Spine Health. PROCEDURE 6 — EXTENSION IN STANDING

The patient stands with the feet well apart and places the hands (fingers pointing backwards) in the small of the back across the belt line. He leans backwards as far as possible, using the hands as a fulcrum, and then returns to neutral standing. The exercise is repeated about ten times. As with extension in lying it is necessary to move to the very maximum to obtain the desired result.

Fig. Extension in standing.

Effects:

Extension in standing produces similar effects on derangement and dysfunction as extension in lying, but it is less effective in the earlier treatment stages of both syndromes. Whenever extension in lying is prevented by circumstances, an extension stress can be given by extension in standing.

READ:   Spine Health. PROCEDURE 3 — EXTENSION IN LYING

In derangement, extension in standing is designed to reduce accumulation of nuclear material in the posterior compartment of the intervertebral joint, provided this accumulation is not gross. In the latter case extension in lying will have to be performed first. The procedure is very important in the prevention of the onset of tow back pain during or after prolonged sitting or activities involving prolonged stooping, and is very effective when performed before pain is actually felt.

Spine Health. PROCEDURE 17 – SELF-CORRECTION OF LATERAL SHIFT Having corrected the lateral shift and the blockage to extension, it is now essential to teach the patient to perform self-correction by side gliding in standing followed by extension in standing. This must be done on the very first day, so that the patient is equipped with a means of reducing the derangement himself at first sign of regression. Failure to teach self-correction will lead to recurrence within hours, ruining the initial reduction, and the patient will return the next day with the same deformity as on his first visit. I have discarded the technique of self-correction as described previously and instead I now teach patients to respond to pressures applied laterally against shoulder and pelvis. Initially, therapist’ assistance is required. Patient and therapist stand facing each other. The therapist places one hand on the patient’s shoulder on the side to which he deviates, and the other hand on the patient’s opposite iliac crest. The therapist applies pressure by squeez...
Kyphosis: Causes, Symptoms and Diagnosis What Causes Kyphosis? Kyphosis, also known as roundback or hunchback, is a condition in which the spine in the upper back has an excessive curvature. The upper back, or thoracic region of the spine, is supposed to have a slight natural curve. The spine naturally curves in the neck, upper back, and lower back to help absorb shock and support the weight of the head. Kyphosis occurs when this natural arch is larger than normal. If you have kyphosis, you may have a visible hump on your upper back. From the side, your upper back may be noticeably rounded or protruding. In addition, people with hunchback appear to be slouching and have noticeable rounding of the shoulders. Kyphosis can lead to excess pressure on the spine, causing pain. It may also cause breathing difficulties due to pressure put on the lungs. Kyphosis in elderly women is known as dowager’s hump. Common causes of kyphosis Kyphosis can affect people of any age. It rarely occurs in newborns because it’s usually caused...
Spine Health. PROCEDURE 5 — SUSTAINED EXTENSION To apply a sustained extension stress to the lumbar spine an adjustable couch, one end of which may be raised, is a necessary piece of equipment. The patient lies prone with his head at the adjustable end of the couch which is gradually raised, about one to two inches at the time over a five to ten minute period. Once the maximum possible degree of extension is reached, the position may be held for two to ten minutes, according to the patient’s tolerance. When lowering the patient the adjustable end of the couch should slowly be returned to the horizontal over a period of two to three minutes. This must not be done rapidly, for acute low back pain may result. Fig. Sustained extension. Effects: The procedure is predominantly used in the treatment of derangement. The effect is similar to that of the third procedure, but a time factor is added with the graduated increase and the sustained nature of the extension. In certain circumstances a sustained extension stress is preferable...
Acute Low Back Pain. General Instructions You must retain the lordosis at all times (lordosis is the hollow in the lower back). Bending forwards as in touching the toes will only stretch and weaken the supporting structures of the back and lead to further injury. Losing the lordosis when sitting will also cause further strain. SITTING When in acute pain you should sit as little as possible, and then only for short periods only. At all times you must sit with a lordosis. Therefore you must place a supportive roll in the small of the back, especially when sitting in a car or lounge chair. If you have the choice you must sit on a firm, high chair with a straight back such as a kitchen chair. You should avoid sitting on a low, soft couch with a deep seat; this will force you to sit with hips lower than knees, and you will round the back and lose the lordosis. The legs must never be kept straight out in front as in sitting in bed, in the bath or on the floor; in this position you are forced to lose the lordosis. W...
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...