Downloaded 14 times
Uploaded byProf. Satyen Bhattacharyya
Exercise Prescription for Low Back Pain
The document discusses the prevalence of lower back pain (LBP) and outlines a four-phase rehabilitation approach including treating the cause, focusing on range of motion (ROM), strengthening muscles, and prescribing exercises. It highlights the importance of proper assessment and tailored exercise selection based on pain characteristics and biomechanics. Additionally, it elaborates on essential muscle groups and various aerobic and flexibility activities to support recovery.
More Related Content
Similar to Exercise Prescription for Low Back Pain
More from Prof. Satyen Bhattacharyya
Exercise Prescription for Low Back Pain
- 1. Prof. Satyen Bhattacharyya AssociateProfessor : BIMLS, Bardhaman 8348050005 www.fitofine.org fitofine fitofine Exercise Prescription for LBP
- 2. Prevalence • Other neckrelated problems are with prevalence of 48% in lifetime and yearly of 23% to 39%. • 50-80% of adult population experiences back pain in lifetime and 40% of them has back pain in any one year.
- 3. Normal individuals • Discbulge : 50% - 66% • Disc herniation : 30% • Degenerative changes : up to 90%
- 4. Layout of LBPrehabilitation • Treat the cause (phase 1) • Focus on ROM (phase 2) • Train the Muscles (group wise) (phase 3) • Prescribe Exercise with activities (phase 4)
- 5.
- 6. • Exercise • Manualtherapy • Other adjunct
- 7. Which exercise to choose& how to choose? Assessment Response to Range of motion Location of pain
- 8. choose your treatmentaccording to that With proper knowledge in BIOMECHANICS Go by
- 9. Assessing and Decisionmaking • PAIN is your fiend • Nature of pain will describe about pathology • Types of Pain by origin – by receptors- local(intact outer annulus fibrosus) referred (herniated disc) thermal radicular (herniated disc) chemical (organ ref. pain) central (intact outer annulus fibrosus) mechanical(structural changes/positional fault etc)
- 10. Assessment is the KEY Symptomatic changes Mechanical changes •Site • Constant/intermittent • Severity • Paresthesia • Numbers of analgesic intake • Pain on movement • ADL • ROM • Deformity • Movement deviation • Movement quality • Curve reversal • Functional loss
- 11.
- 12.
- 13. Exercise to beperform in • Sagittal plane: Flexion – Extension • Transverse plane: Rotational component • Frontal plane: Side flexion
- 14. Several House ofthoughts or confusion? • Which one to select? • Should we assess first? • Should we apply only one house of thoughts? • Or we should combine and deliver? • Hippocrates (460 BC – 370 BC) • Cato, Galen • Bone setter • Hutton’s manipulation • D.D.Palmer, B.J.Palmer • A.G.Timbrell Fisher • James Cyriax • John Mennel • F.M.Kaltenborn • G. Maitland • R. McKenzie • B.R.Mulligan MANUAL THERAPY
- 15. Mobilization Therapist overpressure Patient overpressure Patient generated Manipulation Totally Independent 70% Totally Dependent 25% to 28% Canapply Mulligan, Maitland, Chiropathy McKenzie is the best option here 1% to 3%
- 16. Patient generated & Patient overpressure Canbe done in Saggital plane: Flexion – Extension Transverse plane: Rotational component Frontal plane: Side flexion Combined plane movement
- 17. Therapist overpressure & Mobilization Different house ofthoughts Different force, level, angle of pressure End range overpressure Different technique of mobilization
- 18.
- 19. Push to eachROM • Rotation • Side flexion • Flexion • Extension • Combined movement
- 20.
- 21. VOMIT Victim of MedicalImaging Technology • 85% nonspecific Pain • Less than 5% required scan
- 22.
- 23.
- 24.
- 25. Muscle (group wise) Core muscle Glutes Thighmuscle (all compartment) Postural muscle
- 26. CORE MUSCLE 1st tostrengthen • Traverse abdominis • Internal and external obliques • Rectus abdominis • Multifidus and erector spinae
- 27. Transverse abdominis • With otherabdominal muscles, TrA helps to maintain abdominal tension and support abdominal viscera, increase intraabdominal pressure that is helpful in forceful expiration, coughing, defecation. • It's an important core muscle that supports lumbopelvic during our movement. • Unilateral action: ipsilateral trunk rotation
- 28.
- 29. External oblique • Bilateral contractionof EO along with rectus abdominis and internal oblique flexes the trunk by drawing the pubis towards the xiphoid. • Unilateral action: ipsilateral side flexion and contralateral trunk rotation • External abdominal oblique muscle with other abdominal muscles helps to maintain abdominal tension and support abdominal viscera, increase intraabdominal pressure that is helpful in forceful expiration, coughing, defecation.
- 30.
- 31. Internal oblique • Internal abdominaloblique flexes the trunk when bilaterally contracted and lateral flexion upon unilateral contraction, compression causes increase in the intraabdominal pressure
- 32.
- 33. Rectus abdominis • The mainaction for rectus abdominis is flexion of the trunk (flexion of thoracic and lumber spine), while it works by drawing symphysis and Sternum toward each other. • Also, it works on posterior pelvic tilt with other abdominal muscles.
- 34.
- 35. Multifidus • Bilateral contractionextends the vertebral column. • Unilateral contraction contralaterally rotates the vertebral column to the opposite side.
- 36.
- 37.
- 38. 2nd to strengthen Glutes Thigh muscle Otherlower limb muscle
- 39.
- 40.
- 41.
- 43.
- 44.
- 46.
- 47. Aerobic • Aerobic activitiesmake you breathe harder and make your heart and blood vessels healthier. These include: • Walking • Dancing • Swimming • Water aerobics • Jogging and running • Aerobic exercise classes • Bicycle riding (stationary or on a path) • Some gardening activities, such as raking and pushing a lawn mower • Tennis • Golfing (without a cart)
- 48. Flexibility • Flexibility-enhancing activitiesensure a good range of motion in the joints. Loss of flexibility can be a predisposing factor for physical issues, such as pain syndromes or balance disorders. Gender, age, and genetics may all influence range of motion. Flexibility exercises include: • Stretching • Yoga • Tai Chi or Qi Gong • Pilates
- 49. Muscle-strengthening • • Muscle-strengthening activities buildup your strength. These activities work all the different parts of the body—legs, hips, back, chest, stomach, shoulders, and arms—and include: • Heavy gardening (digging, shoveling) • Lifting weights • Push-ups on the floor or against the wall • Sit-ups • Working with resistance bands (long, wide rubber strips that stretch) • Pilates
- 50. Pain should decrease & increase ROM Ifnot Change your FLAPS Force Level Angle Pressure Side Always remember Try to Treat in weight bearing position as patient complaints of pain in loaded only When to treat not loaded? Joint is inflamed or the SIN (severity, irritability & nature of pain) is high
- 51.
Editor's Notes
- #16 Patient generated force is ext, fle, eis, fis, reis, rfis, etc. patient overpressure is breath out and do the movt and fix towel in the back and do the extension etc