Dear Jason,
I really wonder in what kind of mood McKenzie was in when he said all those
things.
"All they need is a return to normal activitie after surgery."?? One the
four syndromes McKenzie identifies is dysfunction - flexion ROM is not full
and painless because of scar formation (note that McKenzie's definition is
different from the regular definition). His book is full of techniques and
exercises to mobilise such a dysfunction, both post-derangement and
post-operative......
Would you have the references at hand of the articles you're referring to,
about abd. exs. activating the multifides muscles?
R.,
Frank
----- Original Message -----
From: "Jason Steffe" <[log in to unmask]>
To: <[log in to unmask]>
Sent: woensdag 8 augustus 2001 1:13
Subject: Re: Core stability questions/Proper sitting posture
Frank is hitting the nail on the head. I read the same publication that
Barrett did and was quite surprised. He goes on to say that (I'm
paraphrasing here) S/P laminectomy and discectomy patients don't need
rehabilitation if the surgery is successful. All they need is a "return to
normal activities." I'm not sure what he means by successful.....I assume
he is talking about resolution of pain and not restoration of function. One
doesn't necessarily lead to the other.
With regards to stab ex's he states that low back patients "will regain
their strength in due course."
Recent research by Jull, Richardson and Hides clearly shows that the
multifidus and Transverse abdominus do not automatically "turn on" with
resolution of symptoms and return to normal activities. This turned out to
be true a year later in a follow-up investigation with the same population.
They concluded that this cycle may leave an individual vulnerable to LBP
recurrence.
I think that when he stated that the concept of stabilization is noble but
futile, I took it to mean that he was referring to the pelvic tilt (stop,
stabilize, and then carry on). The pelvic tilt, and anyone with EMG
knowledge can refute or agree, tends to predominantly activate the rectus
and not so much the TA and multifidus. The quad. ab isom. exercise has been
shown to condition, strengthen and "turn on" the multifidus and TA by the
above mentioned authors. They have a book out, which is excellent, called
Therapeutic Exercise for Spinal Segmental Instability.
Jason
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