Dear Sood,
In my opinion you are talking about two different mechanisms when
you say lordosis verses extension exercises.
When someone is placed in high heels the following happens:
1. Anterior pelvic tilt increases lordosis (as you say)
2. Increases in vertebral shear at L4-5 and L5-S1 levels
3. Glut max is at a mechanical disadvantage
4. Centre of Gravity is shifted forwards over a decreased base
(If you lift your foot up you shorten your base a few centimetres)
By the way, this is why you have an anterior tilt - to maintain
COG over the shortened base
5. Iliacus is in a shortened position and becomes tight
6. Psoas may increase shear stresses when attempting to bring
the swing leg through.
7. decreased shock absorbtion through the sacrum and pubic
rami as the sacrum is now nutated and locks the SIJ
8. Walk with increased knee flexion (possibly because they can't
get into hip extension)
9.develop tight calves
10. May have poor abdominals from anterior tilt
These all add up to shear, increased load through the lumbar
spine, and faulty stability mechanics ---> PAIN.
With lumbar extensions you are no doubt producing some shear
but it is controlled, and NWB. It is more like an intervertebral
mobe. Thus it is feasible that this could ease pain.
Does this make sense?? Let me know what you think.
Scott.
--
On Sat, 11 Mar 2000 22:27:24 Sood wrote:
>Dear friend,
> I was just wondering if anyone has studied the effect of footwear
>with heigh heels have on back pain,biomechanics and pathogenesis of .I think for sure it increases Lumbar lordosis,Won't it be a fashionable idea to maintain lumbar lordosis in the ladies by the use of
>high heels instead of lumbar taping ? In Plantar fascists they sure helped some of patients by shifting
>weight from heel to fore -foot. Just few days back I helped a back pain lady patient of pain by changing her footwear from heigh heels to No heels.She had pain in lower back migrating to both
>legs which centralized with EIL.
> Please tell me if lordosis was able to help her than why
>heels which increased the lordosis also increased the pain and removal of heels helped to reduce pain?
>
>Dr.Sarveshwar Sood
>Orthopaedic Surgeon & Head Department of Physical
>Medicine & Rehabilitation,
>Member American Academy Of Pain Management.
>S.B.L.S.Hospital
>812/1,Housing Board Colony
>Model Town,Jalandhar city
>Punjab State.India
>E-mail [log in to unmask]
>http://Personal.vsnl.com/sarvesh
>
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