Spine Health. PROCEDURE 2 — LYING PRONE IN EXTENSION

The patient, already lying prone, places the elbows under the shoulders and raises the top half of his body so that he comes to lean on elbows and forearms while pelvis and thighs remain on the couch. In this position the lumbar lordosis is automatically increased. Emphasis must be placed on allowing the low back to sag and the lordosis to increase.

Fig. Lying prone in extension.

Effects:

Procedure 2 is a progression of procedure 1 and merely enhances its effects by increasing extension.

Again, in derangement some time must be allowed to affect the contents of the disc and, if possible patients should remain in this position for five to ten minutes. In more acute patients sustained extension may not be well tolerated due to pain, and initially we must rely on the use of intermittent extension.

READ:   Spine Health. PROCEDURE 4 — EXTENSION IN LYING WITH BELT FIXATION
Hyperlordosis: Treatment, Prevention, and More What’s hyperlordosis? Human spines are naturally curved, but too much curve can cause problems. Hyperlordosis is when the inward curve of the spine in your lower back is exaggerated. This condition is also called swayback or saddleback. Hyperlordosis can occur in all ages, but it’s rare in children. It’s a reversible condition. Keep reading to learn about the symptoms and causes of hyperlordosis and how it’s treated. What are the symptoms of hyperlordosis? If you have hyperlordosis, the exaggerated curve of your spine will cause your stomach to thrust forward and your bottom to push out. From the side, the inward curve of your spine will look arched, like the letter C. You can see the arched C if you look at your profile in a full-length mirror. You may have lower back pain or neck pain, or restricted movement. There’s limited evidence connecting hyperlordosis to lower back pain, however. Most hyperlordosis is mild, and your back remains flexible. If the arch in your bac...
Spine Health. PROCEDURE 11 — SUSTAINED ROTATION/MOBILISATION IN FLEXION The patient lies supine on the couch, and the therapist stands on the side to which the legs are to be drawn, facing the head end of the couch. The patient’s far shoulder is held firmly on the couch by the therapist’s near hand, providing fixation and stabilisation. With the other hand the therapist flexes the patient’s hips and knees to a rightangle and carries them towards himself, causing the lumbar spine to rotate. With the patient’s ankles resting on the therapist’s thigh the knees are allowed to sink as far as possible and the legs are permitted to rest in that extreme position. The lumbar spine is now hanging on its ligaments in a position which combines side bending and rotation. By pushing the knees further towards the floor the therapist applies overpressure to take up the remaining slack in the lumbar spine. Depending on the purpose for which the procedure is used, the position of extreme rotation is maintained for a shorter or longer period. Fig. Sustained rotation/mob...
Spine Health. PROCEDURE 16 — CORRECTION OF LATERAL SHIFT This procedure has two parts: first the deformity in scoliosis is corrected; then, if present, the deformity in kyphosis is reduced and full extension is restored. The patient, standing with the feet about thirty centimeters apart, is asked to clearly define the areas where pain is being felt at present. The therapist stands on the side to which the patient is deviating and places the patient’s near elbow at a right angle by his side. The elbow will be used to increase the lateral pressure against the patient’s rib cage. The therapist’s arms encircle the patient’s trunk, clasping the hands about the rim of the pelvis. Now the therapist presses his shoulder against the patient’s elbow, pushing the patient’s rib cage, thoracic and upper lumbar spine away while at the same time drawing the patient’s pelvis towards himself. In this manner the deformity in scoliosis is reduced and, if possible slightly overcorrected. Initially, there will be significant resistance to the procedure, wh...
TYPICAL TREATMENT PROGRESSION — THE POSTURAL SYNDROME The days referred to in the treatment progression are related to treatment sessions which do not necessarily take place on consecutive days. This also applies for the treatment progressions of the dysfunction and derangement syndromes. Day one Assessment and conclusion/diagnosis. Postural discussion ensuring adequate explanation of the nature of the problem. The patient must understand the cause of pain. I usually give the simple example of pain arising from the passively bent forefinger. We must satisfy ourselves and the patient that the pain can be induced and abolished by positioning. If it is not possible to induce pain during the first treatment session, the patient must be instructed mow to abolish pain by postural correction when next it appears. Commence with postural correction exercises and give postural advice; do not try to teach too much the first visit. Discuss the importance of maintenance of the lordosis while sitting prolonged, and demonstrate the u...
TREATMENT OF EXTENSION DYSFUNCTION By far the most common form of ⚡ dysfunction ⚡ is that involving loss of extension. Having already explained and taught the postural requirements, we must now instruct the patient in the methods required to regain lost extension. We must explain to him the reasons for the need to recover the extension movement. The patient must realise that without an adequate range of extension it is not possible to sit with a lordosis, even when a lumbar support is used. For some patients it is imperative that the range of extension be improved, otherwise they will be unable to sit correctly. It is my experience that, following adequate explanation, patients will co-operate with the treatment and work hard at their recovery. They will perform exercises that cause discomfort or even pain, as long as they understand the reasons for doing so. Fig. Recovery of loss of extension, using the procedure of extension in lying. Exercises In order to systematically stretch the lumbar spine in extension, I...