Function of the anterior column vs the posterior column in the lumbar spine
Anterior: weightbearing
Posterior: guiding motion
LE myotomes
2: hip flexion
3: knee extension
4: DF
5: big toe extension
S1: eversion
S2: PF or knee flexion
Lower Crossed Syndrome muscles
Tight: iliopsoas, TFL, rec fem, adductors, erector spinae
Weak: abs and glute max
Orientation of cervical, thoracic and lumbar facets
C: 45 degrees
T: 60 degrees
L: 90 degrees
For palpation what spinal level is PSIS, last rib and iliac crest lining up with
PSIS: S2
Last rib: T12
Iliac crest: L4
Decide if this is a tonic or phasic muscle:
Piriformis, glutes, abdominals, QL
Glutes and abs: phasic
Anterior innominate rotation: what does the short arm and long arm of the innominate do?
Short arm glides inferior on short arm of sacrum
Long arm glides posterior on long arm of sacrum
Sahrmann Levels: tell em
2: single leg sliding on table
3: double leg sliding on table
4: single leg out without touching table
5: double leg out without touching table
Central Sensitization: increased ____, decreased _____
excitation, inhibition
Pubococcygeus: Origin, insertion and actions
O: posterior surface of pubis and anterior obturator fascia
I: coccyx and distal sacrum
A: supports pelvic viscera, sacral counternutation
Explain the difference between SLR and crossed SLR, then what is normal, referred, HS or neurodynamic findings with SLR
30-70 degrees: neurodynamic or HS (differentiate with head movement)
above 70: likely referred
0-30: should feel nothing
Postures that are at risk for lumbar extension movement fault
short, pregnant or large belly, APT, sitting at edge of chair
Do some math:
BW: 100 lbs, Sacral angle: 30 degrees
What is the normal force and anterior shear?
Normal force: 100 lbsxcos(30) = 86.6 lbs
Anterior shear: 100 lbs x sin(30) = 50 lbs
CPR for lumbar manipulation for acute LBP
Pain does not go below the knee
Onset < 16 days ago
Lumbar hypomobility
Either hip has >35 degrees of IR
FABQ work subscale score <19
Order these for what is the first priority to last:
Motor function, ROM and muscle length, pain, posture, functional movements
Pain, posture, ROM and muscle length, motor function, functional movements