Back Management Understanding Your Anatomy Of Your Back, And How To Protect IT. Scott Tremmel PT Jordan Rosenberger SPT

Our Goals: Understand Back anatomy What are common Back problems How can we avoid back injuries with lifting What are some exercises we can do to help protect our backs

Anatomy of our spine

Spine is broken down into four regions Cervical Thoracic Lumbar Sacral

Cervical Spine 7 vertebra: C1-C7 Movement: rotation, side bending, flexion, extension Make up our neck, support our head Nerves innervating primarily shoulders, arms and hands

Thoracic Spine 7 vertebra: T1- T12 Movement: Rotation, flexion, extension Makes up our upper trunk Innervates: chest and abdomen Thoracic Spine

Lumbar spine 5 VERTEBRA: L1- L5 Movement: Flexion and extension Makes up our lower back Innervates primarily the legs

sacrum 5 Vertebra: S1- S5 Triangle shape bone between hipbones of the pelvis Movement: Anterior and inferior Innervates: pelvis, lower leg and foot

Spinal cord Protected by the spinal column/vertebra Carries information and signals to and form the brain Nerves branch off the spinal cord innervating specific regions of the body

Intervertebral DISC Shock absorber between spinal columns composed of an annulus fibrosus and a nucleus pulposus Think of Carmel Cream candy Intervertebral DISC

Back FACTS 33 Bones 23 disc 31 pairs of nerve roots+ 62 nerve roots 77 back muscles Back injuries in the work force cost $13.4 to $50 billion annually 1 million in back injuries in work place each year 1 out of 5 illness/injuries reported at work are from the back

Common back injuries AND SPINE DISORDERS

Common muscular problems Muscles Strain Muscle Pull Muscle Spasm Symptoms: Muscles sore upon touch Sudden pain Pain in localized and doesn’t radiate down limbs Creates tightness and difficulty moving limbs Common muscular problems

Narrowing of spaces in the spine (backbone) that results in pressure on the spinal cord and/or nerve roots Arthritis in the Spine Stenosis

Condition caused by protrusion, herniation or prolapse of a vertebral disc from its normal position in the vertebral column Bulging disc

Signs and symptoms of bulging disc and stenosis Weakness in distal limbs Numbness Radiating pain Loss of sensation Pain increases with positional changes Burning sensation

Prevention and taking care of our bodies Two things we can control to prevent injury: Lifting Techniques and Strengthening

Lifting Technique Use your legs! Keep a neutral spine This is where your strength and power comes from Using your legs protects your back Keep a neutral spine Bend at the knees NOT at the hips

Sitting Posture Protect your back in sitting! This can be easily done by making a towel roll to help support your back

What Types of Exercises? Stabilization – exercises that are designed to make surrounding musculature strong Some of the exercises are for the hip or abdomen Indirectly help decrease or prevent low back pain

Hip Exercises Clamshell Sidelying Hip Abduction Lay on side knees bent and hips rolled forward Open up top knee, like a clamshell Hold for 2-3 seconds before slowly closing Perform 3 sets of 10 on each side Sidelying Hip Abduction Lay on side with top leg straight and bottom leg bent Keep hips rolled forward Lift top leg up, hold for 2-3 seconds Slowly lower leg down

“Core” Exercises Transverse Abdominis Draw In Feel for the spot directly to the middle of your hip bones Suck belly button straight back, like you are trying to put on a pair of tight pants You should feel a band of muscle subtly raise into your hand Hold for 5 seconds, repeat 10 times Easiest : In lying Hardest : Standing up

“Core” Exercises Modified Plank Plank Holding abdomen/Transverse Abdominis in tight prop up on your forearms and knees Raise body of the ground and hold Perform exercise up to 3 times per day Goal: 1 x 60 seconds Work up to this! It is okay to do 3 sets of 20 seconds to start off with Plank Holding abdomen/Transverse Abdominis in tight, prop up on forearms and toes Raise body of the ground and hold Do not stick bottom up in the air, or let it sag down Goal: 1 x 60 seconds Work up to this! It is okay to do 3 sets of 20 seconds to start off with

More “Core” Exercises Modified Side Plank Side Plank Lying on your side Holding abdomen/transverse abdominis in tight Prop up on forearm and knees Lift off of floor, holding form Goal: 1 x 50 seconds This is a much harder exercise than regular planks, so work up to it! Make sure you even out – hit both sides! Side Plank Lying on your side Holding abdomen/transverse abdominis in tight Prop up on forearm and legs Lift off of floor, holding form Goal: 1 x 50 seconds This is a much harder exercise than regular planks, so work up to it! Make sure you even out – hit both sides!

Hips and Core Bridging How to make this harder Bend knees Place feet shoulder width apart Perform a Transverse Abdominis Draw in Squeeze butt cheeks together Raise bottom up into air Hold for 5 seconds, repeat 10 times How to make this harder Bridge up and raise one leg, creating a single leg bridge Continue to do a double leg bridge, but with legs balancing on an exercise ball

Things to Avoid Sit Ups Twisting Flexing your back Holding your breath Twisting Abdominal Machine Sit Ups

Questions?