PT521 Lumbar Spine Biomechanics and Manual Therapy

30-35º

typical lordotic angle in the cervical spine

40º

typical kyphotic angle in the thoracic spine

45º

typical lordotic angle in the lumbar spine

rotation

What motion is limited the most in the lumbar spine?

anterior longitudinal ligament

widest ligament in the lumbar spine

posterior longitudinal ligament

spinal ligament 1/2 to 1/4 the size of the anterior longitudinal ligament

posterior

in which direction is a herniated disc more likely?

ligamentum flavum

connects the laminae of adjacent vertebrae

facet capsulary ligament

encloses the articulating joints of the spine; often another area of inflammation in the spine

supraspinous ligament

Connects tips of spinous processes (C7 to sacrum)

anterior, superior

in lumbar flexion, the inferior articular facet of superior vertebra slides ____________ and _____________ relative to superior articular facets of the inferior vertebra

opens

does the IVF open or close with lumbar flexion?

reversal of lumbar lordosis

what should happen to the lumbar spine in. mutli-segmental flexion?

away from facets, toward discs and posterior spinal ligament

Shift of forces in the lumbar spine during lumbar flexion

inferior, posterior

in lumbar extension, the inferior articular facet of the superior vertebra slides ______________ and ______________ relative to superior articular facets of the inferior vertebra

close

does the IVF open or close in lumbar extension?

facet joints

where does the load shift in lumbar extension?

anteriorly, tension on anterior longitudinal ligament

in what direction does the nucleus pulposus migrate toward in lumbar extension?

1: contralateral

2: ipsilateral

during lumbar rotation, the inferior articular facet compresses against the superior facet on the (1)_________________ side and gaps on the (2) _________________ side

posterior, inferior

during lumbar sidebending, the inferior facets slide ______________ and _____________ on the same side that the lumbar side bending is occuring.

superior, anterior

during lumbar sidebending, the inferior facets slide ______________ and _____________ on the opposite side that the lumbar side bending is occuring.

width of thumb

what can you compare the size of a lumbar spinous process to?

PPIVM

passive physiological intervertebral movements; vertebral segment passively moved through its available range of flexion and rotation

lower lumbar spine (L4-S1) (good for SIJD)

the general lumbosacral manipulation is best used for hypomobility where?

upper lumbar spine (L1-L2)

the sidelying neutral gapping manipulation is best used for hypomobility where?

log roll

key component of the sidelying neutral gapping manipulation

belly button to belly button

where do you align your body for sidelying neutral gapping manipulation

2 rounds of 6

how many sets and reps are recommended for movement with mobilization for extension

lumbar flexion snag

Manual therapy technique to improve lumbar flexion, involving a belt around the ASIS

posterior tilt

what position does the lumbar flexion snag put your pelvis in

higher

when doing manual lumbar traction with a belt, the lower the belt is on YOU (the PT), the __________ the patient will feel the stretch in their lumbar spine

30 sec holds, 10 sec relax

how long should you hold a lumbar traction with a belt?