Different Muscles, Different Roles

Bergmark, A. Stability of the lumbar spine: A study in mechanical engineering. Acta Orthop Scand 1989;60:Suppl.230 In this mechanical engineering dissertation, Bergmark differentiates the concept that certain muscles surrounding the lumbar spine play different roles. In physical therapy lingo, we call the larger muscles, that we tend to exercise at the gym, as ‘global’ muscles..while the smaller muscles that connect more vertebrae to vertebra as ‘local’ muscles. ‘Global’ muscles such as the rectus abdominis, external obliques, and latissmus dorsi are more designed for force production, movement and torque. While the ‘local’ muscles such as the lumbar multifidus, primarily the deep multifidus that attach 1-2 vertebrae are designed for intersegmental spinal stability. In daily function we need an interplay between ‘global’…

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Increased Spending on Low Back Pain

Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA 2008;299(6):656-664. In this article, this study examined national expenditures for back and neck problems or related trends from 1997 to 2005. In 1997, the mean medical expenditures with spine problems was $4695 compared with $2731 among those without spine problems. In 2005, the mean medical expenditures with spine problems was $6096, compared with $3516 among those without spine problems. And total estimated expenditures among those with spine problems increased 65% in this time, without significant reports in improvements in health status measures. Although expenditures for outpatient visits accounted for the largest proportion of total cost, the greatest relative increase among…

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Cervicogenic Headache Treatment

Jull GA, Trott P, Potter, H, et al. A Randomized Controlled Trial of Exercise and Manipulative Therapy for Cervicogenic Headache. Spine 2002;27(17):1835-1843. This randomized controlled trial is a great resource for the treatment of cervicogenic headaches. This study demonstrated that patients with cervicogenic headaches had signicificantly reduced headaches after 12 month follow-ups with the use of manual therapy and specific exercises when compared to a control group that resumed normal activity. Specific exercise consisted mainly of activating the longus colli or deep neck flexors. 10% more patients gained relief with combined manual therapies and exercise regimens than compared to isolated treatment techniques. In further blog entries, we will explore the role of the longus colli and other cervico-scapular muscles for…

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Hamstring Injuries

In, Hoskins W, Pollard H. Hamstring injury management – Part 1: Issues in diagnosis. Manual Therapy 2005;10:96-107, the authors provide a research review of the possible factors in hamstring injury. Muscle strength and balance: Various studies have found different ratios in quadriceps and hamstring strength ratios, which could be dependent on the specific sport. Warm up: There is a lack of literature existing to identify best warm-up procedures Fatigue: The authors showed that fatigue is a factor as the incidence of hamstring injuries occurred greatest at the end of a games or matches (Woods 2004). Flexibility: There is conflicting evidence on the relationship of hamstring flexibility and injury. Body Mechanics: The authors found that poor lumbo-pelvic mechanics can indirectly cause…

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Motion Stability