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Supraspinous Ligament Sprains

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Supraspinous Ligament Sprains Unraveling the Mystery of Low Back Pain #5: Supraspinous Ligament Sprains Instructor: Ben Benjamin, Ph.D. Instructor: Ben Benjamin, Ph.D. ben@benbenjamin.com 1 SPONSOREDSPONSORED BY:BY: 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 SPONSOREDSPONSORED BY:BY: Mattes chair Side-lying position system Webinar Goal Explore the assessment and treatment of supraspinous ligament injuries: • Supraspinous ligaments L1-L5 • Suprasacral ligaments 2 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 Anatomy of the Supraspinous Ligaments • Connect all five lumbar vertebrae • Connect L5 to the sacrum • Sometimes called the supraspinal ligaments 3 Anatomy of the Supraspinous Ligaments • Run between the tips of the spinous processes 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 4 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 Connections with Other Structures • Thoraco-lumbar fascia • Longissimus thoracis muscle • Multifidus muscle 5 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 Assessment Test 1: Active flexion 6 Test 2: Active extension Test 3: Side-flexion Palpation • Center of each lumbar vertebra • Continue down to the sacrum and coccyx • Any pain indicates an injury • Video 7 Theory 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 8 Treatment Friction Therapy Watch the video at the end of the Webinar Myofascial Therapy Watch the video at the end of the Webinar 9 Massage Therapy Primary Low Back Exercises Questions Facebook.com/DrBenBenjamin 10 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? 11.
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