1. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. The Spine PE 236 Amber Giacomazzi MS, ATC

2. © 2005 The McGraw-Hill Companies, Inc. All rights reserved.

7. Cervical Injuries Cervical Sprain “________” –Same mechanisms as a strain but to a higher degree –Signs and Symptoms __________________ –Treatment Refer to physician ______________

8. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Cervical Injuries Stretching of the _____________________ Commonly referred to as a “_____” or a “______” Dangers—reoccuring stretching—C4-T1 –Signs and Symptoms _______________ –Treatment ______________ Ice __________ (____________________) Prevent (neck roll)

9. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Low Back Pain –Cause of Injury Congenital anomalies Mechanical defects of the spine (___________________________) ___________________ - Signs and Symptoms Pain, possible weakness, __________, muscle strains and bony defects ________________________________________________ –Treatment ________________________________ ________________________– avoid unnecessary stresses and strains associated with daily living Lumbar Injuries

10. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Lumbar Vertebrae Fracture and Dislocation –Cause Compression fractures or fracture of the spinous or transverse processes Compression fractures are usually the result of ________ __________________________________ Fractures of the processes are generally the result of a ______ __________ Dislocations tend to be rare –Signs and Symptoms _________________________ ______________________________________________ Localized swelling and guarding Lumbar Injuries

11. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Treatment –X-ray and physician referral –Transport with _________ _____________________ _____________________ –____________________

12. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Low Back Muscle Strain –Cause of Injury ____________________________ generally in conjunction w/ some type of __________ Chronic strain associated with ______________________ –Signs and Symptoms Pain may be ______________; pain w/ _____________ and _________________ –Treatment RICE to decrease spasm; followed by a __________________ ____________________ Elastic wrap/back brace may be useful for support and compression Complete bed rest may be necessary if it is severe enough NSAID’s Lumbar Injuries

13. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Back Contusions –Cause of Injury Significant impact or direct blow to the back –Signs and Symptoms Pain, swelling, discoloration, ____________ and point tenderness –Treatment RICE for the first ____________ Ice massage combined with gradual stretching Recovery generally last ___________________ Lumbar Injuries

14. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Sciatica –Cause of Injury Inflammatory condition of the ___________ Nerve is vulnerable to _______ or _________ that place abnormal amounts of ____________________________ –Signs and Symptoms Arises _______________; produces ___________ _______________________ Sensitive to palpation with ________________ intensifying the pain –Treatment Rest is essential; acutely – recovery = 2-3 weeks Treat the cause of inflammation; traction if disk protrusion is suspected; NSAID’s Lumbar Injuries

15. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Herniated Disk –Cause of Injury Caused by ______________ and ___________ due to use (_______ ________________ __________) –_______________

16. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. –Signs and Symptoms _______________________________ Symptoms are worse in the __________ Onset is sudden or gradual, pain may increase after the athlete sits and then tries to resume activity _______________________ increase pain, while back ____________ reduces pain Straight leg raise to _____________ is painful –Treatment Rest and ice for pain management _________________ may be comfortable _____________________ should be integrated as athlete improves Lumbar Injuries

17. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Spondylolysis and Spondylolisthesis –Cause of Injury Spondylolysis refers to __________________ due to ___________ __________ (stress fracture results) ______________________________ is referred to as spondylolisthesis and is often associated with a spondylolysis –Signs and Symptoms Pain and persistent aching, _____________ with increased pain ____________ Frequent need to change position or “____” back to reduce pain ___________________________________ Lumbar Injuries

18. © 2005 The McGraw-Hill Companies, Inc. All rights reserved.

20. –Treatment Bracing and occasionally bed rest for 1-3 days will help to reduce pain Major focus should be on exercises directed at controlling or _______________________________ Progressive trunk strengthening, ______________________, concentration on abdominal work Braces can also be helpful during high level activities _____________________

21. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Sacroiliac Joint Dysfunction Sacroiliac Sprain –Cause of Injury Result of ____________________ __________, stumbles forward, falls backward, steps too far down, _____ _________________, bends forward with knees locked during lifting –Signs of Injury Palpable pain and tenderness over the joint, _____________ w/ some muscle guarding __________________________

22. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Care –Ice can be used to reduce pain –Bracing can be helpful in acute sprains –________________ ________________ ________________

23. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Assessment of the Spine History –Mechanism of injury (___________________) Numbness, tingling, burning? _______________________________ Do you have equal strength in both sides of the body?

24. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. –Other general questions _______________________________________ What were you doing when the pain started? Did the pain begin immediately and how long have you had it? ________________________________________ Past history of back pain Sleep position and patterns, seated positions and postures Assessment of the Spine

25. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Observations –Body type –Postural alignments and asymmetries should be observed from all views –Assess ________ ___________ between anatomical landmarks Assessment of the Spine

26. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Postural Malalignments

27. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Palpation –Should be performed with athlete prone Head and neck should be slightly flexed, pillow under hips if suffering from low back pain –_________________________________ _________________________________ ___________________ –Muscles should also be palpated bilaterally Assessment of the Spine

28. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. Special Tests –Test for lumbar spine should be performed standing, sitting, supine, side-lying and prone –Assess levels of pain and motion restriction during the following tests _________________________ Assessment of the Spine

29. © 2005 The McGraw-Hill Companies, Inc. All rights reserved. –_____________________ Applies pressure to SI joint and may indicate problems with sciatic nerve, SI joint or lumbar spine