Motion Stability's Blog

Different Muscles, Different Roles by Motion Stability
April 12, 2008, 8:08 pm
Filed under: Movement Dysfunction

Bergmark, A. Stability of the lumbar spine: A study in mechanical engineering. Acta Orthop Scand 1989;60:Suppl.230

In this mechanical engineering dissertation, Bergmark differentiates the concept that certain muscles surrounding the lumbar spine play different roles. In physical therapy lingo, we call the larger muscles, that we tend to exercise at the gym, as ‘global’ muscles..while the smaller muscles that connect more vertebrae to vertebra as ‘local’ muscles. ‘Global’ muscles such as the rectus abdominis, external obliques, and latissmus dorsi are more designed for force production, movement and torque. While the ‘local’ muscles such as the lumbar multifidus, primarily the deep multifidus that attach 1-2 vertebrae are designed for intersegmental spinal stability. In daily function we need an interplay between ‘global’ and ‘local’ muscles to so that we have muscle that are designed to stabilize the spine, while others provide movement and force production. In core stability training, we need to design programs that can specify muscle contractions of both groups of muscles. Too many general programs focus on the larger global muscles, and even when professionals talk about exercising the ‘local’ muscles, we have found a lack of specificity to the situation. The use of real-time ultrasound imaging in ‘local’ muscles provides the most direct visual feedback to the client how to contract the transversus abdominis, pelvic floor, and lumbar multifidus.

Increased Spending on Low Back Pain by Motion Stability
April 12, 2008, 7:50 pm
Filed under: Spine

Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA 2008;299(6):656-664.

In this article, this study examined national expenditures for back and neck problems or related trends from 1997 to 2005. In 1997, the mean medical expenditures with spine problems was $4695 compared with $2731 among those without spine problems. In 2005, the mean medical expenditures with spine problems was $6096, compared with $3516 among those without spine problems. And total estimated expenditures among those with spine problems increased 65% in this time, without significant reports in improvements in health status measures. Although expenditures for outpatient visits accounted for the largest proportion of total cost, the greatest relative increase among expenditure categories was due to increased medication use. This article demonstrates that traditional management of low back pain, which includes imaging, injections, medication intake and other conservative management interventions are not providing proper solutions, and causing an inflated rate in expenditures. A more broad, but defined perspective of what pain is, and what it can do to alter the neuro-musculoskeletal system needs to be explored to fully understand how to treat it. We will continue to explore this in the blog site.