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

3. 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

4. Anatomy of our spine

5. Spine is broken down into four regions
Cervical
Thoracic
Lumbar
Sacral

6. 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

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

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

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

10. 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

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

13. 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

14. Common back injuries AND SPINE DISORDERS

15. 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

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

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

18. 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

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

21. 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

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

23. 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

24. 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

25. “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

26. “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

27. 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!

28. 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

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

30. Questions?