Debra Dent – Spine Health & Trunk Stability: Influence of the Thorax & Respiration

Outline

Clinical Observations & Implications

• Evidence-based practice and clinical observation
• Clinical implications for patient populations
  • Chronic low back and SI joint pain
  • Scoliosis and trunk weakness in the elderly
  • Chronic hip and lateral knee pain
  • Chronic cervical pain and headaches
  • Shoulder impingement
  • Thoracic outlet syndrome
  • Fibromyalgia
  • Balance and gait deviations
  • Athletic performance
• Case histories — Could this be your patient?
  • Chronic pain
  • Marathon runner/triathlete
  • Chronic low back and neck pain

Anatomy

• Respiratory and thoracic anatomy/biomechanics
  • Thoracic anatomy
  • Rib anatomy
  • Thoracic biomechanics
  • CT junction biomechanics
  • TL junction biomechanics
    • Trunk musculature
      • Core-inner group
      • Outer group
      • Posterior oblique
      • Deep longitudinal
      • Anterior
      • Lateral
      • Psoas/hamstring integration
      • Scalenes, SCM, C spine muscles
    • Muscles of inspiration
    • Muscles of expiration
  • Mechanics of respiration
    • Normal breathing-mechanical effects
  • Physiology of respiration
    • Lung volumes
    • Lung perfusion
    • Hyperventilation/alkalosis
• Fascial integration
  • Thorocolumbar fascia
  • Lateral femoral fascia/IT band
  • Abdominal fascia
  • Cervical/UE and Pelvis/LE biomechanical relationships

Neuromuscular Control

• Central nervous system on muscle tone and movement
• Sympathetic and parasympathetic responses

Lab Demonstration

• Evaluation and treatment techniques
• Evaluation of posture as it relates to respiratory function, UE, pelvis and lumbar function

• Mechanics of respiration
• Diaphragmatic, lateral costal, sternal, apical breathing
• Diaphragm position
• Seated arm raise
• Seated trunk rotation
• Standing torque
• Muscle function testing
  • Supine active SLR
  • Prone active SLR and active arm raise
    • TA, multifidus, and pelvic floor function
    • Posterior oblique system
    • Anterior oblique system
    • Lateral system
• Rib position and mobility testing and active mobilizations
• Length testing and lengthening techniques
• Core facilitation entry training program
• Case histories evaluations, treatments, and outcomes

Theory & Evidence-Based Practice

• Suboptimal breathing patterns
  • Over-inflation
  • Upper chest breathing
• Diaphragm and thoracic restrictions effects on the lumbar spine/hips/LE, C spine and UE- trunk rotation, or lack of trunk rotation effects
  • Posture and flawed load transference
  • Trunk stability and the diaphragm/core/incontinence
  • Hypertonicity/over activation of the superficial trunk muscle
  • Chronic low back and SI joint pain with poor control
  • Scoliosis and trunk weakness in the elderly
  • Chronic hip and lateral knee pain
  • Chronic cervical pain and headaches
  • Shoulder impingement issues
  • Thoracic outlet syndrome
  • Fibromyalgia
  • Balance and gait deviations
  • Athletic performance
• Respiratory alkalosis/hyperventilation and the consequences
• Chronic fatigue, fibromyalgia, chronic pain