ATC 222
The Spine
Chapter 25
Natasha Tibbetts, ATC
Quiz
1.
2.
3.
4.
What is the medical or technical term for
spearing?
List 3 signs of a serious cervical spine
injury.
What is the name given to the first
cervical vertebra?
Define hypoesthesia.
Anatomy

Vertebral column

7 cervical vertebra
C1=Atlas
 C2=Axis





12 thoracic vertebra
5 lumbar vertebra
5 sacral vertebra
Intervertebral disks


Annulus pulposus
Nucleus pulposus
Anatomy (Cont’d)

Ligaments





Anterior longitudinal
Posterior longitudinal
Supraspinous
Interspinous
Spinal cord and Spinal nerves
Anatomy Examples
Spinal Anatomy
Anatomy (Cont’d)
Ligaments
Motion of the Spine

Vertebral Column General Motions




Specific Cervical Motion



Rotation occurs at C1-C2
Flexion/Extension=atlanto-occipital joint
Specific Thoracic Motion


Flexion/Extension
Right/Left lateral flexion
Right/Left rotation
Flexion/Extension is 20-30 degrees MAX!
Specific Lumbar Motion

90% of Flexion/Extension occurs at L4-L5-S1
Cervical Injury

Catastrophic injury


Warning signs





Definition
Unconsciousness
Deformity
Loss of strength/movement in extremities
Anesthesia/paresthesia/hypoesthesia in extremities
Assessment



Stabilize and calm athlete
Call EMS
ABC’s
Mechanisms of Injury

Axial loading







Spearing
Straight column
Hyper-flexion
Hyper-extension
Lateral hyperflexion
Rotation
Combination

Whiplash
Specific Injuries



Fractures
Dislocations
Strain





Pain in muscle primarily (localized)
Point tenderness
Pain with AROM (restricted motion)
Pain with passive stretch of muscle
Pain/weakness with strength testing
Injuries (Cont’d)

Brachial Plexus Syndrome






C5-T1
Can be caused by traction or compression
Paresthesia and weakness
Burning/Tingling
Return to play criteria
Treatment
Thoracic and Lumbar Injuries

Postural deviations




Kyphosis
Lordosis
Scoliosis
Normal posture




Pages 645-648
Ear-shoulder-hip-knee-ankle
Level knees, hips, and shoulders
Normal vertebral curves
Postural Examples
Injuries (Cont’d)

Congenital abnormalities



May also be mechanical
Spondylolysis vs. Spondylolysisthesis
Causes and treatment
Sciatica



Definition
Signs and symptoms
Causes



Mechanical
Structural
Compression
Swelling
 Disc Herniation
 Tumor

Herniated Lumbar Disk

Lumbar disks are under constant stress





Most often injured between L4-L5, 2nd most common is
between L5-S1
Mechanism


Forward bending and twisting places abnormal strain on lumbar
region
Signs and Symptoms




Degeneration
Tears
Cracks
Centrally located pain that radiates unilaterally
Symptoms worse in morning
Forward bending/sitting increases pain
Treatment



Pain reducing modalities
Postural self-correction exercises
Back and abdominal strengthening
Bulging
Prolapsed
Extrusion
Prevention of Spinal Injuries

Cervical Spine

Muscle Strengthening


Cervical region
Range of Motion
C-spine should have full ROM
 Can be increased through stretching


Using correct techniques

Rules and regulations

Head should not be used as a weapon!
Prevention (Cont’d)

Lumbar Spine

Correction of Biomechanical Abnormalities




Correct lifting techniques



Emphasis on trunk flexibility
Maximum ROM
Abdominal strength
Appropriate breathing
“Lift with your legs, not your back”
Core Stabilization


Increase stability of trunk
Helps athlete maintain spine and pelvis in comfortable and
acceptable mechanical position