Paul Thawley

BSc (Hons) MSc (sports med) Pg Dip

Team GB Physiotherapist, Honorary clinical fellow, UCL

The Spine, Dynamic control and Back pain

Spinal Stability

• Anatomy, Joint shapes and congruency

• Passive, stability ligaments

• Active stability

• Tensegrity

• Time in tension

• Common patterns of back pain And first aid

The Normal spine Huge variation in anatomy between individuals

What is the anatomy of the Spine?

Differing pelvic positions, all normal!

These are postures and pelvic position can create problems, although normal

What is pelvic neutral, why is it important

Common problems

The internal support system

Transverse abdominus

It’s a circle around the lumbar spine

Inner stability!

Its limited in what it can do due to its attachment

Schematic view of muscles and control

Tensegrity

Very clever concept; restricted hamstrings can change pelvic attitude!

Restricted hip flexors put pressure on low back

Tensegrity

We’ve Heard So Much of the ‘CORE’, What About the ‘SLINGS’?

GOBAL MUSCLES

SLINGS:

All planes of movement provides support and power in ballistic / active movement

Core stability alone is too simplistic a concept

In Normal running gait how is the spine effected by the following

Weak gluts

Over active / weak adductors

Tight hamstrings

Poor quads

Tight calf's

Importance of Gluteus medius and adductor groups

New Concepts in Stability and control related to function

Think of elite athletes and progressive research as F1 to family car development

• Supine core exs? Translation to daily function asp, as they have v low level carry over to anti gravity postures.

• Must be challenging and adopt the SAID principle, but must be set at appropriate level of control

• Must involve slings and anti rotation control

• What about time in tension as a pose to sets and reps?

Trunk Stiffness Advanced Pelvic ControlTrunk Stiffness Advanced Pelvic Control

Sumo squats 8 x 30secs Holds

Core tight Sitting pushing through heels. Turnout feet to increase adductor work

Abs long arms draw in with Abs Level pelvis 4 x 5reps of 15 secs. Also Diagonals

Tuck hold in position 3 x 3 at 20secs control!

Hold 15 secs x 10

Flat low back +++ ! Hold 30 secs x 10 reps

Spiderman / walk back and forward alt arms and leg. Coffee table ! 6 x 30 secs work

IF YOU GET TIRED AND LOOSE FORM STOP AND REST. FORM IS EVERYTHING!

Common spinal problems and first aidFacet likes movement

Disc ? Leg pain movement pain

Ligaments

Muscle spasm

RX

Active rest

No NSAID for 48hrs

Seek advise if symptoms are not settling in 48 – 72 hours

Culture and psychology of LBP, all sensation is perceived as pain why?