Eval Chapter 15

Chapter 15: Exercise Prescription for Flexibility and Neuromotor Fitness

Author: Frica M. Taylor

Outline of Key Topics

• The Lumbar Spine

• Spinal Curvature: Functional and Structural

• Mechanics of the Spine and Hip Joint

• Core Stability

• Recommendations for Stretching

• Recommendations for Neuromotor Fitness Activities

The Lumbar Spine

• Motion Segment:

  • Composed of two vertebrae and their intervening intervertebral disc.

  • Facet Joint: Junction of the superior and inferior articular processes; controls movement direction and magnitude.

  • Ligaments:

    • Provide reinforcement and support; all ligaments contain pain receptors, meaning sprains can indicate potential back problems.

• Intervertebral Discs:

  • Functions include allowing flexibility and acting as shock absorbers.

  • Avascular: Discs absorb fluid, becoming tighter during sleep which can lead to morning back injuries.

Spinal Curves

• Lordotic Curves (concave): Cervical and lumbar regions.

• Kyphotic Curves (convex): Thoracic region.

• The Neutral Spine:

  • A balance of curves helps cushion compressive forces on discs.

• Scoliosis: A lateral curvature that may affect spinal functionality.

Functional and Structural Curves

• Functional Curves:

  • Can be altered by changing posture (temporary).

• Structural Curves:

  • Fixed and not easily changed; may develop from long-term poor posture leading to increased difficulty achieving an ideal spine position.

Stabilizing Systems of the Spine

• Passive Stabilization:

  • Involves bony structures, ligaments, joint capsules, discs.

• Active Stabilization:

  • Involves muscles and tendons, requiring neural control.

  • Coordination between systems is essential for spinal stability.

Mechanics of the Spine and Hip Joint

• Pelvic Position: Critical for maintaining spinal integrity.

• Muscular Tightness:

  • Tight hip joint muscles can impair abdominal core control of pelvic alignment.

• Ideal Pelvic and Spinal Position: Optimal alignment facilitates daily activities and exercise.

• Weak core muscles and poor hip flexibility frequently lead to low back pain.

Common Causes of Low Back Problems

• In adults: Often due to repetitive motion injuries causing damage to muscles, nerves, ligaments, and tendons.

• In children: Typically caused by muscle sprains and strains.

Core Stability (CS)

• Definition: Stability provided by trunk musculature; enhances performance and prevents low-back pain.

• Purpose: Control forces to protect spinal structures and achieve functional stability without excessive spinal load.

Trunk Muscles Involved in Core Stability

• Local Muscles: Deeper muscles providing segmental support (e.g., Transverse abdominis, Multifidus).

• Global Muscles: Superficial muscles that respond to loads (e.g., Rectus abdominis, Erector spinae).

• Local and Global Muscle Table (Table 15.1):

  • Local Muscles: Transversus abdominis, Internal oblique.

  • Global Muscles: Rectus abdominis, Erector spinae, etc.

Exercises for Core Stability

• Start with deep abdominal recruitment exercises before introducing global musculature.

• Recommended Exercises:

  • Trunk curl, Dead bug, Side bridge (plank), Bird dog.

• Stabilization Exercises: Both local stabilizers and global muscles should be engaged on unstable bases (e.g., Swiss ball).

Exercises Not Recommended for Core Stability

• Supine bilateral straight-leg raise, bent-leg raise, hanging bent-leg raise, static cross-knee curl-up.

  • These exercises can stress the lumbar discs due to psoas muscle engagement.

ACSM Flexibility Guidelines

• Frequency: Flexibility exercises should be performed 2-3 days/week.

• Duration: Each stretch should last 10-30 seconds, repeated 2-4 times for a total of 60 seconds.

• Older Adults: Should hold stretches for 30-60 seconds.

• Guidelines: Avoid stretching to pain, warm-up is essential, and typical stretches that can lead to injury should be avoided.

Stretching Techniques

• Types:

  • Static stretching, Active, Passive, Ballistic, Dynamic, and Proprioceptive neuromuscular facilitation (PNF).

• General Recommendation: A flexibility program should target all major muscle groups and avoid painful positions.

Exercises for Neuromotor Fitness

• Focus on balance, agility, and proprioception; intended to reduce fall risk in older adults.

• Frequency: Should be performed 2-3 days/week for 20-30 minutes.

Progression for Neuromotor Fitness

• Techniques to increase difficulty include:

  • Reducing the base of support, decreasing sensory input, disrupting the center of gravity.

Alternative Training Approaches

• Suggested methodologies include Pilates, Yoga, Tai Chi, and aquatic training.

Causes of Low Back Problems

In Adults: Often due to repetitive motion injuries that cause damage to muscles, nerves, ligaments, and tendons.

In Children: Typically caused by muscle sprains and strains.

Core Stability Muscles

• Global Muscles: These are superficial muscles that respond to loads, including:

  • Rectus abdominis

  • Erector spinae

• Local Muscles: These are deeper muscles providing segmental support, including:

  • Transverse abdominis

  • Multifidus

Definition:

• "Global" muscles are larger muscles that produce movement and stability for larger ranges of motion, while "local" muscles provide stability and control in smaller segments.

Primary Causes of Disc Injuries

• Disc injuries can occur due to excessive load, awkward movements, or repetitive strain that compromise the integrity of the intervertebral discs.

Curves of the Back

• Three Main Curves:

  • Lordotic Curves: Concave (Cervical and Lumbar regions)

  • Kyphotic Curves: Convex (Thoracic region)

  • Scoliosis: A lateral curvature affecting spinal functionality.

Structural vs Functional Curves

• Functional Curves: Can be altered by changing posture (temporary).

• Structural Curves: Fixed and not easily changed; they may develop from long-term poor posture, leading to difficulties in achieving an ideal spine position.