Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain PDF
Preview Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain
SECONEDD ITION THE EUTIC EXERCISE FO LUMBOPELVIC STABILIZATION A MotoCro ntrAoplp roacfho rt he reatmeanntd P revention ofL ow BaPcaki n CAROLYN RICHARDSON PAULH ODGES JULIHEI DES ,/j)CHURCHIU lIVINGSTON� :u SECOND EDITION THERAPEUTIC EXERCISFEO R LUMBOPELVIC STABILIZATION A MotoCro ntrAoplp roafcohr theT reatmaenntdP revention ofL owB acPka in TherapeuEtxiecr cifsoerL umbopelvSitca biliza(tpiroenv iouesnltyi tlTehde rapeuEtxiecr cifsoer SpinaSle gmentSatla bilizaitnLi oownB ackP aini)sb asedo n thee videnfcreo mr esearch undertakbeynt hea uthorosv era numbero fy earTsh.e s ignificoafnt chee sfei ndintgost he treatmeanntd p reventioofln o wb ackp aina ren ow widelayc knowledgneodt,o nlya mong researchbeurtas l soa,n dp erhapmso rei mportantalmyo,n gp ractitiocnoenrcse rnweidt ht he managemenatn dp reventioofbn a ckp ainI.n t hinse w edititohne yh avet aketnh eo pportunity toe xtentdh es copoef t heb ookt oa ccommodatteh em ostr ecenetv idencweh,i chh ase merged sincteh ef iresdti tiwoans p ublishiend1 999. KeyF eatures • Writtebny t hreoef t hef oremosrets earchientr hse f ielodfm usculoskeldeytsaflu nction • Incorporathteev se rlya tersets earfcrho mk eyw orkerisnt hef ield • Demonstrattheesc linircealle vanocfet her esearfcihn dintgost hes tudenatn db usy practitioner • Presenat nse w, problem-solvingt oab papcrkpo aaicnah s sessmeanntd m anagemenbta sedo n thel ateusntd erstandoifnt gh ea natomyp,h ysioloangdyb iomehcanicisn volved • Suggesftust urdei rectifoonrcs l inimcaanla gemenatn df uturree search • Extensivielllyu strwaittehld i ndei agramasn dp hotographs. TherapeuEtxiecr cifsoerL umbopelvSitca bilizaptrieosne ntthse l ateisntf ormatoino n thmeu scle systemisn volviendt hep reventiaonndm anagemenotf m usculoskelpeatianal n dd ysfunicotn, andi ntroduac eusn iquaep proactho c linimcaanla gemenatn dp reventiboans edo n that researcIhti. sa ni mportabnoto ki nt hati tn oto nlyp resentthse e videnbcuet a lsgoi vepsr actical guidancoen how thef indinmgasy b ea pplieidne veryday practiTchee.f iresdti tiwoans w idelwye lcomeadn d / Thipsr oducitsa pproprifaotre. acc,laimbeydr esearchaenrdsc linicailainksTe h.i nse w • manuatlh erapy editiwoinl clo ntintuoep rovidaen i ndispensparbalcet ical referenscoeu rcfeo ra ltlh osweo rkinign t hef ielodf • physiotherapy musculoskeleptaailna ndd ysfunction. • chiropractic • osteopathy • orthopaedics /�\ �� • paimna nagement CHURCHILL LIVINGSTONE • primarcya re :u An imprionftE lseviLetrd ISB0N- 443-07293-0 Visiotu rw ebsite for II r additioonuatls tanding products ELSEVIERw ww.elsevierh.ceoaml th 9 780443 72923 TherapeuEtxiecr cfiosre LumbopelSvtiacb ilization ForC hurchLiilvlgi snione: Commissigo EndiintoMra:lY Law/ SaxeWnoal faard ProjeDcetv elopmMeanntag erM:a irMic Cubbin ProjecMta nagerS:a manthRao ss Dec;gin:J uditWhr ight Therpaetci Exercise u forL umbopelvic Stabilization A MotoCro ntrAoplp roafcohr t he TreatmeanntdP reventoifLo onw BaPcaki n SECONEDD ITION CarolRyinc hardsBPohnt y(PHhoDn s) Associate ParnodfR eesasdoeDrr,i visoifoP nh ysiotheSrcohpoy,oo lfH ealtahn dR ehabilitSactiieonnc e, UniverosfiQ tuye enslaBnrdi,s baAnues,t ralia Pau I HWo.d geBsP hty(MHDo(nNse)u rPohsDc i) NHMRCS eniRoers earFcehl laonwd A ssociPartoef esDsiovr,i soifoP nh ysiotherapy,o fHS ecahlotaohnl d RehabilitatioUnn SicvieeronsfciQ etuy,e ensland, Brisbane, Australia JuliHei deBsP hMtPyh tyPShtD CliniScuaple rviTshoeUr, n iverosfiQ tuye ensl/MaantdeHro spiBtaaclSk t abilCiltiynB irci,s baAnues,t ralia Thibso okh asb eene ndorsbeydt heM ACP ma MANIPULATION ASSOCIATOIFO N aD CHARTERED PHYSIOTHERAPISTS /�\ ""�" CHURCHILL LIVINGSTONE - EDINBURGHL ONDON NEW YORK OXFORDP HILADELPHSITAL OUISS YDNEYT ORONTO2 004 CHURCHILLL IVINGSTONE An impriontfE lseviLeirm itde f)Ha rcouBrrta caen dC ompanyL imite1d9 89 �)H arcourtP ublisLhimeirtsed 1 999 G�E)ls eviLeirm ite2d0 04A.l lr gihtsr eserved. Ther igohftC a rolyn RichardsPoanu,lH odgesa ndJ uliHei dets ob ei dentifaise d authorso ft hiwso rkha sb een assebrytt heedm ina ccordanwciet hth e Copyright, Designasn dP ateAnctts1 988 No pMto fth isp ublicatmiaoyn b er eproducsetdo,r eidna retrevials ysteom,r transmititnae ndy f ormo rb ya nym eanse,l ectrmoenchiacnci,al , photopcyoing, recordingo ro therwwiistheou,t e ithtehre p rirop ermiiosns oft hep ublishoerra s licenpceer mittriensgt riccotpeydi ngi nt hUen itKeidng dom issuebdy the CopyrightL icensiAngge ncy90, T ottenhCaomu rRto adL,o ndon WIT4 LP. Permissimoanysb es oughtd irectflryo mE lsevieHre'asl tShc iencReisg hst Departmine Pnhti ladelpUhSiAap:,h one(:+ 12)1 52 387 86f9a,x : 2(1+.2153) 82 2 39, e-maihle:a lthperm.issions@elseYvoiuem ra.yca olms.coo mplete yourr equest on-lviian teh Eel sevhiomeerpa ge( http://wewlws.evier.com). bys electing' CustomSeurp poratn' dt hen'O btaining Permissions'. Firsedti tion 1999 Seconedd it2i0o0n4 [SB0N4 430 72903 BritiLsihb rarCya taloguiinnPg u blicatDiaotna A cataloguer ecorfdo trh ibso oki sav ailbale fromt heB ritiLsihb rary LibraorfyC ongresCsa talogiinnPg u blication Data A catalorge corfdo rt hiboso k isav ailafblreo tmh eL ibraorfy oCngress Notice Knowledeg andb esptr acticei nth isf ieladr ec onstancthlanyg ingA.s n ew researacnhd e xperiebnrcoaed en ourk nowledgceh,a ngeisnp r actcie,t reatment andd rug therapmya yb ecomen ecessaorrya ppropriRaetaed.e sra re advised to chectk hmeo stc urreinJfotlrm at iopnr ovide(dio )np rocedurse featuroerd( ub)y them anufactuorfee ra chpr oductt ob ea dministerteodv ,e rify ther ecommended dose orf ormultah,em ethoda ndd uratioonf a dministratanido cno,nt raindica tion[st.i st her esponsiboiflt ihtepy r actitiroenyleirn,go nt heiorw n experience andk nowledgoeft hep atient, tom aked iagnosteosd ,et ermine dosageasn dt he besttr eatmenfto re achi ndividpuaatli eanntd, t ot akael alp proprisaatfetye precautiToont sh.e f ulleesxtt eonftt hel awn,e ithtehreP ublisnhoertrh e a uthor 110rt heM ACPa ssumaen yli abiltiy foarn yi njuarnyd /odra mage. TheP ublisher yours ourcfeo rb ooks, journaalnsd m ultimedia The int heh ealtshc iences Publish.r"s poliics1y 0u se www .elsevierhealth.com papemra nufachJred trosmu stainfaobrlees ts I PrintiednC hina v Contents Preface VII 6.T her oloef w eightbeaarnidnn go n Acknowledgements ix weightbeamruisncgl e9s3 CarolRyinc hardson SECITON 1 Introduction SECTIO3N Impairmeinntt h ej oint --_ ......... _--= protectmieocnh anismcso:n cepts 103 1.T het imet om ovef orwar3d CarolRyinc hardson 7.T hed el oamdo deolf i njur1y0 5 CarolRyinc hardson SECTIO2N Thej oinptr otection 8.J oinitn jur1y1 9 mechanisms 9 JuliHei des 9. Paimno dels1 29 PART1 Introduction 11 PauHlo dges 2.L umbopelvic sat faubnicltiitoymn:oa dle olf t he biomechanaincdms o torc ontro1l3 SECTIO4N Impairmeinntt sh ej oint PauHlo dges protectmieocnh anisimnsl ow backp ain 139 PART2 Specijfoiicn ptr otectoifot nh e 10.A bdominmaelc haniisnml owb ackp ain1 41 spinsaelg ments 29 PauHlo dges 3.A bdominmaelc haniasnmd s uppoorftt he 11.P araspimneaclh aniisnml owb ackp ain1 49 lumbasrp inaen dp elvi3s1 JulHiied es PauHlo dges 12.I mpairmeinntm su sclceosn trolpleilnvgi c 4.P araspimneaclh aniasnmd s uppoorftt he orientaatnidow ne ightbear1i6n3g lumbasrp ine5 9 CarolRyinc hardson JulHiied es SECTI.O5N Treatmeanntd p revention PART3 Thea ntigramvuistcyl seu pport ofl owb ackp ain 173 system 75 5.S tiffnoefst sh el umbopelrveigci ofno r 13.P rinciopflt ehse' segmensttaalb ilization' loatdr ansf7e7r exercimsoed el 175 CarolRyinc hardasnodJn u lHiied es Caronl RyichardJsuolniH,ei deasn dP auHlo dges 14.L ocasle gmentcaoln tro1l8 5 JulHiied eCsa,r olRyinc hardasnodnP auHlo dges 15.C losecdh aisne gmentcaoln tro2l2 1 CarolRyinc hardasnodJn u liHeid es 16.O penc haisne gmentcaoln traonld p rogression intfou nctio2n3 3 Carolyn RichaanrdJd usloiHnei des Referenc2e4s7 Index2 65 vii Preface Overt hep asdte cadaem ajofro cuosfr ehabilitatCiloinn ical studailessco o hnalvier mtehdep resence hast urnedt oe xerctiosi em provteh es tabiolfitt hye ofm uscldey sfunctiinovnosl vintgh ed eepm uscle lumbasrp inea ndp elviTsh.e raer ea v arieotfcy l in systeinm pelvipca ins yndromeOst.h edre velop icaaln dr esearocphi nioinn st hiasr eaan dm any mentinsc ludger eatuenrd erstandoiftn hgem ech methodhsa veb ecompeo pulairnb otht hec linicaaln ismfso rc ontraonld c oordinaotfit ohnis sy stem arenaan df itneisnsd ustTrhyi.bs o okp rovidaens andt hee ffecotfus n loadianngd,p aina ndi njury. overvioefwo uri nterpretoaftt hieof ni eblads eodn Ourr ecenrte searicnhv olvinmgi crogravity envi ourr esearacnhd c linical prWhaiclteit chee.f irstr onmenitssp roviditnhgeo pportuntiote yva luate editiopnr ovideadn introdunc titoo our new thee ffecotfes x tremeen vironmetnhtasat r el ikely modelosf e xerciasnedt hes tatoefkn owledgea t toh avea ni mpacotn functioennavli ronmeonnt s thatitm e,t hisse conedd itiporno vidaen su pdated EarthAn. additionaarle at hati sc ontinuitnog view thaintt egrattehesb urgeoningr esearinc thh is expanids in thea ssessmeonfmt u sclceo ntrino l fiealndd t hec liniacdavla nces. lumbopelvpiaci nIn. thifise ldw e havem ade Inr elatitootn h erapeuetxiecr ciins leo wb ack majoard vanciensn on-invasimveet hodtso a ssess painw,e belietvhea tth ef ocuosf e xerciisnet erthissy stem. ventiobnys physiotheraapnids ottsh ehre alth Asr esearpchhy siotherainp tihseat rse oaf t hera professiosnhaoluslb de d esignteode stabltihseh peuteixce rcfiosrle o wb acpka iwne havec hosetno optimuimn teracotfim ouns clense cessatrocy o n investigina tthee,f irinsstt ancet,h en europhysio troaln dp rotetchtej ointdsu,r intgh ep erformancel ogicmaelc hanismsin volvedin joinptr otection ofa greavta rioeftyf u nctiobnoadlym ovements. ofth e lumbo-pelrveigci oann dth e dysfunctions In ourf iresdti tiwoen f,o cusoendt hes ysteomf whichc ano ccuErv.e nt hougmhan y oft hei deas deepm uscletsh aotu rr esearacnhd c liniecvail andh ypothesesp resentheadv en oty etu ndergone dences uggesatr ev itainl c ontrooflt hel umbar rigorosucsi entisfcircu tinwye, f eetlh awte havea n segmenttsh:em ultifitdruasn,s verasbudso minis,o bligatini ao tne xbto oko nt herapeuetixce rcitsoe diaphragamnd t hep elvifcl oomru scleSso.h ow providdeet aiolfts h en eww ayst oa pproaechx er haso urr esearpcrho gresosevdet rh el as5t y ears? cisper escripatswi eolnal s p rovidihnygp othefsoers Severkaely a spechtasv ep rogressFeodri. n stancew hy certaeinx ercitseec hniqtureasd itiounsaeldl y longt ermf ollow-duapt an ow indicattehsa tth e byp hysiotheraarpeil sitkset loyb ev ereyf fective. interventdieosncsr ibine thde firesdti tiloend t o Thust her esearfcinhd ingsp luasr guehdy pothe reductioofln o wb ackp ain recurrernactee Osu.r sesin thitse xhta veb eenu sedt og ivseo mei nsight biomechansitcuadli heasv ec onfirmtehdei mportinttoh erapeeuxteircc tiescehn iquwehsi cahr el ikye l antc ontribuotfit ohned eepm uscle sytsotc eomn tob ee ffectainvdea lstoo d evelonpo n-invasive troolfn otj ustth el umbasrp in,be uta lstoh ep elvis.m easurewshi ch wilrle flectth ep roblemins the viiiP REFACE musculoskelseytsatle inm relatitoojn o inptr otecusingt herapeuetxiecr ciassae p reventamteiavse tionTh.e principlperse sentceadnb ea ppliteoda ny urea ndt op romotae c hange inl iesftyle,n oto nly regioonft heb ody. asa treatmenta fteprr oblemhsa veo ccurrTehdi.s Oneo ft hem aina imso fo urp asats w ella so ur isa m ajrof ocufso rou ro ngoing work. futurree searicsht od emonstratthea tt hep re We hopet hayto uf indr eadintgh es econedd ition scribetdh erapeuetxiecr cisaerse r esultinign oft hitse xtbotohko ughptr ovokinagn de njoyable. improvemeinn tt hej oinptr otectsiyosnt emasn,d We aree xcittehda tth ew orkc ontinuetso e volve henced emonstratthea cth angesin thesem echa andg rowin new directiWoen hso.p et hatth ibso ok nismasr ec loselliyn ketdot her esolutainodne ven wilble u seftuolc linicisatundse,n tansd researchers preventoifop na infsuylm ptomsA.s a finanlo te, alikea,n d may stimulanteew ideawsh ichw ill we alswoo uldl ikteoe mphasitzhee i mportanocfe ultimatheellytp h oswei th lumbopelpvaiicn .
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