Professional Documents
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ABDOMINUS
SUPPORT OF ABDOMINAL CONTENTS VIA
CIRCUMFERENTIAL ARRANGEMENT
BILATERAL CONTRACTION CAUSES DRAWING
IN OF ABDOMINAL WALL
CAN WORK WITH MULTIFIDUS VIA TENSION OF
THORACOLUMBAR FASCIA
CONTRIBUTES TO BOTH SUPPORTING AND
TORQUE ROLES
MULTIFIDUS
Multifidus
FUNCTION (MULTIFIDUS)
Provides control of shearing forces of intervertebral
motion segments
Unique segmental arrangement of multifidus suggests
capacity for fine control of movement
Control anterior rotation translation in trunk flexion
Continuously active in upright posture compared with
recumbency
Provides anti gravity support
Active in both ipsilateral and controlateral trunk rotation
Stabiliser rather than prime mover
Gluteal Stabilizers
Psoas
Closed chain vs. open chain
Hip Musculature
functioning
Works with erector spinae,
multifidus & deep abdominal
wall
Works to balance anterior shear
forces of lumbar spine
Gluteus maximus
Hip extension & external rotation
during OKC, concentrically
Eccentrically hip flexion &
internal rotation
Decelerates tibial internal
rotation with TFL
Stabilizes SI joint
Faulty firing results in decreased
pelvic stability & neuromuscular
control
Hamstrings
Concentrically flex the knee, extend the hip & rotate the
tibia
Eccentrically decelerate knee extension, hip flexion &
tibial rotation
Work synergistically with the ACL to stabilize tibial
translation
Spinal stabilization
Must effectively utilize strength, power, neuromuscular control &
endurance of the “prime movers”
Weak core = decreased force production & efficiency
Protective mechanism for the spine
Facilitates balanced muscular functioning of the entire kinetic chain
Enhances neuromuscular control to provide a more efficient body
positioning
Postural Considerations
Core functions to maintain postural alignment &
dynamic postural equilibrium
Optimal alignment = optimal functional training and
rehabilitation
Integrated proprioceptively
enriched multi-directional
movement controlled by
an efficient
neuromuscular system
PROPRIOCEPTION
The Theories
“MUSCLE PAIN SYNDROMES ARE
SELDOM CAUSED BY ISOLATED
PRECITATING FACTORS AND
EVENTS BUT ARE THE
CONSEQUENCES OF HABITUAL
IMBALANCES IN THE MOVEMENT
SYSTEM” (Sahrmann 1993)
REPEATED MOVEMENTS
SUSTAINED POSTURES
ALTERS MUSCLE LENGTH
ALTERS STRENGTH
ALTERS STIFFNESS
ALTERS FLEXIBILITY
ALTERS CARTILAGE AND BONE
STRUCTURE – BY OVERLOADING AT
COMPENSATORY SITES OF MOVEMENT
PAIN
POSTURAL MUSCULAR
DYSFUNCTION DYSFUNCTION
STRUCTURAL/SEGMENTAL
DYSFUNCTION
POSTURE AND PAIN
Poor posture can lead to increased stress on the
stabilising system of the joints (Chek P 1999)
Multifidus dysfunction occurs after first
episode acute unilateral LBP (Hides et al 1994)
Multifidus dysfunction does not spontaneously
restore following resolution of pain and
disability (Hides et al 1996)
Specific retraining does restore dysfunction
(Hides et al 1996)
TrA contraction is delayed during normal
movements in subjects with low back pain
(Richardson et al 1999)
Mulifidus function can be affected by spinal
surgery
Atrophy of multifidus has been shown to be
more prevalent in post operative patients
(Jull, et al 1999)
Sherington’s Law of Reciprocal
Inhibition: