Lumbopelvic Rhythm: Difference between revisions

No edit summary
m (Rephrasing of the introduction to be clearly deliver the topic. Some arrangement of the paragraphs. limk to erector spinae page)
Line 5: Line 5:
</div>
</div>
== Introduction ==
== Introduction ==
[[Lumbar Anatomy|Lumbar joint]] is formed by wedge shaped [[intervertebral disc]] anteriorly and posteriorly by [https://www.physio-pedia.com/Lumbosacral_Biomechanics L5-S1 facet].
The lumbosacral junction is the point of connection between the [[Lumbar Anatomy|lumbar spine]] and the pelvic girdle. The connection is formed by the wedge-shaped [[intervertebral disc]] anteriorly and posteriorly by [https://www.physio-pedia.com/Lumbosacral_Biomechanics the L5-S1 facet]. Cailliet described a specific instance of coordinated simultaneous activity of lumbar flexion and anterior tilting of the pelvis in the sagittal plane during trunk flexion and extension. He combined [[Lumbar Spine Range Of Motion|lumbar]] and [[Pelvic Tilt|pelvic motions]].<ref name=":0">Cailliet R: Soft Tissue Pain and Disability(ed. 3) ,Philadelphia F.A. Davis,1996</ref>When the femur, pelvis, and spine move in a combined coordinated manner, it produces a larger ROM than what might be available to one segment alone. It is an open kinematic chain and is analogous to [https://www.physio-pedia.com/Scapulohumeral_Rhythm the Scapulo-Humeral Rhythm.][[File:Basics of lumbar spine.jpg|center|thumb|<ref>basics of lumbar spine. source: pixy.org.CCO public domain, No attribution required. Available from https://pixy.org/1364428/ [last accessed 23/9/2020]</ref>]]
 
Cailliet described a specific instance of coordinated simultaneous activity of lumbar flexion and anterior tilting of the pelvis in sagittal plane during trunk flexion and extension. He combined [[Lumbar Spine Range Of Motion|lumbar]] and [[Pelvic Tilt|pelvic motions]].<ref name=":0">Cailliet R: Soft Tissue Pain and Disability(ed. 3) ,Philadelphia F.A. Davis,1996</ref>When the femur, pelvis, and spine move in a combined coordinated manner, it produces a larger ROM than what might be available to one segment alone. It is an open kinematic chain and is analogous to [https://www.physio-pedia.com/Scapulohumeral_Rhythm Scapulo-Humeral Rhythm.]
[[File:Basics of lumbar spine.jpg|center|thumb|<ref>basics of lumbar spine. source: pixy.org.CCO public domain, No attribution required. Available from https://pixy.org/1364428/ [last accessed 23/9/2020]</ref>]]


==  What Is Lumbopelvic Rhythm? ==
==  What Is Lumbopelvic Rhythm? ==
[[File:Toe touching.png|thumb|<ref>[https://thenounproject.com/benjamin_erich/ Bob holzer]. Uttanasana yoga icon. [https://creativecommons.org/licenses/by/3.0 Lisensed under creative common]. Available from https://thenounproject.com/term/uttanasana/107998/ , [last accessed 23/9/2020]</ref>]]
[[File:Toe touching.png|thumb|<ref>[https://thenounproject.com/benjamin_erich/ Bob holzer]. Uttanasana yoga icon. [https://creativecommons.org/licenses/by/3.0 Lisensed under creative common]. Available from https://thenounproject.com/term/uttanasana/107998/ , [last accessed 23/9/2020]</ref>]]
The activity of bending over to touch one's toes with knees straight depends on the lumbopelvic rhythm. Lumbopelvic rhythm or the hip-spine coordination<ref>Tojima M, Ogata N, Nakahara Y, Haga n. [https://waseda.pure.elsevier.com/en/publications/three-dimensional-motion-analysis-of-lumbopelvic-rhythm-during-tr Three-dimensional motion analysis of lumbopelvic rhythm during trunk extension]. Journal of Human Kinetics 2016 Apr 1;50(1):53-62.</ref> refers to the way in which the lumbar spine, moves in combination with the pelvis. '''It is the kinematic relationship between the lumbar spine and hip joints during sagittal plane movement.'''
The activity of foreword bending over to touch your toes with knees straight depends on the lumbopelvic rhythm. Lumbopelvic rhythm or the hip-spine coordination<ref>Tojima M, Ogata N, Nakahara Y, Haga n. [https://waseda.pure.elsevier.com/en/publications/three-dimensional-motion-analysis-of-lumbopelvic-rhythm-during-tr Three-dimensional motion analysis of lumbopelvic rhythm during trunk extension]. Journal of Human Kinetics 2016 Apr 1;50(1):53-62.</ref> refers to how the lumbar spine, moves in combination with the pelvis. '''It is the kinematic relationship between the lumbar spine and hip joints during sagittal plane movement.'''


'''According to Cailliet'''<ref name=":0" />, the first part of '''bending forward consists of lumbosacral flexion''' '''followed by anterior [https://www.physio-pedia.com/Pelvic_Tilt tilting of pelvis] at hip joints.''' The muscles in the lower back namely erector spinae, [https://courses.lumenlearning.com/suny-fitness/chapter/types-of-muscle-contractions-isotonic-and-isometric/ contract] eccentrically to control the movement against gravity while trunk flexes and pelvis tilts anteriorly. The muscles that flex the hip contract concentrically and this motion is balanced by eccentric contraction of muscles that extend the hip.
'''According to Cailliet'''<ref name=":0" />, the first part of '''bending forward consists of lumbosacral flexion''' '''followed by anterior [https://www.physio-pedia.com/Pelvic_Tilt tilting of the pelvis] and hip joint flexion.''' The muscles in the lower back namely [[Erector Spinae|erector spinae]], [https://courses.lumenlearning.com/suny-fitness/chapter/types-of-muscle-contractions-isotonic-and-isometric/ contract] eccentrically to control the movement against gravity while the trunk flexes and pelvis tilts anteriorly. The muscles that flex the hip contract concentrically and this motion is balanced by eccentric contraction of muscles that extend the hip.


When '''returning to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of the pelvis at the hip, followed by extension of the lumbar spine'''.<ref name=":1">Norkin, C. C., Levangie, P. K.  [https://www.google.co.in/books/edition/Joint_Structure_and_Function/JXb2AAAAQBAJ?hl=en&gbpv=0 Joint Structure and Function: A Comprehensive Analysis]. United States: F.A. Davis Company,2011</ref> The hip extensors initiate the posterior rotation of the pelvis until it is in a better position for [https://www.physio-pedia.com/Erector_Spinae#:~:text=0%25%20Complete%20%E2%80%A2-,Introduction,serratus%20posterior%20superior%20and%20inferior). spinal extensors] to concentrically contract without too much stress being put on them. As these muscles contract concentrically, the hip flexors contract eccentrically to [https://www.youtube.com/watch?v=A4gU0YD6HS4&list=PLqabsnGcY9_IiCNr0f_mkEs9SFFNzGTCc&index=3&t=0s help control the movement]. The aspect of motion of interest includes timing, as well as magnitude-related characteristics.<ref>Zhou J, Ning X, Fathallah F. [https://pubmed.ncbi.nlm.nih.gov/26577865/ Difference in lumbopelvic rhythm between trunk flexion and extension. Clinical Biomechanics]. 2016;32:274-279. doi:10.1016/j.clinbiomech.2015.10.012.</ref>
When '''returning to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of the pelvis at the hip, followed by extension of the lumbar spine'''.<ref name=":1">Norkin, C. C., Levangie, P. K.  [https://www.google.co.in/books/edition/Joint_Structure_and_Function/JXb2AAAAQBAJ?hl=en&gbpv=0 Joint Structure and Function: A Comprehensive Analysis]. United States: F.A. Davis Company,2011</ref> The hip extensors initiate the posterior rotation of the pelvis until it is in a better position for [https://www.physio-pedia.com/Erector_Spinae#:~:text=0%25%20Complete%20%E2%80%A2-,Introduction,serratus%20posterior%20superior%20and%20inferior). spinal extensors] to concentrically contract without too much stress being put on them. As these muscles contract concentrically, the hip flexors contract eccentrically to [https://www.youtube.com/watch?v=A4gU0YD6HS4&list=PLqabsnGcY9_IiCNr0f_mkEs9SFFNzGTCc&index=3&t=0s help control the movement]. The aspect of motion of interest includes timing, as well as magnitude-related characteristics.<ref>Zhou J, Ning X, Fathallah F. [https://pubmed.ncbi.nlm.nih.gov/26577865/ Difference in lumbopelvic rhythm between trunk flexion and extension. Clinical Biomechanics]. 2016;32:274-279. doi:10.1016/j.clinbiomech.2015.10.012.</ref>
Line 23: Line 20:
==  Lumbopelvic Rhythm Contribution to Low Back Pain ==
==  Lumbopelvic Rhythm Contribution to Low Back Pain ==
Lumbopelvic rhythm while bending forward and returning to the initial position has been investigated and a better understanding of trunk motion pattern was achieved as used in research on low back disorders.<ref>Vazirian M, Van Dillen L, Bazrgari B. [https://scholar.google.com/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639918/&hl=en&sa=T&oi=gsb-ggp&ct=res&cd=0&d=49963495382477579&ei=WjhgX-rcJ4apywSo65KACA&scisig=AAGBfm0bw1fhLAWOymkU2-WYE5f8Rcnw8A Lumbopelvic rhythm during trunk motion in the sagittal plane]: A review of the kinematic measurement methods and characterization approaches. Physical therapy and rehabilitation. 2016;3.</ref>. During forward bending, the eccentric contractions of the lumbar and hip extensors help to lower the body in a controlled motion against gravity. If the muscles are weak or fatigued, the weight of the body is enough to overload the muscles, and this causes strain. When the body is returning to the erect position, if the hip flexors are tight or the extensors are too weak to initiate posterior pelvic rotation, the spinal extensors can get overloaded, causing injury and pain.<ref>Lowe W:[https://www.academyofclinicalmassage.com/the-lumbopelvic-rhythm/ The lumbopelvic rhythm. Academy of clinical massage], published july 1,2015. Accessed Sept 2020</ref>(fig.4)[[File:Lumbar vertebra 5 posterior.png|thumb|<ref>lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]</ref>|225x225px|center]][[File:Anterior-lumbar joint.jpg|thumb|<ref>lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]</ref>|center]]
Lumbopelvic rhythm while bending forward and returning to the initial position has been investigated and a better understanding of trunk motion pattern was achieved as used in research on low back disorders.<ref>Vazirian M, Van Dillen L, Bazrgari B. [https://scholar.google.com/scholar_url?url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5639918/&hl=en&sa=T&oi=gsb-ggp&ct=res&cd=0&d=49963495382477579&ei=WjhgX-rcJ4apywSo65KACA&scisig=AAGBfm0bw1fhLAWOymkU2-WYE5f8Rcnw8A Lumbopelvic rhythm during trunk motion in the sagittal plane]: A review of the kinematic measurement methods and characterization approaches. Physical therapy and rehabilitation. 2016;3.</ref>. During forward bending, the eccentric contractions of the lumbar and hip extensors help to lower the body in a controlled motion against gravity. If the muscles are weak or fatigued, the weight of the body is enough to overload the muscles, and this causes strain. When the body is returning to the erect position, if the hip flexors are tight or the extensors are too weak to initiate posterior pelvic rotation, the spinal extensors can get overloaded, causing injury and pain.<ref>Lowe W:[https://www.academyofclinicalmassage.com/the-lumbopelvic-rhythm/ The lumbopelvic rhythm. Academy of clinical massage], published july 1,2015. Accessed Sept 2020</ref>(fig.4)[[File:Lumbar vertebra 5 posterior.png|thumb|<ref>lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]</ref>|225x225px|center]][[File:Anterior-lumbar joint.jpg|thumb|<ref>lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]</ref>|center]]
== Improvement Of Lumbopelvic Rhythm By Correction Of Forward Head Posture ==
== Improvement of Lumbopelvic Rhythm by Correction of Forward Head Posture ==
Research<ref>Dass B, Shinde D, Kala S et.al. [https://www.ijhsr.org/IJHSR_Vol.10_Issue.9_Sep2020/11.pdf Improvement in the lumbo-pelvic rhythm by correction of forward head posture]. Int J Health Sci Res. 2020; 10(9):69-75.</ref> was done on the improvement of lumbopelvic rhythm by correction of forward head posture which concluded that the study showed clinical significance in the improvement of lumbopelvic rhythm by [https://www.physio-pedia.com/Forward_Head_Posture forward head] correction given for 4 weeks of treatment.
Research<ref>Dass B, Shinde D, Kala S et.al. [https://www.ijhsr.org/IJHSR_Vol.10_Issue.9_Sep2020/11.pdf Improvement in the lumbo-pelvic rhythm by correction of forward head posture]. Int J Health Sci Res. 2020; 10(9):69-75.</ref> was done on the improvement of lumbopelvic rhythm by correction of forward head posture which concluded that the study showed clinical significance in the improvement of lumbopelvic rhythm by [https://www.physio-pedia.com/Forward_Head_Posture forward head] correction given for 4 weeks of treatment. This included [https://www.youtube.com/watch?v=-gfwdRTdV8U cervicothoracic fascia release], [https://www.physio-pedia.com/Maitland%27s_Mobilisations Maitland mobilisation], [https://www.healthline.com/health/fitness-exercise/trapezius-stretches stretching of the upper trapezius], [https://www.verywellfit.com/how-to-pectoral-stretch-exercise-2696346 pectorals] [https://www.spine-health.com/wellness/exercise/easy-levator-scapulae-stretch-neck-pain#:~:text=Tilt%20the%20chin%20downward%20until,Repeat%20on%20other%20side. , and levator scapulae] , and neck exercises like [https://www.youtube.com/watch?v=gIBoxQ6AlS0 chin tuck] and chin drop.
 
This included [https://www.youtube.com/watch?v=-gfwdRTdV8U cervicothoracic fascia release], [https://www.physio-pedia.com/Maitland%27s_Mobilisations Maitland mobilisation], [https://www.healthline.com/health/fitness-exercise/trapezius-stretches stretching of trapezius], [https://www.verywellfit.com/how-to-pectoral-stretch-exercise-2696346 pectorals][https://www.spine-health.com/wellness/exercise/easy-levator-scapulae-stretch-neck-pain#:~:text=Tilt%20the%20chin%20downward%20until,Repeat%20on%20other%20side. , levator scapulae] , and neck exercises like [https://www.youtube.com/watch?v=gIBoxQ6AlS0 chin tuck] and chin drop.
== Implications  ==
== Implications  ==
#It is used to identify '[http://www.hanslindgren.com/blog/self-assessment-and-treatment-of-the-pelvic-cross-syndrome/#:~:text=The%20Pelvic%20Cross%20Syndrome%20is,bottom%20of%20the%20lower%20back. Pelvic cross syndrome]' in gymnasts.<ref>Kruse D, Lemmen B. [https://pubmed.ncbi.nlm.nih.gov/19142076/ Spine Injuries in sport of Gymnastics. Current Sports Medicine Reports.] 2009;8(1):20-28</ref>
#It is used to identify '[http://www.hanslindgren.com/blog/self-assessment-and-treatment-of-the-pelvic-cross-syndrome/#:~:text=The%20Pelvic%20Cross%20Syndrome%20is,bottom%20of%20the%20lower%20back. Pelvic cross syndrome]' in gymnasts.<ref>Kruse D, Lemmen B. [https://pubmed.ncbi.nlm.nih.gov/19142076/ Spine Injuries in sport of Gymnastics. Current Sports Medicine Reports.] 2009;8(1):20-28</ref>

Revision as of 19:45, 8 December 2023

Original Editor - Chelsea Mclene

Top Contributors - Chelsea Mclene, Fatma ElZahraa, Kim Jackson and Sehriban Ozmen  

Introduction[edit | edit source]

The lumbosacral junction is the point of connection between the lumbar spine and the pelvic girdle. The connection is formed by the wedge-shaped intervertebral disc anteriorly and posteriorly by the L5-S1 facet. Cailliet described a specific instance of coordinated simultaneous activity of lumbar flexion and anterior tilting of the pelvis in the sagittal plane during trunk flexion and extension. He combined lumbar and pelvic motions.[1]When the femur, pelvis, and spine move in a combined coordinated manner, it produces a larger ROM than what might be available to one segment alone. It is an open kinematic chain and is analogous to the Scapulo-Humeral Rhythm.

[2]

What Is Lumbopelvic Rhythm?[edit | edit source]

[3]

The activity of foreword bending over to touch your toes with knees straight depends on the lumbopelvic rhythm. Lumbopelvic rhythm or the hip-spine coordination[4] refers to how the lumbar spine, moves in combination with the pelvis. It is the kinematic relationship between the lumbar spine and hip joints during sagittal plane movement.

According to Cailliet[1], the first part of bending forward consists of lumbosacral flexion followed by anterior tilting of the pelvis and hip joint flexion. The muscles in the lower back namely erector spinae, contract eccentrically to control the movement against gravity while the trunk flexes and pelvis tilts anteriorly. The muscles that flex the hip contract concentrically and this motion is balanced by eccentric contraction of muscles that extend the hip.

When returning to the erect posture, this rhythm is reversed. It is initiated by posterior tilting of the pelvis at the hip, followed by extension of the lumbar spine.[5] The hip extensors initiate the posterior rotation of the pelvis until it is in a better position for spinal extensors to concentrically contract without too much stress being put on them. As these muscles contract concentrically, the hip flexors contract eccentrically to help control the movement. The aspect of motion of interest includes timing, as well as magnitude-related characteristics.[6]

[7]

[8]


Lumbopelvic Rhythm Contribution to Low Back Pain[edit | edit source]

Lumbopelvic rhythm while bending forward and returning to the initial position has been investigated and a better understanding of trunk motion pattern was achieved as used in research on low back disorders.[9]. During forward bending, the eccentric contractions of the lumbar and hip extensors help to lower the body in a controlled motion against gravity. If the muscles are weak or fatigued, the weight of the body is enough to overload the muscles, and this causes strain. When the body is returning to the erect position, if the hip flexors are tight or the extensors are too weak to initiate posterior pelvic rotation, the spinal extensors can get overloaded, causing injury and pain.[10](fig.4)

[11]
[12]

Improvement of Lumbopelvic Rhythm by Correction of Forward Head Posture[edit | edit source]

Research[13] was done on the improvement of lumbopelvic rhythm by correction of forward head posture which concluded that the study showed clinical significance in the improvement of lumbopelvic rhythm by forward head correction given for 4 weeks of treatment. This included cervicothoracic fascia release, Maitland mobilisation, stretching of the upper trapezius, pectorals , and levator scapulae , and neck exercises like chin tuck and chin drop.

Implications[edit | edit source]

  1. It is used to identify 'Pelvic cross syndrome' in gymnasts.[14]
  2. It is used to identify weakness, inflexibilities, or muscle imbalances that contribute to low back pain.

[15]

Further Reading[edit | edit source]

Lumbosacral Biomechanics

Lumbo-Pelvic Stability

Pelvic tilt

References[edit | edit source]

  1. ↑ 1.0 1.1 Cailliet R: Soft Tissue Pain and Disability(ed. 3) ,Philadelphia F.A. Davis,1996
  2. ↑ basics of lumbar spine. source: pixy.org.CCO public domain, No attribution required. Available from https://pixy.org/1364428/ [last accessed 23/9/2020]
  3. ↑ Bob holzer. Uttanasana yoga icon. Lisensed under creative common. Available from https://thenounproject.com/term/uttanasana/107998/ , [last accessed 23/9/2020]
  4. ↑ Tojima M, Ogata N, Nakahara Y, Haga n. Three-dimensional motion analysis of lumbopelvic rhythm during trunk extension. Journal of Human Kinetics 2016 Apr 1;50(1):53-62.
  5. ↑ Norkin, C. C., Levangie, P. K. Joint Structure and Function: A Comprehensive Analysis. United States: F.A. Davis Company,2011
  6. ↑ Zhou J, Ning X, Fathallah F. Difference in lumbopelvic rhythm between trunk flexion and extension. Clinical Biomechanics. 2016;32:274-279. doi:10.1016/j.clinbiomech.2015.10.012.
  7. ↑ Alexandra Kopelovich . Lumbopelvic rhythm . Available from : http://youtu.be/yvVbwcv_sVQ [last accessed 15/9/2020]
  8. ↑ Vanessa Yingling . PelvicLumbarMotion . Available from : https://youtu.be/KQgp_dtXm7Q [last accessed 15/9/2020]
  9. ↑ Vazirian M, Van Dillen L, Bazrgari B. Lumbopelvic rhythm during trunk motion in the sagittal plane: A review of the kinematic measurement methods and characterization approaches. Physical therapy and rehabilitation. 2016;3.
  10. ↑ Lowe W:The lumbopelvic rhythm. Academy of clinical massage, published july 1,2015. Accessed Sept 2020
  11. ↑ lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]
  12. ↑ lumbar joint - anterior. sorce: anatomography. Available from https://commons.wikimedia.org/wiki/File:Lumbar_vertebrae_anterior.png [last accessed 23/9/2020]
  13. ↑ Dass B, Shinde D, Kala S et.al. Improvement in the lumbo-pelvic rhythm by correction of forward head posture. Int J Health Sci Res. 2020; 10(9):69-75.
  14. ↑ Kruse D, Lemmen B. Spine Injuries in sport of Gymnastics. Current Sports Medicine Reports. 2009;8(1):20-28
  15. ↑ NESTA & Spencer Institute . Integrated motion of lumbar spine . Available from : https://youtu.be/qbjiXos89Dc [last accessed 15/9/2020]
Retrieved from "https://www.physio-pedia.com/index.php?title=Lumbopelvic_Rhythm&oldid=347402"