rehabilitation

What is Rehabilitation?

Rehabilitation is the process whereby injured or malfunctioning musculoskeletal tissue is facilitated through the healing process or re-educated to perform its normal function.

At Bodymotion Chiropractic and Sports Injuries Clinic, we take a proactive approach to treating back injuries. As such, once pain has reduced, our attention is directed to off-loading the area of pain and stabilising the spine. This aims to tackle the dysfunction at its root thus helping to prevent further malfunction and reccurrences.

How does rehabilitation help with back pain?

The musculoskeletal core is made up of the spine, pelvis, hips and abdominal structures.

The cores musculature is responsible for:

1. The maintenance of stability of the spine and pelvis,
2. Helping to transfer energy from large to small body parts during activity
3. Provide a solid base for our peripheral limbs to work from.1

If our core is weak, or our spine moves abnormally due to a dysfunction, then joints and tissues

will be stressed in a way they are not familiar with or not designed to cope with. This is one of the ways by which injuries can occur to the back and neck pain.

The easiest way to describe the core is to explain its function in relation to its design. Some authors have described it as the ‘abdominal box’. Our abdominals acts as the front (our 6 pack muscles) while our paraspinals and gluteals act as the back. The diaphragm is the roof and the pelvic floor as the base. An integral part of the core is a muscle called the transverses abdominis (TVA); it wraps around the abdomen and lies underneath our internal obliques. It is a deep muscle laying 4 layers deep in our abdominal tissue acting as a natural corset.3  

The ‘abdominal box’.5

Closely related to the TVA is the thoracolumbular fascia. This is an expanse of tissue incorporated into the maze of core muscular attachments. It acts as ‘natures back belt’ and plays a big role in core stabilisation. The TVA has large attachments to the middle and posterior portions of the thoracolumbular fascia creating a stability blanket across the entire midriff.2

Image from DeRosa C, Porterfield JA; 1998.

This concept is easier to understand when relating it to securing a tent against the wind. The tent itself (thoracolumbular fascia) is held up by the centre pole (spine), and without the support and tension provided by the guy ropes (abdominal musculature) the centre pole bares the full weight of the tent putting it under stress (back pain). In this state the tent is vulnerable to being blown over (injury). When the guy ropes are pulled tight (core contracts and stabilises) the tent (thoracolumbular fascia) is pulled tight, giving the pole (spine) even, bilateral stability and integrity against the elements (activity).

What can i Expect In my rehabilitation Assessment and Treatment

Rehabilitation treatment aims to address the issue at hand through three stages;

1. Address the symptoms – This aims to have the patient leave the clinic in a better state than they entered. Relieving pain eases the mind and body simultaneously, allowing the patient to approach their rehab program with a focused and enthusiastic manner.
2. Remove the restriction – Second is to remove the restriction that is causing the symptoms.
3. Remove the cause – Finally, we remove the cause of the restriction, tackling the problem at the root of the cause, preventing associated issues further up the chain.

Here at Bodymotion we look at the whole body when assessing injuries. More than often, an assessment will include a postural and biomechanical assessment, muscle strength and flexibility testing, an in depth social and medical history and special test for the injured area.

Our Rehabber, Jack Fishwick specialises in sports related musculoskeletal injuries, however, he also holds the knowledge and skills to treat anything from a sprained ankle to post operative knee injuries to prolapsed discs.

Treatments/ techniques used by Rehabilitators:

• Electrotherapy (Ultrasound and Interferential)
• Muscle Strengthening
• Muscle Lengthening Techniques (E.G. muscle energy techniques)
• Taping
• Proprioceptive Training
• Core Stability
• Sports Massage and Soft Tissue Techniques
• Sports Specific Rehabilitation Training

If you have any questions regarding Rehabilitation, please do not hesitate to conact Jack at jfishwick@body-motion.co.uk

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1. Kibler WB, Press J and Sciascia A. The Role of Core Stability in Athletic Function. Sports Med. 2006: 36; 189-198.
2. Hides J, Hodges P, Jull G, Richardson C. Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain: Scientific Basis and Clinical Approach. Edinburgh (NY): Churchill Livingstone; 1999.
3. Nadler DO, Scott F, Venu Akuthota MD. Core Strength. Arch Phys Med Rehabil. 2004: 85; S86-92.
4. DeRosa C, Porterfield JA. Mechanical Low Back Pain: Perspectives in Functional Anatomy. 2nd ed. Philadelphia: WB Saunders; 1998.
5. Image from (http://www.nzihf.co.nz/media-resources-1/articles/core-training-as-a-personal-trainer-where-do-i-start) 7/12/2010.