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

The Cervical Spine – Understanding The Science Behind Both Movement And

DysfunctionBy 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.









Basic anatomyWhen we look at the neck, there are seven bones(vertebrae) that are part of the supportive column of the spine.









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.









There are over 700 muscles in the human body. Each with a specific function and task.









Common injuries and causes of cervical spine The most common are cervical whiplash, osteoarthritis, disc injury including pinched nerve(radiculopathy).









a. Cervical whiplashMechanism 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.









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.









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).









d. Cervical disc injuryMechanism 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).









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.









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.









Common AssessmentsFor safety and based on the clients past medical history, length of time from injury and general health, I would recommend the following assessments.









Training strategies and programming for neck injuriesWith any injury, the most important thing to remember is the type of injury, healing time and prior level of function of the client.









a. Whiplash injuriesWhiplash injuries can take a long to heal ranging form 3 months up to one year in duration.









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.









c. Cervical Radiculopathy due to pinched nerveRecommendations 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.









d. Cervical Radiculopathy due to disc injuryRecommendations 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.









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.







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

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