Unraveling the Mystery of Low Back Pain #5: Supraspinous Ligament Sprains
Instructor: Ben Benjamin, Ph.D.
1 Instructor: Ben Benjamin, Ph.D.
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Over 30 years of experience building the finest portable treatment tables and accessories. Products that are visually stimulating, ergonomically supportive, and incredibly comfortable. The superior design and engineering capabilities merge to create the ultimate experience for you and your clients.
www.oakworks.com 717.235.6807
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Mattes chair
Side-lying position system
Webinar Goal
Explore the assessment and treatment of supraspinous ligament injuries: • Supraspinous ligaments L1-L5 • Suprasacral ligaments
3 Pretest
1. The supraspinous ligament is also known as the supraspinal ligament. True or False? 2. The suprasacral ligament connects the sacrum to the ilium. True or False? 3. The interspinous ligament is not continuous from vertebra to vertebra; it only connects two spinous processes to each other. True or False? 4. The supraspinous ligament in the low back limits lumbar flexion. True or False? 5. The posterior layer of thoracolumbar fascia and multifidus muscles combine to form the lumbar supraspinous ligaments. True or False? 6. The suprasacral ligament holds the sacrum to the pelvis. True or False?
Anatomy
4 Anatomy of the Supraspinous Ligaments
• Connect all five lumbar vertebrae • Connect L5 to the sacrum • Sometimes called the supraspinal ligaments
Anatomy of the Supraspinous Ligaments
• Run between the tips of the spinous processes
5 Anatomy of the Supraspinous Ligaments
• Run between the tips of the spinous processes • Form a continuous line from one to the next
Anatomy of the Supraspinous Ligaments
• Small degree of elasticity • Limit forward flexion and help stabilize the lower spinal area
6 Anatomy of the Interspinous Ligaments
• Underneath the supraspinous ligaments • Thin, membranous structures • Connect adjoining spinous processes, from root to apex
Anatomy of the Interspinous Ligaments
• Connect with the ligamenta flava and supraspinous ligaments • Narrow and elongated in the thoracic region • Broader and thicker in the lumber region • Not continuous
7 Connections with Other Structures
• Thoraco-lumbar fascia • Longissimus thoracis muscle • Multifidus muscle
Anatomy of the Suprasacral Ligaments
• Extension of the supraspinous ligaments • Connect the bony protuberances on the sacrum • Provide stability and structure Bony protuberances of the sacrum
8 Assessment
Test 1: Active flexion
9 Test 2: Active extension
Test 3: Side-flexion
10 Palpation
• Center of each lumbar vertebra • Continue down to the sacrum and coccyx • Any pain indicates an injury
• Video
Theory
11 Assessment Results for Supraspinous Ligament Injuries
• Pain on forward flexion • Sometimes pain on extension and/or side-flexion • Local pain on palpation
Risk Factors for Supraspinous Ligament Injuries
• Insufficient strength in the stabilizing muscles • Insufficient flexibility of hamstrings and quadriceps • Head-forward posture • Slumping in a chair
12 Treatment
Friction Therapy
Watch the video at the end of the Webinar
13 Myofascial Therapy
Watch the video at the end of the Webinar
Massage Therapy
14 Primary Low Back Exercises
Questions
Facebook.com/DrBenBenjamin
15 Post-test
1. The supraspinous ligament is also known as the supraspinal ligament. True or False? 2. The suprasacral ligament connects the sacrum to the ilium. True or False? 3. The interspinous ligament is not continuous from vertebra to vertebra; it only connects two spinous processes to each other. True or False? 4. The supraspinous ligament in the low back limits lumbar flexion. True or False? 5. The posterior layer of thoracolumbar fascia and multifidus muscles combine to form the lumbar supraspinous ligaments. True or False? 6. The suprasacral ligament holds the sacrum to the pelvis. True or False?
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