#Repost @rehabscience ・・・
Functional Spinal Control
Movement control of our spine is dependent on the interaction between three primary subsystems. These subsystems include the neural (control center), muscular (active) and osteoligamentous (passive).
Thinking of spinal control within this framework is helpful in understanding how injury or pain might compromise control and how deficits in one subsystem may create greater reliance on the others. Here are three examples:
1️⃣ Some people experiencing low back pain (LBP) demonstrate inhibition of the muscular stabilizers of the spine, which means then they may be at a greater risk of stressing passive subsystem elements (ligaments, discs, etc) due to diminished muscle control leading to excessive mobility between adjacent vertebrae.
2️⃣ Some people with LBP demonstrate reflexive tightening of the abdominal girdle, which is thought to be the brain's response to danger and it's solution to protecting the back. In reality, there may be too much neuromuscular activity, which increases compressive forces on spinal tissue and may result in more pain.
3️⃣ Someone who has disrupted a passive subsystem element (i.e. fracture/spondylolisthesis, ligament instability/tear, etc) would have to rely to a greater degree on the neural and muscular subsystems (unless they have surgery) in order to control their spine as the passive restraints have been negatively altered.
We are all unique in terms of how and to what degree these subsystems work together based on factors such as genetics, athletic background, injury history and so on. Hopefully, trainers and rehab folks will find this simple illustration to be a useful tool in helping patients/clients understand the factors involved in spinal control.
Hodges PW et al. Moving differently in pain: a new theory to explain the adaptation to pain. Pain. 2011.
MacDonald D et al. Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain. Pain. 2009.
Panjabi MM. The stabilizing system of the spine. J Spinal Disord. 1992.