofwhichcontributetothereductionofpainandinflammation.Diseasesthatcanbehelpedbyacupuncturearespondylosis,spinalosteoarthritis,prolapsedlumbardiscormuscular/ligamentouslumbarstrainBibliographywww.bodyprospt.comwww.spine-health.comwww.yogajournal.comwww.acupuncture.orgwww.back1.com