Physical Therapy

&  Wellness Center, Inc.

7800 Red Road. Suite 105. South Miami, FL 33143

Do you know about the mechanics of the spine?

Do you have or have suffered from neck pain?
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Let's start with the CERVICAL spine.

The anatomy: 7 vertebra, 8 spinal roots in each side.

Facets (joints): The C1 or "Atlas" vertebrae is flat. The C2 or "Axis" vertebrae has a pivot point called The Dens. The C3-C7 facets are at a 45 degree angle in the coronal "crown" orientation.

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Movement: Greater than 50% of the cervical spine flexion/extension happens @ OA (occiput/skull & Atlas). Greater than 50% of cervical spine rotation happens @ AA (Atlas & Axis). What is the role of the C3-C7 vertebra? These vertebra support the weight of the head. Because the head is heavier on the back than the front, the cervical spine has a natural lordotic posture.

Injury: The C5-C6 levels are the most vulnerable because they are most susceptible to wear and tear. The C7 level is most vulnerable during high velocity injuries. The OA and AA joint become tight & painful due to stress, poor scapular strength & stabilization, shoulder injuries, forward head posture and more.

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Pain: There are two common complains of pain related to cervical spine dysfunction: Pain at the level of OA and AA or pain at the base of the neck (lower cervical spine levels).

Movement Organization: To organize your spine tuck your chin to allow for the most movement or degrees of freedom. Engage your core and utilize the proper mechanics. Flex and extend your cervical spine from OA, rotate from AA and experience pain free mobility.

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Align your Spine: Posture is the position in which you hold  your body upright against gravity while standing, sitting or lying down. Proper posture involves training your body to stand, walk, sit and lie in positions where the least strain is placed on supporting muscles and ligaments during movement and everyday activities.

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Let's review the THORACIC spine.

The anatomy: 12 vertebra, 12 spinal roots in each side.

Facets (joints): The Thoracic facets are at a 60 degree angle in the coronal ("Head Crown") orientation.

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Movement: Rotation (transverse plane), Lateral Flexion or Side Bending (coronal plane).

Facts:

1. The thoracic spine, ribs, sternum and clavicle provide all the points of support for the shoulder complex.

2. The thoracic spine and the rib cage provide protection to the heart, lungs and organs.

3. Abnormal posture or  alignment of the thoracic spine alters head position, shoulder mobility, cardiopulmonary function, pelvis position and more.

The chicken or the egg? Does the forward head lead to increased thoracic kyphosis or vice versa? It is known that this combination will lead to neck pain, upper back tightness, shoulder injuries and “The Upper Crossed Syndrome”. Proper shoulder movement is dependent on the thoracic spine. If the thoracic spine is hypo-mobile or has increased kyphosis, the scapula will not be in the proper position. This will lead to rotator cuff injury, weakness of the scapular stabilizers, tightness of the pectoralis, shoulder impingement, tightness of the long head of the biceps, brachial plexus injury and more.   

Golf: It is all about the rotation of the thoracic spine and power of the core muscles.

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Movement Organization: Stand tall and allow the spine processes to glide back and down. As you slightly extend the thoracic spine, the scapulae are able to glide downward, allowing for the proper glenoid-humeral and scapula-thoracic rhythms.

Align your spine: Posture is the position in which you hold your body upright against gravity while standing, sitting or lying down. Proper posture  involves training your body to stand, walk, sit and lie in positions where the least amount of strain is placed on supporting muscles and ligaments during movement and everyday activity.​

the mechanics of the LUMBAR spine  

Theanatomy: 5 vertebra, 5 spinal roots in each side. Range of motion: small in all planes.

Facets (joints): The Lumbar facets are at a 90 degree angle in the sagittal orientation.

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Movement: Flexion/Extension (greatest movement in the sagittal plane) and Rotation (least movement in the transverse plane).

Facts:

1. The lumbar spine is designed for weight bearing.

2. Poor alignment of the L5 <-> S1 <-> pelvis could alter posture, neck, upper back shoulder ROM, and hip ROM.

3. Tightness of hip flexors will pull the lumbar spine into extension (excessive lordosis), creating pressure to the posterior aspect.

4. Most common injury is due to the lack of lumbar stabilization (by activating pelvic floor and transverse abdominis) when flexing forward to pick up a small object from the floor or to put on socks, returning to the upright position and then rotating the lumbar spine. This causes a torque action resulting in severe muscle spasm, locking of a facet, herniation of the disc and/or aggravating preexisting conditions like scoliosis, arthritis or impingement.

How to avoid low back pain:

1. Core Control.

2. Activating the pelvic floor and transverse abdominis.

3. Minimizing neural tension (nerves need to slide, bend, elongate and withstand compression to allow the movement).

4. Maintaining proper flexibility (hip flexors, thoracic spine mobility, hamstrings and calves).

5. Spinal segmental mobility.

6. Postural awareness.

7. Proper body mechanics when lifting.

8. Proper ergonomics at work

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Movement Organization: Stand tall and allow the spine to move forward and back. As you align your pelvis in neutral, allow the lumbar spine to move segmentally in case you need to flex or extend the lumbar spine.