The spine (or backbone) runs from the base of the skull to the pelvis. It serves as a pillar to support the body's weight and to protect the spinal cord.
There are three natural curves in the spine that give it an "S" shape when viewed from the side. These curves help the spine withstand great amounts of stress by providing a more even distribution of body weight.
Excess body weight, weak muscles, and other forces can pull at the spine's alignment:
- An abnormal curve of the lumbar spine is lordosis, also called sway back.
- An abnormal curve of the thoracic spine is kyphosis, also called hunchback.
- An abnormal curve from side-to-side is called scoliosis.
The spinal column divided into 5 major columns and made of 33 individual bones:
- Cervical
- Thoracic
- Lumbar
- Sacral
- Coccyx
Intervertebral discs& muscles of the spine
- Each vertebra in your spine is separated and cushioned by an intervertebral disc, which keeps the bones from rubbing together
- The muscular system of the spine is complex, with several different muscles playing important roles. The muscles in the vertebral column provide spinal support and stability and serve to flex, rotate, or extend the spine.
Spinal cord:
The spinal cord is a slender cylindrical structure about the diameter of the little finger. As the spinal cord runs through the spinal canal, it branches off into 31 pairs of nerve roots, which then branch out into nerves that travel to the rest of the body.
The three main functions of the spine are to:
- Protect the spinal cord, nerve roots and several of the body’s internal organs.
- Provide structural support and balance to maintain an upright posture.
- Enable flexible motion.
Common problems of spine and back:
- Pain –may be related to age related changes, poor posture or occupation related and sudden injuries
- Injuries may occur due to fall from height, motor vehicle accident and gunshot injuries .this may cause serious impact on our spine like fracture dislocation and sometimes leads to paralysis of body totally.
- In some people called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer "jelly" pushes out through a tear in the tougher exterior.
- Compression fracture. A fracture that occurs in the cylindrical vertebra, in which the bone essentially caves in on itself, can cause sudden pain. This type of fracture is most common due to weak bones, such as from osteoporosis, and is more common in older people.
- Sports injuries, especially in sports that involve twisting or large forces of impactDefects of a vertebra's pars interarticularis (spondylolysis) and the slippage of one vertebra in relation to another vertebra (spondylolithesis) are common causes of back pain in the young athlete.
How to stay healthy with our spine –here we go
A comprehensive physical therapy treatment program will be of value to correct the various areas of muscular and soft tissue tightness and weakness throughout the neck, upper back and shoulder region.
Posture correction plays a major role in spine rehabilitation:
- Ergonomically we need to correct the person work place according the individual comfort and heights of chair table, computer screen with eye level and hand resting support should be adjusted
- Proper standing and sitting posture maintained.
- Stay active and exercise weekly thrice for at least 30 minutes,Change your position frequently. If seated, stand up, if standing, walk around .Perform a different task every hour and so use different muscles to relieve back
Driving:
- Adjust the seat height and distance so knees are slightly bent and back supported by the seat back.
- Recline your seat slightly to decrease back strain if needed
- Use lumbar support to support the natural curve in your low back (cushions or rolled towels work too)
- While using mobile phones sit and use ,try to keep at eye level reduce the neck strain
House hold activities
- Mopping: Stand upright, keep elbows close to the body, and move with it like a dance partner, avoiding torso twisting
- Vacuuming: Stand upright and move with the vacuum
- Bathroom: Use a small stool to sit or kneel in comfort while cleaning the lower fixtures
- General: If bending for a task, arch back, take breaks, and change postures frequently
- Standing at sink or counter: Use a wide stance and lean your stomach on the counter edge to lower your body and prevent leaning forward
Exercises to strengthen your back and spine:
Walking erectly with 'neutral' head position. Make an effort to 'walk tall' (chest up, shoulders back) and with your head positioned in 'neutral.
Supine retraction or standing retraction of neck:
While lying on your back with your head in neutral position, place your fingers on your chin and push downward so your chin tucks and your head is pushed downward into its resting surface.
Isometric exercises for neck:
- Eachexercises try to do for 5 repetitions, holding for 10 secs and then slowly progress up to 10 repetitions
- To start, sit in a chair with your feet flat on the floor or you could stand in front of the mirror,Relax your shoulders and keep your head level
- Press your palm against your forehead, Resist with your neck muscles. Hold for 10 seconds and Relax.
- Do the exercise again, pressing on the side of your head,Switch sides.
- Do the exercise again, pressing on the back of your head.
Supine Head Lifts
- Lying face down on a firm surface, raise your chest, shoulders and head up by resting on your elbows.
- Let your head hang fully downward so your chin is on or near your chest.
- Lift your head upward to the head-neutral position, being sure to retract your head (tuck your chin) as you move
Scapular retraction:
- Stand with your arms at your sides. Keep your head and neck in neutral position.
- With chest lifted, gently but firmly pull both shoulders backward while squeezing both shoulder blades backward and downward
Neck rotation:
While sitting or standing with your head and neck in neutral position, slowly turn your head to the left as far as you comfortably can and hold for five seconds, similarly repeat it for other side
Lower back strengthening exercises
Partial Sit up or Crunch:
- Strengthens abdominal muscles .Lie on back with knees bent, feet flat on floor and arms crossed over chest.
- Raise head and shoulders slightly until shoulder blades are just off floor. (You may not be able to get far at first.)
Arm and Leg Reach:
Strengthens buttocks, abdomen and shoulders .Kneel on hands and knees with neck parallel to floor. Keep weight evenly distributed, knees hip-width apart and back straight. Stretch one arm straight
Next, lift one leg straight as you get stronger, rise opposite arm and leg at the same time.
Bicycle:
- Strengthens buttocks, abdomen and shoulders, Lie flat on back. Place fingers on head. Tighten abdominal muscles and bring knees to a 45˚ angle. Lift shoulders off the ground.
- Turn upper body to the left, bringing the right elbow toward the left knee and extending right leg in a cycling motion. Switch sides and repeat.
Stability ball exercises
Back extension
- Start with the stomach and hips on the ball, legs extended straight behind (toes resting on the ground).
- Hold onto the ball with the hands for balance. Raise the chest high (like a yoga “cobra”), bringing the hands to the back of the head.
Bridge and with heel dig
- Lie on your back with your legs resting on top of the ball. Raise your hips and buttocks off the floor into a bridge.
- Tighten your abdominal muscles.
Swiss Ball Dumbbell Shoulder Press : ( 3 sets and 15 repetition)
- It on the Swiss ball. Keep your feet flat on the ground and hold a dumbbell in each hand right near the edge of your shoulders. Keep your palms facing forward, elbows in line with the chest, and core engaged.
- Exhale and lift the dumbbells as you extend your arms above your head. Let the two dumbbells touch.
- Inhale and bring the arms back down to the starting position.
Advanced plank & side plank:
- Lie on the ball on your stomach, with your feet touching the floor behind the ball. Lean forward until you touch the floor with your hands.
- Walk your hands away from the ball until you feel the ball reach your upper thighs . Keep your shoulders directly above your hands.
Hamstring curl
- Lie with your back flat on the floor with the back of your calves on top of a stability ball and your legs straight.
- Brace your core and squeeze your glutes to raise your hips off of the floor so that your body forms a straight line from shoulders to heels. This is your starting position.
- Drag your heels to roll the ball as close to your butt as possible or until your knees form 90-degree angles.
- Pause, and then slowly straighten your legs as you roll your feet away from your glutes, returning to the starting position.
Russian twist
- Lie with your upper back on a stability ball and your feet flat on the floor with your knees bent at a 90 degree angle. Brace your core and keep your hips extended so your torso forms a straight line from head to knees.
- Extend your arms straight above your chest and press your palms together. This is your starting position.
- Rotate your torso to roll onto one shoulder as far as you can while raising the other from the ball. Your hips should stay square with the floor.
- Reverse the move to return to the starting position. And repeat it for opposite side
Stability ball roll out
- Place your hands on a stability ball and kneel with your knees hip-width apart and your toes on the floor for stability.
- Keeping your back flat and core braced, and without moving your knees, slowly roll forward so the ball comes to your forearms, until your body forms a straight line from your head to your knees.
- Pause, and then roll back to the starting position.
References:
- Bertozzi et. al. Effect of Therapeutic Exercise on Pain and Disability in the Management of Chronic Nonspecific Neck Pain: Systematic Review and Meta-Analysis of Randomized Trials. Phys Ther. 2013; 93:1026-1036
- https://www.spine.org/KnowYourBack/Prevention/Exercise/Cervical-Exercise
- Physiotherapy management of low back pain-a Review of Surveys January 2011South African Journal of Physiotherapy 67(1):70-20
