[headline style=”1″ align=”center” headline_tag=”h2″]Why Preventing Motion Is Important
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The lumbar spine is commonly injured. Often times this is because the thoracic spine and hips typically become hypo-mobile while the lumbar spine moves too much. Overtime this increases stress which can cause serious pathology such as stenosis, spondylolisthesis, or a disc injury. Blocking motion at the lumbar spine while mobilizing the other adjacent areas or segments is a exercise strategy that is often needed. In this post I will disclose how I use two forms of locking to achieve this: facet and ligamentous.
[headline style=”1″ align=”center” headline_tag=”h2″]What is Locking of the Spine
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As a manual therapist we block the lumbar spine to prevent motion when manipulating. Just like we do with hands-on care, we can also apply this same concept with exercise. We can lock it two ways:
1). Facet
2. Ligamentous
Because the facet joints dictate motion of the spine, if we position the joint in one plane we can either restrict or enhance motion in another plane. This is facet locking.
The spine has an array of ligaments that connect to each vertebra. We can put these ligaments on stretch or tension, which can restrict motion. I use it most frequently by posterior tilting the pelvis which flexes the spine and restricts motion at those segments. See below.
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[headline style=”1″ align=”center” headline_tag=”h2″]Fryette’s Laws
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Before disclosing how I use locking clinically, we first need to understand Fryette’s two laws. This forms the basis for the concept. Once you understand these two laws, you can create your own exercises.
Law 1: When the lumbar and thoracic spine is neutral, rotation one direction is coupled by opposite side lateral flexion.
For instance, rotation right is coupled with left lateral flexion.
Law 2: When the lumbar and thoracic spines are beyond neutral in either flexion or extension, the spine will rotate and side bend the same direction.
For instance, rotation right is coupled with lateral flexion to the right.
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[headline style=”1″ align=”center” headline_tag=”h2″]How I Use Locking
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I typically use locking for three types of patients:
- Block Hyper Mobilities and Mobilize Hypo-mobile Segments
- Stenosis Patients
- Disc Patients
Below you will see several of these examples.
[headline style=”1″ align=”center” headline_tag=”h2″]Hypo and Hyper Segments
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[headline style=”1″ align=”center” headline_tag=”h2″]Spondylolisthesis
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[headline style=”1″ align=”center” headline_tag=”h2″]Stenosis
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[headline style=”1″ align=”center” headline_tag=”h2″]Disc Pathology
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For the disc injury, you will typically want to hold the spine in a extended position if it is a Mckenzie type of disc. For instance, if a lesion was on the right L3/L4 segment, I may want to extend the spine in an anterior pelvic tilt using facet locking. This will then allow mobilization of the above segments.
Conversely, if it is a disc that responds to opening of the foramen, I may want to keep the patient’s spine neutral in the sagital plane so I can maximize opening the foramen in the frontal or transverse plane. For instance, if the lesion was on the right, I could put a pillow under the left hip. This will laterally flex left and rotate spine to the right.
[headline style=”1″ align=”center” headline_tag=”h2″]Conclusion
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Facet and ligamentous locking is a simple exercise strategy. You can use these concepts to successfully rehabilitate an array of lumbar spine pathologies. Understanding the ligamentous anatomy and the premise of Fryette’s rules forms the foundation. Give this a try and let me know if you have any questions.
