Intervertebral Disc Between each vertebra Provide cushion between vertebra Firmly attached to each vertebra No such thing as a “slipped disc” Intervertebral Disc The Cushion
Facet Joints 24 pair = 48 joints! Allow movement of spine Made of same “stuff” as all other joints The Links
Wh at Ma kes All Go ‘Ro und Muscles of the back Spenius capitis Splenius cervicis Serratus posterior superior Serratus posterior inferior Iliocostalis lumborum Iliocostalis thoracis Iliocostalis cervicis Longissimus thoacis Longissimus cervicis Longissimus capitis Spinalis thoracis Spinalis Cervicis Spinalis Capitis Semispinalis thoracis Semispinalis cervicis Semispinalis capitis Multifidus Rotatores Interspinalis Intertransversarii Obliquus capitis inferior Obliquus capitis superior Rectus capitis posterior minor Rectus capitis posterior major Longus colli Longus capitis Rectus capitis anterior Rectus capitis lateralis Trapezius Rhombois Serratus anterior Levator scapula
“The more there is to mess up the more likely something will mess up.” 33 vertebra + 23 discs + 48 joints (24 pair) + 64 muscles (32 pair) + 54 nerves (27 pair) 222 different things to break! Murphy’s Law?!
“The numbers don’t lie… “back injury -- the number one reason Americans miss work, after the common cold. Across the country in 1999, more than 420,000 people missed work because of back injury. Each lost an average of 6 days on the job.” U.S. Bureau of Labor Statistics.U.S. Bureau of Labor Statistics 8 out of 10 people will experience a back related injury.
Spring…too much… Hyperlordosis Too much curve in the spine Not enough stability Compresses Joints Examples Standing for prolonged periods Over weight Pregnant
Muscles: The Balancing Act Big Belly Pregnant Overweight People who have to stand for prolonged periods Tight Hip Flexors: Rotate pelvis down to front-causes too much arch in LB Weak Gluts: Can’t help rotate pelvis back to take arch out of back Weak Abs: Can’t help rotate pelvis back- causes too much arch in LB Just say “No to Crack”
Spring…Too little. Hypolordosis Not enough curve in the spine Not enough flexibility Abnormal pressure on back of disc Examples Sitting for prolonged periods Poor posture Sleeping on too soft of mattress
The Balancing Act: II “Flat Back” Poor sitting posture Slouching while standing Poor lifting technique Tight Gluts: Rotate pelvis backward, too much arch gone Tight hamstrings: Rotate pelvis backward, to much arch gone
What’s a guy to do? Move! If you stand for a long time… Sit Down once an hour for a few minutes If you sit for a long time… Stand Up once an hour for a few minutes If your belly’s big…Lose Weight! If your legs are tight…Stretch! If you have no butt…Exercise! *tip* Use a timer to remind you to sit/stand once an hour
Oh…My poor back! 3 types of back problems Acute Chronic Recurrent
“I bent forward and picked up _______” Acute problems Usually can pinpoint a time and/or incident Usually localized in low back Pain may vary from mild to extreme Examples Muscle spasm Locked facet (joint) “Crick in my neck” “Catch in my back” Impinged facet “I drove 8 hours straight” Uh, Oh!
“I’m sorry, I can’t go _____ because of my bad back” Chronic problems Problem that lasts longer than 14 days Usually from “wear and tear” May stem from an acute problem Examples Arthritis Degenerative disc Nerve inflammation
Same story...different day Recurrent Problems Acute “flair ups” of chronic condition Made worse by certain activities Examples Sacroiliac Joint Problems (SI) Where pelvis joins the spine Can cause shooting pain
Is there anything I can do? Sprained Ankle? R.I.C.E. Rest. Up to 7-10 days. Ice. 20 minutes every 2-3 hours while awake. 24-48 hours. Compression. ACE wrap. Elevation. Above heart level. Hurt back? R.I.C.E. Rest. Up to 7-10 days. Ice. 20 min. every 2-3 hours while awake. 24-48 hours. Controlled movement. Exercise Knees side to side. SKC. DKC.
Easy Back Exercises Knees side to side Lie flat Bend knees Keep together Feet on floor Rotate knees side to side Pain free range Let your hips roll Repeat for 1-2 min.
Easy Back Exercises Single Knee to chest Lie flat on back Bend knees Keep feet on floor Grasp knee, pull to chest *don’t hold your breath* Repeat 5x each leg
Easy Back Exercises Double Knee to chest Lie flat on back Bend knees Keep feet on floor Grasp both knees, pull to chest *don’t hold your breath* Repeat 5x
Good Sitting Posture Sit up Back straight Slight curve in LB Shoulders pulled back Head over shoulders Chin tucked in slightly Comfortable, Huh?
What a Pain in the Neck! Acute injury Treat same as acute injury to LB i.e. LIKE A SPRAINED ANKLE!! Rest (10-12 days) Ice (24-48 hours) Controlled movement Slowly rotate head from side to side in pain free range
More Neck/Back Exercises “Arch Back Like a Cat”
Help With Your Posture… Helps control/protect your LB Allows you to pull your shoulders back
Huff and Puff… Cardiovascular Conditioning Get OK from Dr. before starting any CV conditioning program Don’t try to start where you should be in 4 weeks Start with walking program before running Stretch legs before starting Start at front door, walk specified time out…then turn around and walk back
5 Week Interval Walking Program SMTWThFS Wk 12 min Stretch 3x3 2 min Stretch 3x33 minOff Wk 2Off3 min Stretch 3x33 min Stretch 3x35 min Off Wk 3Off5 min Stretch 3x35 min Stretch 3x37 minOff Wk 4Off7 min Stretch 3x37 min Stretch 3x3 10 min Off Wk 5Off 10 min Stretch 3x3 10 min Stretch 3x3 12 min Off
How Many Times Have I Heard This… Proper lifting Plan ahead Get help if heavy or awkward Feet shoulder width apart Bend knees Majority of body weight on dominant/strong leg for balance Back straight Head up “Lead with your head, not your butt” Keep load close to body Don’t twist body…move feet Practice with all items (light or heavy)
The Straw That Broke the Camel’s Back 12345678910 11121314151617181920 21222324252627282930 31323334353637383940 41424344454647484950 51525354555657585960 61626364656667686970 71727374757677787980 81828384858687888990 919293949596979899 Oh No!
Tips and Tricks… Standing Activities Periodically sit Shift weight from foot to foot Rotate pelvis/hips back occasionally Prop one foot up if possible Good shoes Arch support Heel counter
Tips and Tricks… Sitting activities Stand periodically 90-90 rule Ankles bent to 90 degrees Knees bent to 90 degrees Hips bent to 90 degrees Sit closer to work Top of computer monitor at eye level Lumbar support if needed
Tips and Tricks Sleeping Supine (on back) Pillow under head Not to big Pillow under knees Prone (on stomach) Pillow under hips (not stomach) Side lying Pillow under head Pillow between knees
The Bottom Line… Sleep how you can get the most sleep!
Believe ½ of What You See, None of What you Hear … You Need a Firm Mattress You Need a Flat Pillow All Waterbeds are Bad Always Use Heat Back Braces Make Your Back Weak You Should Always Use a Lumbar Support When Sitting Sit-ups are Good for You
The Last Word… Get plenty of rest Drink plenty of water Eat a balanced diet Maintain a healthy weight Get plenty of exercise Practice good form constantly When in doubt, Seek professional help