Lower trunk & pelvic 1

Curvatures of the Vertebral Column Primary curvatures are anteriorly concave - Thoracic curvature - Pelvic curvature Secondary curvatures are anteriorly convex - Cervical curvature - Lumbar curvature Cervical curvature develops when a baby begins to hold up its head Lumbar curvature develops when a child begins to stand T11

Movement of core muscle : EMG activity of each of the trunk muscles relative to that of the prime mover. (Hodges & Richardson 1997)

Inner Core Muscle - Deep

Core Stability The core has been described as a BOX with the abdominals in the front paraspinals and gluteals in the back, the diaphragm as the roof, and the pelvic foor and hip girdle musculature as the bottom "Core stability" describes the ability to control the postion and movement of the central portion of the body

Importance of core stability Mechanical base for motion of the distal segments Many extremity prime movers attach to the core Core muscles are active before initiatio- n of extremity movement "Proximal stability for distal mobility"

Diaphragm Inspiration - increase of thoracic cavity Increase of intra-abdominal pressure

Transversus Abdominis Abdominal pressure - stabilizer

Multifidus Bilateral movement Unilateral movement - Neck&Trunk extension Bilateral movement - Lateral flexion

Pelvic floor muscles 1. Piriformis 2. Coccygeus 3. Levator ani 4. Obturator internus

Outer Muscle - Superficial

Rectus Abdominis Trunk flexion Posterior pelvic tilt

External Abdominal Oblique Internal Abdominal Oblique Contralateral rotation Ipsilateral rotation Flexion, Lateral flexion, Posterior pelvic tilt, Abdominal pressure

Latissimus Dorsi Distal part Proximal part - Shoulder adduction - Shoulder IR - Shoulder extension - Scapula depression &downward rotation Proximal part - Pelvic ant. tilt - Pelvic elevation

Quadratus Lumborum Unilateral movement Bilateral movement - pelvic elevation - lateral flexion of trunk Bilateral movement - extension of lumbosacral(increase of lumbar lodosis)

Erector spinae Group Unilateral movement Bilateral movement - lateral flexion of vertebral Bilateral movement - extension of vertebral & head

Mobilizer & Stabilizer Rectus abdominis Internal Oblique External Oblique Quadratus lumborum Latissimus dorsi Erector spinae group Diaphragm TrA Multifidus Pelvic floor

Muscle sling

Muscle sling Anterior Spiral Posterior Biceps-pectoralis major-internal oblique-contralateral hip abductor Spiral Rhomboid-Serratus anterior-external oblique -contralateral internal oblique- hip adductor Posterior Hamstring-gluteus maximus- thoracolumbar fascia-contralateral latissimus dorsi- triceps

Janda's lower cross syndrome

Janda's lower cross syndrome

Tight Thoraco-lumbar Extensors Weak Thoraco-lumbar Extensors Tight abdonimals Weak abdonimals Weak Hip Flexors Tight Hip Flexors