Spinecare Topics
Spinal Rehabilitation and Stabilization
The purpose of spinal
rehabilitation is to reduce pain and improve function. This is accomplished through the
implementation of effective therapeutic exercise. Spine rehabilitation is indicated for individuals who have
become physically deconditioned as the result of injury, inactivity, a
degenerative process, pain inhibition or fear-avoidance behavior. Even though many
obvious test abnormalities may not be present, the problems associated with
chronic musculoskeletal pain can be devastating to the individual and their
family.
The importance of spinal
rehabilitation is based upon a few basic facts. Abnormal or inefficient muscle function around a joint can
lead to chronic musculoskeletal pain.
This may be caused by loss of muscle integrity, muscle incoordination,
muscle weakness, muscle atrophy, muscle spasms and decreased muscle
endurance. The majority of muscle
and related soft tissue problems do not require surgery. An unguarded or
unprotected joint leads to cumulative trauma to the tissues of the joint that
results in increased musculoskeletal pain. The goals of a spinal rehabilitation program are to improve
muscle control, to improve muscular endurance, to improve coordination and to
promote stability and function of the spine.
Before starting a
supervised exercise program, one should have an assessment of musculoskeletal function
including strength, flexibility, endurance, coordination, and balance. Whenever possible the evaluation should
document quantifiable loss of function (functional deficit). The attending rehabilitation specialist
will design an exercise program to address the “functional weak links�. The tailored program should address
individualized intensity, frequency and duration of exercises required in order
to improve function. Motivation is key to successful participation in a spinal
rehabilitation. Active encouragement is sometimes necessary because of a lack
of perceived improvement. In some cases improved function will precede a
significant reduction of pain.
Spinal exercises should be
performed within a functional training range (FTR). The FTR refers to the range or magnitude of movement that is
painless. To achieve this goal, specialized
equipment is not always necessary.
Many of these exercises can be performed with body weight and low-tech
equipment such as elastic bands.
The attending
rehabilitation specialist should be experienced in directing a spine
rehabilitation program in order to improve muscular endurance, flexibility,
muscular coordination, balance, postural control, strength and flexibility
through therapeutic exercise. The resulting goal of the therapeutic approach is
to improve the dynamic capacity of supporting muscles of the spine and thereby
stabilize the spinal region.