What is Lumbar stability!
Lumbar stability referees to the ability of the muscles within the lower back to support the spine and keep it in a natural position. The lumbar spine is responsible for supporting the weight of the upper body as well as being the centre of your bodies balance. Lumbar stability is so important as it plays a vital role in maintaining proper posture, preventing injury and reduces the potential for lower back pain.
The lumbar spine has several functions, including:
- Supports upper body, distributes body weight. The lumbar spine connects to the pelvis and bears most of the body’s weight, as well as the stress of lifting and carrying items.
- The lumbar spine transfers the weight from your upper body to the legs.
- Allows movement, the muscles of the lower back and flexibility of your lumbar spine allow your trunk to move in all directions — front to back (flexion and extension), side to side (side bending) and full circle (rotation), as well as twist. The last two lumbar vertebrae allow for most of this movement.
- Protects the spinal cord, which is encircled and protected by the bones within the spine, starts at the base of your skull and ends at the first lumbar vertebra. The vertebrae in the spine also provide a bony enclosure for the individual nerves that descend from the end of your spinal cord. This “tail of nerves” is called the cauda equina.
- Controls leg movement. The nerves that branch from your lower spinal cord and cauda equina control leg sensations and movement.
There are a number of structures that are involved in lumbar stability
The lumbar spine acquires its stability mainly from the intervertebral discs, as well as the surrounding ligaments and muscles. The posterior ligamentous complex (PLC) is crucial for maintaining spinal stability. The PLC is made up of the supraspinous ligament, interspinous ligament, ligament up flavum and the facet capsule ligaments. The PLC limits excess motion and compressive forces. The facet joint itself plays an important role in stabilisation, due to its role in load transmission. The facets act as posterior load bearing components for stabilising the motion segments during flexion and extension, whilst restricting any rotational movement. The biomechanical motion of these joints maintain normal health and function of the spine during physiological loading. Facet motion can become distorted, if the tissue within the facet joint is altered due to injury, degeneration or surgery. If the integrity of the PLC or facet motion is lost, the lumbar discs will become a pain generator. This in turn increases the stress applied to the disc resulting in an increase in degeneration to the surrounding structures.
Why is Lumbar Stability Important?
The lumbar spine is considered unstable if abnormal loading, strains or excessive motion develops in the functional spinal unit. Poor lumbar stability can lead to an imbalance in the muscles that support the spine, causing the lower back to be more vulnerable to injury. This can result in back pain, as well as other issues such as sciatic disc degeneration and spinal stenosis. By improving lumbar stability this can help reduce the risk of injury, improve posture, and reduce back pain.
How Chiropractic can help
A full medical history is taken, spinal x rays (if clinically indicated) and a 5 step analysis. This provides in-depth detailed information in order to understand the cause of the pain. Chiropractic can be applied to help to improve proprioception, improve nerve function, improve spinal mobility and reduce pain by enhancing the biomechanics of the affected motion segments.
Exercises that will help you improve your lumbar stability
Pelvic Tilts
Pelvic tilt is performed by lying on your back with your knees bent and your feet flat on the ground. Slowly tilt your pelvis forward, flattening your lower back against the ground. Then tilt your pelvis back, arching your lower back away from the ground. Focus should be on engaging your lower abdominal muscles and keeping the upper body relaxed.
Gluteal Bridges
To perform bridging, lie on your back with your knees bent and your feet flat on the ground. Slowly lift your hips off the ground, keeping your feet and shoulders on the ground. Hold for a few seconds, then slowly lower your hips back down to the ground. Repeat this movement several times, focusing on engaging your gluteal muscles and keeping your core stable.
Superman
To perform superman, start on your hands and knees with your wrists directly under your shoulders and your knees directly under your hips. Slowly lift your right arm and left leg, extending them straight out in front of you and behind you, respectively. Hold for a few seconds, then lower your arm and leg back down to the ground. Repeat on the other side, lifting your left arm and right leg. The focus should be on core stabilisation and your back straight throughout the movement.
Planks
Planks are a great exercise for improving lumbar stability and core strength. To perform a plank, start in a push-up position with your hands and toes on the ground. Lower yourself down onto your forearms, keeping your elbows directly under your shoulders. Engage your core and glutes and hold the position for as long as you can without letting your hips drop. Start with shorter holds, such as 10-15 seconds, and work your way up to longer holds as your strength improves.
References
- Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review Ross A. Hauser,a,*Danielle Matias,a David Woznica,b Benjamin Rawlings,a and Barbara A. Woldina
- Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira M, Genevay S. Low back pain series: what low back pain is and why we need to pay attention. Lancet (Internet).2018; [Accessed 2021 July 26]; 391(10137): 2356-2367. doi: 10.1016/S0140-6736(18)30480-X.
- Czaprowski, D., & Białek, M. (2017). The impact of lumbar stabilization exercises on lumbar muscle strength, functional capacity, and pain in patients with segmental lumbar instability. PM&R, 9(9), 885-895. doi: 10.1016/j.pmrj.2017.02.004
- Perolat R, Kastler A, Nicot B, Pellat JM, Tahon F, Attye A.Facet joint syndrome: from diagnosis to interventional management. Insights Imaging. 2018; 9(5): 773-89. doi: 10.1007/s13244-018-0638-x.
