Low Back Disorders: Evidence-based Prevention and RehabilitationAccess the latest research and applications to build effective prevention and rehabilitation programs for your patients or clients with Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition. Internationally recognized low back specialist Stuart McGill presents original research to quantify the forces that specific movements and exercises impose on the low back, dispels myths regarding spine stabilization exercises, and suggests prevention approaches and strategies to offset injuries and restore function. Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition, -gain valuable information on measured loading of the back during specific activities and apply it to avoid common--but counterproductive--practices in back rehabilitation; -learn how to analyze each patient''s or client''s unique physical characteristics and lifestyle factors to tailor preventive measures and treatments to individual needs; -learn how to help patients and clients progress through the stages of rehabilitation: corrective exercise, stability or mobility, endurance, and strength; and -acquire the information necessary to design an effective injury-prevention program. With an expanded repertoire of pain-free motion exercises and additional information on ways to find and adjust stabilization exercises, Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition, offers you new tools to help your patients and clients achieve pain-free exertion. The text includes exercises and activities that provide a solid foundation of physical work in preparation for more advanced activities in sports and occupations. Also, the process of transitioning into performance exercise is outlined with an explanation of the critical stages of the performance pyramid, including the design of appropriate corrective exercise, building joint and whole-body stability, enhancing endurance, training true strength, and transitioning to ultimate performance. Low Back Disorders: Evidence-Based Prevention and Rehabilitation, Second Edition, Additionally, the text offers these practical features to guide your learning and inform your practice: -More than 475 photos, graphs, and charts support the research and the scientific basis for the text''s conclusions. -More than 50 tests and exercises with step-by-step instructions help you develop successful programs for your patients and clients. -Special sections highlight how the anatomical, biomechanical, and research results can be applied to clinical situations. -Extensive discussions on individualizing treatment for clients or patients help you improve your assessment skills by learning what questions to ask and what avenues of investigation to pursue with each patient or client. -Reproducible handout sheets for each of the 25 basic rehabilitation exercises, which include photos and blank lines for instructions, enable the creation of instruction sheets tailored to the current needs and progress rates of each patient or client. |
Contents
Scientific Foundation | 1 |
Introduction to the Issues | 2 |
The Unfortunate Adverse Impact on Bad Backs | 3 |
Is It True That 85 of Back Troubles Are of Unknown Etiology? | 5 |
Is It True That Most Chronic Back Complaints Are Rooted in Psychological Factors? | 6 |
Does Pain Cause Activity Intolerance? | 7 |
IllAdvised Rehabilitation Recommendations | 8 |
Can Back Rehabilitation Be Completed in 6 to 12 Weeks? | 10 |
NIOSH Approach to Risk Assessment | 125 |
1993 Guideline | 126 |
Snook Psychophysical Approach | 127 |
Ergowatch | 128 |
Biological SignalDriven Model Approaches | 130 |
EMGAssisted Optimization | 131 |
Reducing the Risk of Low Back Injury | 133 |
Compensation Board StatisticsAn Artifact? | 134 |
Should the Primary Goal of Rehabilitation Be Restoring the Range of Motion? | 11 |
A Final Note | 14 |
Scientific Approach Unique to This Book | 15 |
In Vivo Lab | 16 |
Development of the Virtual Spine | 21 |
Epidemiological Studies on Low Back Disorders LBDs | 22 |
Three Important Studies | 23 |
Do Workers Experience LBDs Because They Are Paid to Act Disabled? | 24 |
Does Pain Have an Organic BasisOr Is It All in the Head? | 25 |
Are Biomechanical Variables and Psychosocial Variables Distinct? | 28 |
How Do Biomechanical Factors Affect LBD? | 29 |
What Are the Lasting Physiological Biomechanical and Motor Changes to Which Injury Leads? | 30 |
What Is the Optimal Amount of Loading for a Healthy Spine? | 31 |
What Are the Links Between Personal Factors and LBD? | 32 |
What the Evidence Supports | 33 |
Functional Anatomy of the Lumbar Spine | 35 |
Vascular Anatomy | 36 |
Posterior Elements of the Vertebrae | 41 |
Intervertebral Disc | 44 |
Muscles | 47 |
Muscle Size | 48 |
Muscle Groups | 49 |
Abdominal Muscles | 56 |
Psoas | 60 |
Quadratus Lumborum | 61 |
Muscle Summary | 62 |
Longitudinal Ligaments | 63 |
Other Ligaments in the Thoracolumbar Spine | 65 |
Lumbodorsal Fascia LDF | 66 |
A Quick Review of the Pelvis Hips and Related Musculature | 67 |
Clinically Relevant Aspects of Pain and Anatomic Structure | 70 |
Can Pain Descriptors Provide a Reliable Diagnosis? | 71 |
Normal and Injury Mechanics of the Lumbar Spine | 72 |
Kinetics and Normal Lumbar Spine Mechanics | 76 |
Loads on the Low Back During Various Exercises | 87 |
Dubious Lifting Mechanisms | 91 |
IntraAbdominal Pressure | 92 |
Lumbodorsal Fascia | 94 |
Hydraulic Amplifier | 95 |
Biomechanics of Diurnal Spine Changes | 96 |
Muscle Cocontraction and Spine Stability | 97 |
Injury Mechanisms | 98 |
Injury Mechanics Involving the Lumbar Mechanism | 99 |
Biomechanical and Physiological Changes Following Injury | 108 |
Motor Changes | 109 |
Specific Patterns of Muscle Inhibition Following Injury | 110 |
Myths and Realities of Lumbar Spine Stability | 113 |
Quantitative Foundation of Stability | 114 |
Potential Energy as a Function of Height | 115 |
Potential Energy as a Function of Stiffness and Elastic Energy Storage | 117 |
Muscles Create Force and Stiffness | 118 |
Sufficient Stability | 119 |
Injury Prevention | 123 |
LBD Risk Assessment | 124 |
Studies on the Connection Between Fitness and Injury Disability | 135 |
LBD Prevention for Workers | 136 |
What Are the Ways to Reduce the Reaction Moment? | 138 |
Should One Avoid Exertion Immediately After Prolonged Flexion? | 143 |
Should IntraAbdominal Pressure IAP Be Increased During Lifting? | 144 |
Are Twisting and Twisting Lifts Particularly Dangerous? | 145 |
Is There Any Way to Make Seated Work Less Demanding on the Back? | 148 |
Some ShortAnswer Questions | 150 |
LBD Prevention for Employers | 152 |
Injury Prevention Primer | 154 |
A Note for Consultants | 157 |
The Question of Back Belts | 158 |
Scientific Studies | 159 |
Biomechanical Studies | 161 |
Studies of Belts Heart Rate and Blood Pressure | 162 |
Psychophysical Studies | 163 |
Low Back Rehabilitation | 165 |
Building Better Rehabilitation Programs for Low Back Injuries | 166 |
Finding the Best Approach | 167 |
Stages of Patient Progression | 169 |
Establish Stability Through Exercises and Education | 181 |
Develop Endurance | 182 |
Guidelines for Developing the Best Exercise Regimen | 183 |
Basic Issues in Low Back Exercise Prescription | 184 |
Evaluating the Patient | 189 |
First ClinicianPatient Meeting | 190 |
Some Provocation Tests | 192 |
A Note on Motion Palpation | 198 |
Some Functional Screens | 199 |
The Stiff Spine | 203 |
Testing for Aberrant Gross Lumbar Motion | 204 |
Testing Muscle Endurance | 210 |
Developing the Exercise Program | 213 |
Clinical Wisdom | 214 |
Flossing the Nerve Roots for Those With Accompanying Sciatica | 216 |
Identifying Safe and Effective Exercises | 217 |
Incorporating and Patterning the Muscles | 218 |
Selecting Safe and Effective Exercises | 220 |
A Sample | 221 |
Exercises That May Be Used in a Stabilization Program | 222 |
Advanced Exercises | 230 |
Safely Increasing Challenges | 231 |
Safely Progressing Back Exercises | 233 |
Occupational and Athletic Work Hardening | 236 |
Low Back Exercises Only for Athletes | 238 |
Looking Forward | 241 |
EPILOGUE | 243 |
HANDOUTS FOR PATIENTS OR CLIENTS | 244 |
APPENDIX | 268 |
GLOSSARY | 274 |
276 | |
301 | |
ABOUT THE AUTHOR | |
Other editions - View all
Low Back Disorders: Evidence-based Prevention and Rehabilitation Stuart McGill No preview available - 2007 |
Low Back Disorders: Evidence-based Prevention and Rehabilitation Stuart McGill No preview available - 2002 |
Low Back Disorders: Evidence-based Prevention and Rehabilitation Stuart McGill No preview available - 2002 |