Understanding the Significance of Posture and Spinal Stabilization in Back Injury Rehabilitation: The three layers involved in overall spine function

Have you injured your back, gone through some sort of rehabilitation and now feel like you are no longer injured but you have a weak' back? Well, maybe you do. Many old school' back rehabilitation programs, back schools and therapists have failed to provide their patients with the confidence to participate in activities they once enjoyed. Yes, the patient may feel' better, but they still feel unstable' or weak' in those injured areas. There is an answer to this problem that will be the topic of a series of articles relating the significance of posture and spinal or core stability to spinal injury rehabilitation.

Rehabilitation professionals have always known that in order to have a healthy back, a person must have strong abdominals and back muscles. For decades back rehabilitation specialists have been prescribing back and abdominal exercises for their patients with back pain. The problem was, many of these patients were not getting any better using standard sit-ups and back strengthening exercises. These rehabilitation programs were limited by a lack of knowledge; rehabilitation professionals did not yet know enough about the structure and function of the spine and its related soft tissue (i.e. muscles and ligaments) to design efficient programs for people with back or spine problems.

We now know that the various muscles of the spine serve very different purposes. Some act as position sensors, some act as stabilizers, and others work to create powerful movements. Each one of these functions can be correlated to three different layers of spine and posture: deep, middle, and outer.

The deep layer consists of the vertebrae, intervertebral discs, ligaments, and small postural/proprioceptive muscles. With regard to movement of the spine, the function of the deep layer is twofold. The ligaments and discs serve to limit the size of bending, sliding and rotating motions of the spine. They act as a doorstop, preventing the vertebrae from moving too far in any direction. If these motions had no limit, normal pain free spinal movement would not be possible. The discs, ligaments, and small muscles of the deep layer sense changes in position and posture of all the joints of the spinal column (roughly 75 joints found throughout the spinal column) and send this postural information back to the brain. Our brain depends on this postural information to effectively organize and use the joints and muscles that support spine and posture function.

The muscles of the middle layer and the ligaments of the deep layer perform the job of stabilizing the spine. The muscles of the middle layer provide stability during normal ranges of motion, whereas stability at the end ranges of movement occurs via the ligaments of the deep layer. This layer consists of two abdominal muscles and two back muscles. The abdominals are the transversus abdominus and the internal oblique and the back muscles are the multifidus and the quadratus lumborum, for those interested in details.

The outer layer consists of the big power' muscles that create the larger movements of the spine and posture. These are the muscles strengthened by traditional back and abdominal exercises. They are the erector spinae, external oblique, and the rectus abdominus.

Our trunk, or our core, is the foundation of our entire body. It acts like a platform from which our legs and arms (extremities) function. If this platform is unstable, the arms and legs will have to work harder. The strength of our chest, arms, shoulders or outer layer back muscles does not matter if we have weak spinal stabilizers. A weak and unstable core puts the spine and extremities at greater risk for dysfunction and injury. The core must be stable in order for the spine and extremities to function with optimum efficiency. If our spine is poorly stabilized some part of the body will eventually become injured.

Spinal stability not only plays a role in back injury, but also in postural and extremity function. Incorporating these concepts into your everyday workout and rehabilitation programs will result in enhanced body function and injury protection. The following articles will go into more depth on how to train and rehabilitate each layer.

All questions related to this article and/or health concerns can be directed to:

Advanced Spine & Wellness Center

302 King Farm Blvd. #120

Rockville, MD 20850

240-361-2225

[email protected]

www.parischiro.com