Biomechanics of core muscles

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biomechanics of lumbar core muscles\
Khushali Jogani
The Sarvajanik College Physiotherapy,
Rmpura,Surat.

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Biomechanics of core muscles

  1. 1. By: Khushali Jogani The Sarvajanik College Of Physiotherapy Rampura,Surat
  2. 2.  What is core  Models for spinal stabilization  Muscles of core  Biomechanics of core muscles  References
  3. 3.  What is core? CORE is defined as a clinical manifestation in which a delicate balance of movement and stability occurs simultaneously.  The “core” has been described as a box with the abdominals in the front, paraspinals and gluteals in the back, the diaphragm as the roof, and the pelvic floor and hip girdle musculature as the bottom.
  4. 4.  Attention to core is important because it serves as a muscular corset that works as a unit to stabilize the body and spine, with and without limb movement.  In short, the core serves as the center of the functional kinetic chain.
  5. 5.  Stabilization of lumbar spine is provided by the passive support of the osseoligamentous structures, the support of the muscle system, and control of the muscle system by the central nervous system.  Interrelated parameters of spinal stability need to be considered due to the multisegmental nature of the lumbar spine.
  6. 6.  Control of spinal orientation, which relates to the maintenance of the overall posture of the spine against imposed forces and compressive loading.  Control of the intersegmental relationship at the local level (i.e.lumbar segmental control), irrespective of changes in the overall orientation of the spine.  Control of lumbopelvic orientation
  7. 7.  The main function of lumbopelvic hip region is to transfer the loads generated by the body weight and gravity during standing, walking and sitting.  Panjabi introduced an innovative model for the spinal stabilization system(effective load transfer) which serves as an appropriate model for understanding the entity of spinal stability and instability.  It included passive, active and neural control systems and all these three systems produce approximation of joint surfaces which is essential if stability is to be insured.
  8. 8.  The amount of approximation required is variable and and difficult to quantify as it depends on individual’s structure and forces they need to control.
  9. 9.  The integrated model of function is been proposed for managing impaired function.  It has four components: -form closure -force closure -motor control -emotional
  10. 10. 1. Form closure - It was coined by Vleeming and snijders. - All joints have variable amount of form closure. - Depending on individual’s anatomy –decides the force closure. - Form of lumbar spine, pelvis &hip are included.
  11. 11.  The Lumbar region -compression -torsion or rotation -posteroanterior translation  The pelvic girdle  The hip
  12. 12. 2. Force Closure  If the articular surfaces of the lumbar spine, pelvic girdle, and hip were constantly and completely compressed, mobility would not be possible. However, compression during loading is variable and therefore motion is possible and stabilization required.  This is achieved by increasing compression across the joint surface at the moment of loading
  13. 13.  The amount of force closure required depends on the individual's form closure and the magnitude of the load. The anatomical structures responsible for force closure are the ligaments,muscles, and fascia. 3. Motor control 4. Emotions
  14. 14.  By active subsystem of panjabi model, muscles provides the mechanism by which control system may modulate the stability of spine.  Stability of spine is important because movement is important for optimal spinal health.  Movement is required to assist in dissipation of forces and to minimize the energy expenditure.
  15. 15.  Lumbopelvic stability is provided by the core muscles.  Bergmark has categorised the trunk muscles into local and global muscle system.  Local muscle system stabilises the spinal segment whereas global muscle system act as guy ropes to support the vertebrae
  16. 16.  Anterolateral abominal paraspinal wall and abdominal muscles of cavity lumbar region posterior abdominal wall
  17. 17.  Anterolateral abominal wall and abdominal cavity  Global muscles(obliquus internus abdominis, obliquus externus abdominis, rectus abdominis  Transversus abdominis  Diaphragm and pelvic floor
  18. 18.  Global muscles -Four slings of muscle system stabilizes the pelvis regionally. -posterior, anterior, longitudinal, lateral slings -Individual muscles are important for regional stabilization and mobility and it is necessary to understand how they connect and function togather. -Muscle contraction-production of forces-transfer of forces-transfer of load-increases the stiffness of SIJ
  19. 19. -Global muscle-integrated sling system. -participation of muscle in more than one sling- overlap & interconnect-depending on task -obliquus externus abdominis make a powerful contribution to control of buckling forces -contribution to lumbopelvic movement and stabilization is based on moment arm and direction of forces. -if high loads are unpredictable, muscles on both sides are coactivated to stiffen the trunk.
  20. 20.  Transversus abdominis - Due to transverse orientation of muscle it has limited ability to flex, extend or laterally flex the spine. - Limited moment arm to contribute to rotatory torque. - Contribution through spinal buckling. - Though contribution is small,it produces very efficient effect. - Modulation via intra-abdominal pressure(IAP), fascial tension and compression of sacaroiliac joint
  21. 21.  Intra-abdominal pressure -IAP in daily activities -abdominal cavity as ‘pressurized balloon’ -production of extension torque and offset of flexion moment by abdominal muscle -TrA is the most active of abdominal muscles in extension efforts. -concurrent flexion and extension moments may increase spinal stiffness like co-contraction. -IAP increase spinal stiffness
  22. 22.  Fascial tension -thoracolumbar fascia and contribution to spinal stiffness -TrA muscle and its attachment to thoracolumbar fascia. -Mechanics of thoracolumbar fascia -control of intersegmental motion via lateral tension in thoracolumbar fascia. -stabilization of lumbar spine in coronal plane via tension in middle layer of thoracolumbar fascia.
  23. 23.  Pelvic stability -mechanism of stability of sacro-iliac joint is dependent on compression between ilium and sacrum.
  24. 24.  Diaphragm and pelvic floor -contribution through IAP and restriction of movement of abdominal viscera for spinal stability
  25. 25.  Posterior abdominal wall  Psoas -it has tendency to overactivity and tightness -two separate muscles and contribution of posterior fibres for control of intervertebral motion.  Quadratus lumborum -its medial fibres through the attachment to lumbar vertebral transverse processes is capable of providing segmental stability via its segmental attchment
  26. 26.  Paraspinal muscles of lumbar region  Intersegmental muscles -intertransversarii -interspinales  Lumbar muscles -lumbar multifidus -longissimus thoracis -iliocostalis lumborum
  27. 27.  Biomechanical factors -control of neutral zone -control of lordosis -tensioning the thoracolumbar fascia -control of shear forces
  28. 28.  Control of neutral zone -lumbar muscles increase the spinal segmental stiffness and control of neutral zone -increased combined muscle activation -muscle forces decrease the sagittal plane displacement ,anterior rotation and anteroposterior translation -load bearing surface of zygoapophyseal joints -intersegmental nature of multifidus
  29. 29.  Control of lordosis -spinal curves efficient to deal with force of gravity -role of mulitifidus -local and global muscles increase the capacity of spine to withstand the compressive forces without buckling.  Tensioning the thoracolumbar fascia -muscle enhance the spinal stability by increasing stiffness of spinal segment -thoracolumbar fascia contributes to lumbar stabilization by increasing the bending stiffness of spine.
  30. 30.  Control of shear forces -shear forces are those that cause the vertebrae to slide with respect to one another -control of anterior shear forces -Provided by passive elements as well as muscles -lumbar extensor muscles helps in controlling
  31. 31.  Carolyn Richardson,Paul Hodges,Julie Hides Therapeutic exercise for lumbopelvic stabilization. second edition.  Diane Lee,Paul Hodges,The pelvic Girdle,an approch to the examination and treatment of the lumbopelvic-hip region.Third edition.  Carolyn Richardson,Gwendolen Jull, Julie Hides,Paul Hodges. Therapeutic exercise for spinal segmental stabilization in low back pain

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