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Dr Ozello's Sports Medicine Report: Lumbar Spine Sprain/Strain ***Disclaimer: Viewing this video does not take the place of seeing a medical professional or working with a fitness professional. Please visit a medical professional for evaluation, diagnosis and treatment. Please work with a fitness professional to learn proper exercise technique and to develop a proper training program. Never perform an exercise that elicits or intensifies symptoms. If an exercise elicits or intensifies symptoms, stop immediately and use a viable substitute. Perform all exercises through a symptom free range of motion. Lumbar Sprain/Strain Low back pain is one of the most common musculoskeletal complaints. It is the leading cause of disability in the developed world and accounts for billions of dollars in healthcare costs annually. Lumbar muscle strains are typically the result of abnormal tension placed upon a muscles and/or tendon. Follows traumatic incident or repetitive overuse. Strains - Injury to a muscle. Sprain - Injury to a ligament. Symptoms of lumbar Sprain/Strain Intense pain in lumbar spine and/or sacroiliac joints. Sharp, tight, spasm, stiffness, dull, deep ache, tenderness. Provoked by movement and lessened with rest Weakness. Limited lumbar, hip and lower extremity symptom free range of motion due to pain and muscle guarding. Altered gait. Possible limping. Difficultly moving in all planes. Slow & guarded motions. Altered posture. Most lumbar muscle strains respond well to conservative treatment such as Chiropractic treatment and massage therapy. Exercise has become the cornerstone of preventing and rehabilitating low back pain. Larger Multi-Segmental Muscles compensate by co-activation when there is multifidi dysfunction. Motor control errors or lack of abdominals and multifidus acting before larger global muscles increase compressive forces across spinal segments and results in pain. Motor control exercises involve retraining multifidus and transverse abdominis to become active before larger global multi-segment muscles become active. Lumbar Spine Five articulating Vertebrae - L1-L5 Lordotic curve Five pairs of Lumbar Spinal Nerves which exit below the corresponding numbered lumbar vertebra. Multifidi Muscles Origins: Lumbar Region: Mammillary processes. Sacral Region: Posterior aspect of the sacrum, aponeurosis of origin of the Sacrospinalis, from the medial surface of the posterior superior iliac spine & the posterior sacroiliac ligaments. Insertion: Runs superior & medial. Attaches to one spinous process, ranging from one to four segments superior. Actions: Proprioceptive feedback & input due to high muscle spindle density. Bilateral: Extension of the spine. Ipsilateral: Lateral flexion of the spine. Contralateral rotation. Erector Spinae AKA Lumbar Paraspinals Spinalis, Longissimus and Iliocostalis. In lower lumbar spine, appears as a single muscle. Common origin from a thick tendon that is attached to the sacrum, lumbar spinous processes and iliac crest. In upper lumbar area, divides into three muscles: Medial to Lateral - Spinalis, longissimus & iliocostalis. Located posterior and lateral to the vertebra spine. Three long, thin powerful muscles. Run superior on each side of spine. Spinalis: Smallest and most medial. Longissimus: Largest. In between Spinalis and iliocostalis. Iliocostalis: Most lateral. Inserts onto angles of ribs. Transverse Abdominis Origin: Anterior iliac crest, lateral half of inguinal ligament, thoracolumbar fascia & costal cartilage of ribs #7-12 Insertion: Abdominal aponeurosis to linea alba, xiphoid process & pubic symphysis. Innervation: Anterior primary rami (T7-12), Ilioinguinal nerve (L1), Subcostal nerve (T12) & Iliohypogastric nerve (L1). Function: Stabilization of spine, support abdominal wall, compress abdomen, aid forced expiration & increasing intra-abdominal pressure. Abdominal Drawing-in Maneuver (ADIM) • Abdominal Drawing-In Maneuver (ADIM) Abdominal Hallowing AKA Stomach Vacuum • Abdominal Hollowing AKA Stomach Vacuums Fitball Lumbar Spine Extension • Fitball Lumbar Extensions Low Back Pain Playlist • Low Back Pain Reference Back Pain https://www.ncbi.nlm.nih.gov/books/NB... Lumbosacral Facet Syndrome https://www.ncbi.nlm.nih.gov/books/NB... Dr Donald A Ozello DC of Championship Chiropractic in Las Vegas, NV Web Site: http://www.championshipchiropractic.com/ Blog: https://www.championshipchiropractic.... Twitter: / drdozellodc Facebook: / championship-chiropractic-280141628688300 LinkedIn: / dr-donald-a-ozello-dc-716b3233 YouTube: / drdozellodc "Running: Maximize Performance & Minimize Injuries" https://www.amazon.com/Running-Perfor...