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John Petrizzo, PT, DPT, CSCS Demographics Spinal pathology is seen across all demographics and age groups Affects people throughout their lives Number one reason for PT referral Highest cost to employers Functions of the Spine

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  1. John Petrizzo, PT, DPT, CSCS

  2. Demographics  Spinal pathology is seen across all demographics and age groups  Affects people throughout their lives  Number one reason for PT referral  Highest cost to employers

  3. Functions of the Spine  Establishes our posture  Provides an attachment site for many muscles  Transmits forces  Protects the spinal cord

  4. Spinal Anatomy  33 Vertebrae (Approximately)  7 Cervical  12 Thoracic  5 Lumbar  5 Sacral (fused)  4 Coccygeal (fused)

  5. Spinal Anatomy

  6. Spinal Anatomy  Cervical lordosis  Thoracic kyphosis  Lumbar lordosis  Curves of the spine help us to absorb shock!

  7. Spinal Anatomy: Ligaments

  8. Spinal Anatomy: Intervertebral Disc

  9. Posterior Musculature of the Spine

  10. Posterior Musculature of the Spine

  11. Anterior Musculature of the Spine

  12. Anterior Musculature of the Spine

  13. Pathologies: Spinal Stenosis  Stenosis  Diameter of intervertebral foramen is decreased  Management:  Relief with flexion

  14. Pathologies: Spinal Stenosis

  15. Pathologies: Scoliosis  Scoliosis  Lateral curvature

  16. Pathologies: Spondylosis  Spondylosis  Essentially OA of the spine

  17. Pathologies: Spondylosis

  18. Pathologies: Spondylolysis and Spondylolisthesis  Congenital weakness in pars interarticularis  Associated with repeated spinal hyperextension  Gymnastics, dance, etc.  Characterized by LBP  Relief with flexion and modified activity

  19. Spondylolysis and Spondylolisthesis

  20. Spondylolisthesis

  21. Treatment: Stenosis, Spondylosis, Spondylolysis/listhesis  https://www.youtube.com/watch?v=zYVGQwYfsKU  https://www.youtube.com/watch?v=T1FrBPVCtgE  https://www.youtube.com/watch?v=-9XwclhulSE

  22. Herniated Disc  Occurs with “fatigue failure” or traumatic rupture  Difficult to heal  Pain from increased pressure  Disc can no longer withstand compressive forces as well

  23. Herniated Disc

  24. Treatment: Herniated Disc  Controlled rest  Educate on positions to avoid/lifting mechanics  Flexion and rotation!  Stability in area of herniation, mobility above and below!  Postural re-education  Goal is to have progressive centralization of symptoms!

  25. Treatment: Herniated Disc  https://www.youtube.com/watch?v=clfpWjqVP6U

  26. Core Training Options for Back Pain  https://www.youtube.com/watch?v=zEvy5CCvNLA

  27. Remember!  If any exercise or activity that you are doing increases your back pain or related symptoms, STOP!

  28. Questions?

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