the cervical spine – understanding the science behind both movement and dysfunction

The Cervical Spine – Understanding The Science Behind Both Movement And Dysfunction

By Chris Gellert

www.fitnessprofessionalonline.com

The spine is a complex

structure, comprised of

nerves, connective

tissue, bones, discs,

muscles and other

essential integrative

components.

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Specifically, the cervical

spine is a vulnerable area

that is commonly injured

due to fall, trauma, motor

vehicle accident, stress, as

well as poor ergonomic

setups, which all lead to

pain.


By Chris Gellert








Basic anatomy When we look at the

neck, there are seven

bones(vertebrae) that

are part of the

supportive column of

the spine.


By Chris Gellert








Within the cervical region,

there are several key

anatomical structures that

include; spinous process,

transverse process, and

facets, which are an

articular surface within the

bone that allows gliding of

bones to occur.


By Chris Gellert








There are over 700

muscles in the

human body. Each

with a specific

function and task.


By Chris Gellert








Common injuries and

causes of cervical spine

The most common are

cervical whiplash,

osteoarthritis, disc injury

including pinched

nerve(radiculopathy).


By Chris Gellert








a. Cervical whiplash

Mechanism of injury/pathophysiology:

The term “whiplash” commonly refers to

symptoms and signs

associated with a

mechanical event such as a

sudden acceleration and

deceleration of the neck.


By Chris Gellert








b. Cervical

osteoarthritis(degenerative disc disease)

Mechanism of injury/pathophysiology:

Is termed the wear and tear arthritis

because it is thought that the articular cartilage breaks down

because of an imbalance

between mechanical stress and the

ability of the joint to handle the given loads.


By Chris Gellert








c. Cervical Radiculopathy(due to a

pinched nerve)

Mechanism of

injury/pathophysiology: This is where the cervical nerve

root is being compressed,

resulting in inflammation,

creating local to peripheral pain(arm).


By Chris Gellert








d. Cervical disc injury

Mechanism of injury/pathophysiology: A

single incident, or motion that

involves a combined

movement of cervical flexion,

rotation with side bending

repeated over and over may

be the direct cause for a

cervical disc injury(Starkey, C.,

& Johnson, G., 2006).


By Chris Gellert








Types of disc injuries:

1. In Protrusion or bulge, there is

change in the shape of the

annulus that it causes to bulge

beyond its normal perimeter.

2. In Prolapse disc(herniation), the

ligamentous fibers give way,

allowing the nucleus to bulge into

the neural canal. The disc is still

contained by the outer layers of

the annulus and supporting

ligamentous structures.


By Chris Gellert








3. Extrusion is where the disc

protrudes through the annulus

but is contained by the posterior

longitudinal ligament(PLL).

4. Sequestration is where the

nuclear material/free floating

piece of the nucleus has partially

separated from the remaining

nucleus, allowing it to be free in the neural canal and moves into

the epidural space.


By Chris Gellert








Common Assessments

For safety and based

on the clients past

medical history, length

of time from injury and

general health, I would

recommend the

following assessments.


By Chris Gellert








Training strategies and

programming for neck injuries

With any injury, the most

important thing to

remember is the type of

injury, healing time and

prior level of function of

the client.


By Chris Gellert








a. Whiplash injuries

Whiplash injuries can

take a long to heal

ranging form 3

months up to one

year in duration.


By Chris Gellert








b. Cervical degenerative disc disease(DDD)

Recommendations for training: I would teach

them self-stretching of

the upper trapezius and

pectorals, which are

commonly tight.


By Chris Gellert








c. Cervical Radiculopathy due to pinched nerve

Recommendations for training:

Most clients will have completed

physical therapy before meeting

them and it would be an

excellent segway from

rehabilitation to the gym, to

contact the clients physical

therapist with their permission.


By Chris Gellert








d. Cervical Radiculopathy due to disc injury

Recommendations for training: Most clients will have

completed physical therapy

before meeting them and

it would be an excellent segway

from rehabilitation to the gym,

to contact the clients physical

therapist with their permission.


By Chris Gellert








The neck is a complex unit

that is comprised of a

multitude of ligaments,

tendons, connective tissue,

muscles that synergistically

initiate and correct

movement, and stabilize

when an unstable

environment.


By Chris Gellert







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the cervical spine – understanding the science behind both movement and dysfunction

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