To say the spine is rather complex would be an understatement. This short informative excerpt will only scratch the surface of spinal function and the “rehabilitation” of dysfunction. Because of its multiplicity of joint structures (7 cervical, 12 thoracic, and 5 lumbar) stability can quickly become an issue with improper movement pat-terns. The spine attaches to the pelvis at the sacroiliac joints (which is often a location for low back pain due to either spinal or hip instability, or both) and is intricately involved with the shoulder and scapular joints. Dysfunction at any one of these joints will affect proper functioning at the others.
Anatomy of the Spine
The lumbar spine contains the largest joints of the spine to support the load of superior joints of the spine, compression from weight bearing activities, and the weight of the torso. Common dysfunction at the lumbar spine includes excessive extension due to an anterior pelvic tilt, and excessive lateral flexion due to an overactive quadratus lumborum. An overactive latissimus dorsi may also contribute to excessive lumbar extension through its pull at the thoracolumbar fascia when the shoulder rounds excessive-ly forward. The result is often a weakening of deep tissue spinal stabilizing musculature which includes the transverse abdominus, internal obliques, and multifidi of the spine. Basic exercises such as the drawing in maneuver, bracing and prone bridge may become very useful once overactive musculature receives proper attention.
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The thoracic spine, although not as mobile or as large in size as the lumbar, contains a greater number of joints, covers significantly more area of the axial skeleton, and plays a significant role in scapulothoracic stability or activity involving muscles at the scapula and thoracic spine. Continual sitting, improper gait or running form, or other activities which reinforce rounded forward and protracted shoulders and scapula will create weakness in the teres minor and infraspinatus (external rotators of the shoulder and muscles of the rotator cuff), rhomboids, lower and middle trapezius, and excessively tight thoracolumbar fascia. This creates a complex problem that will require more than just one or two isolated exercises, and must begin with efforts to extend the thoracic spine, and depress and retract the scapula.
Here is a review of spinal anatomy for fitness instructors and personal trainers.
The cervical spine is the most mobile area of the spine. The most common dysfunctions at the cervical spine are lateral flexion toward one shoulder, and a forward, or protracted head. The protracted head creates extension at the uppermost cervical vertebrae (C1 and C2) and flexion at the remaining 5 vertebrae. Such a position, it should not be surprising, comes from repeatedly poor posture while seated, standing, or during normal activities. The individual must learn to tuck their chin toward their neck and reinforce this during daily activities and positions that have created this pattern. As well, excessive time spent with shoulders forward and neck tilted to one side while performing activities such as carrying bags on one side of the body and talking on the phone, may draw the neck toward one side and elevate the shoulders. This results in tight and overactive upper trapezius muscles and levator scapulae. Time must be spent performing activities that do not place significant stress upon the cervical spine (movements that may exaggerate the forward head and elevated shoulder positions), support the cervical spine in its neutral position (when possible), and strengthen cervical flexors and stabilizers. Care must also be taken to keep the neck in a neutral or near neutral position while sleeping unless the individual can ensure equal time on each side. Unless there is a desire to wake up every half hour to turn over, sleeping on one’s back may be the best option.
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