The spine - Advanced Sports Medicine

Erector Spinae muscle group

• Iliocostalis (Extension & ipsilateral flexion)

• Longissimus (Back and neck extension & ipsilateral head rotation)

• Spinalis (back and neck extension)

Vertebral column contains

33 Vertebrae - 24 true (movable, 9 false (immovable)

Characteristics of vertebrae

• Body (1st vertebrae does not have one)

• Foramen (opening for spinal cord to pass)

• Processes (Protrusions that surround foramen - articular, transverse, spinous)

Contains 7 vertebrae

Cervical spine

Atlas

The first vertebrae of the cervical spine (Allows head nodding)

Axis

Second vertebrae of cervical spine (Allows head turning)

Upper back - Convex curve, articulates with ribs, 12 vertebrae

Thoracic spine

Lower back - Concave curve, 5 vertebrae, supports majority of body weight

Lumbar spine

5 fused vertebrae, articulation point for hips, convex curve

Sacrum

4 fused vertebrae, attachment site for gluteus maximus

Coccyx

Iliocostalis

Muscle responsible for back extension and ipsilateral flexion

Longissimus

Muscle responsible for back and neck extension + head rotation (ipsilateral)

Spinalis

Muscle responsible for back + neck flexion

Multifidus

Muscle responsible for back extension rotation (contralateral)

Rotatores

Muscle responsible for back extension & rotation (contralateral)

Interspinales

Responsible for back extension

Semispinalis

Responsible for back and neck extension and rotation (contralateral)

Splenius

Responsible for neck extension and rotation, abduction (ipsilateral)

Trapezius

Responsible for neck extension, lateral neck flexion (ipsilateral), & neck rotation (contralateral)

Sternocleidomastoid

Responsible for neck flexion, lateral neck flexion (ipsilateral) & neck rotation (contralateral)

Scalenes

Responsible for neck flexion, lateral flexion & rotation (ipsilateral)

Movements of the spine

Flexion, extension, lateral flexion (ipsilateral & contralateral), rotation

Trapezius, semispinalis capitis, splenius capitis, splenius cervicis

Cervical flexion muscle group

Rectus abdominus, internal & external obliques

Trunk flexion muscle group

Lumbosacral joint

Where 75% of spinal flexion occurs

Extension muscle group

Erector spinae muscles, gluteus maximus

Rotation muscle group

Internal & external obliques

Lateral flexion muscle group

Quadratus lumborum, obliques, latissimus dorsi, iliopsoas, rectus abdominus

Acute facet joint lock (stiff neck) causation

Sleeping in the same position for too long, exposition to cold air, sudden movement of neck

Cervical sprain causation

Sudden movement

Cervical sprain symptoms

Pain past 24 hours, restricted movement, tenderness over transverse processes

Quadratus lumborum strain causation

Overuse + sudden movements

Quadratus lumborum strain symptoms

Sharp and aching pain by SI region, pain increases with sitting, pain with rotation/lateral flexion

Spondylolysis

The break down of vertebral lamina

Spondylolisthesis

Shifted vertebrae, caused by extensive hyperextension

Sports that can cause spondylolisthesis

Gymnastics, swimming, football, volleyball, tennis

Spondylolisthesis symptoms

Persistent ache across lower back, “feeling something go”, tenderness

Intervertebral disc herniation causation

Bad posture (poor mechanics), flexion + twisting

Intervertebral disc herniation symptoms

Unilateral radiating pain, increased pain with flexion, pain worsens in the AM, increased pain with straight leg raises (SLRs) and bringing knees to chest

Sacroiliac joint dysfunction causation

Twisting with feet on the ground, falling backwards, misjudging a step, asymmetrical ASIS or PSIS, leg length discrepancy

Activities that can cause sacroiliac joint dysfunction

Jumping, hurdles, swinging bat/club, throwing, kicking or punting

Sacroiliac joint dysfunction symptoms

Radiating butt pain, increased pain with SLRs, increased muscle tone

Motion towards the opposite side of the muscle(s) contracting

Contralateral

Three types of processes found on most vertebrae

• Spinous process

• Superior articular process

• Transverse process

The three muscles that preform back rotation

Semispinalis, rotatores, multifidus

Methods to reduce risk of hypomobility and hypermobility from a neck sprain

Strengthening exercises for laxity, ROM exercises to reduce hypermobility

Sports at high risk for developing hypermobility issues in the spine

Gymnastics, swimming, football, volleyball, tennis

Muscles that contract during left and right rotation

Right - Splenius, scalenes, mastoid, longissimus

Left - Semispinalis