Spinal Column

Myotomes/Dermatomes Myotomes- movement Dermatomes- sensory

Myotomes C3,4,5Shoulder Elevation C5Shoulder Abduction C6Elbow Flexion C7Elbow Extension C8Finger Flexion T1Finger Abduction

Myotomes L1,2,3Hip Flexion S1Hip Extension Eversion S1,2Plantar flexion L2,3,4Hip Adductors L4Dorsiflexion/inversion L5Hip Abductors Great toe dorsiflexion Great toe dorsiflexion

Injuries/Conditions ScoliosisSpondylolysisSpondylolysthesis Pinched nerve StingerSciatica Bulging disc ParaplegiaQuadraplegia

Scoliosis Curvature of the spine

Spondylolysis Stress Fracture of vertebrae.

Spondylolisthesis Fracture that also has some slippage of the vertebrae. Fracture that also has some slippage of the vertebrae.

Causes Both spondylolysis and spondylolisthesis are most common in football linemen and gymnasts. These two sports involve weight-loading, rotation, and hyperextension (back-arching).

Symptoms Generally, the athlete will have pain across the low back that may radiate down to the buttocks. The muscles of the low back will be in spasm, giving a flat appearance to the normally curved lower back.

Cervical Spine injury causes Falls or collisions Sudden twisting of the neck

C-Spine injury

Symptoms of C-spine injury Pain, usually a pinpoint spot. Tingling in both arms and/or legs. Decreased feeling in arms and/or legs. Muscle weakness in arms and/or legs.

Pinched Nerve Occurs by pressure being put on a nerve. Either by a bone, disc, or swelling.

Signs/Symptoms Muscle weakness Tingling or numbness Pain

Sciatica A protruding disk in your lower spinal column pressing on the roots to your sciatic nerve. Pain in your lower back or hip that radiates down from your buttock to the back of one thigh and into your leg. Pain in your lower back or hip that radiates down from your buttock to the back of one thigh and into your leg.

Sciatica You may also feel weakness, "pins and needles" numbness, or a burning or tingling sensation down your leg. You're most likely to get sciatica when you're years old.

Stingers The brachial plexus is an arrangement of nerve fibers running from the spine (C5- T1), through the neck, the armpit region, and into the arm. The nerves in the neck and shoulder are over-stretched as the head is forced sideways away from the shoulder.

Signs/Symptoms The athlete will experience sudden and severe painful, stinging sensations in 1 of his arms frequently lasting from seconds to minutes, occasionally hours and less frequently days or longer. There is often associated weakness of the muscles in the shoulder and arm that are supplied by the injured nerve. The arm symptoms are usually more severe than neck pain.

Signs/Symptoms First time stingers will usually recover quickly even without treatment, but there is a greater risk of recurrent injury if left untreated. Each additional stinger will likely result in continued neurologic impairment including muscle weakness.

Herniated disc Approximately 90% of disc herniations will occur at L4- L5 or L5- S1. Due to overuse, a disc may weaken and the gel substance puts pressure on the nerve.

Parapalegic Paraplegia is a condition in which the lower part of a person's body is paralyzed and cannot function. It is usually the result of spinal cord injury.

Quadraplegic Quadriplegia is a symptom in which a human experiences paralysis of all four limbs, although not necessarily total paralysis.

Evaluation HistoryObservationPalpation Stress Tests

History Athlete could walk into Training Room. Athlete could be down on the field/court!

History Athlete walks into Training Room.

History Athlete down on field Do not move this athlete until you determine it is safe to do so. Do not take off any equipment until you determine it is safe to do so. If you suspect a cervical spine injury, make sure head is stabilized at all times!

C-Spine injury

Observation DeformityAlignmentPosture/positions Signs of trauma Motionlessness

Palpation Very carefully Palpate for pain over vertebrae. Check for sensation Check for movement

Stress Tests Active Range of Motion Resistive motions

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