Unraveling the Mystery of Low Pain #5: Supraspinous Sprains

Instructor: Ben Benjamin, Ph.D.

Instructor: Ben Benjamin, Ph.D.

[email protected]

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 injuries: • Supraspinous 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 to the ilium. True or False? 3. The is not continuous from 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 and multifidus muscles combine to form the lumbar supraspinous ligaments. True or False? 6. The suprasacral ligament holds the sacrum to the . True or False?

Anatomy

Anatomy of the Supraspinous Ligaments

• Connect all five • 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 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 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