Lumbar and Lumbopelvic Stabilisation

This weekend seminar in Melbourne was both highly informative and very entertaining. Jenny Hynes B.App.Sc(Physio), M.A.P.A., M.Physio (Manips), M.M.P.A. is an excellent lecturer who provided the 40 delegates with a good understanding of the concept of lumbar segmental stabilisation (LSI) and the role it may play in patients with chronic low back pain.

The theory behind LSI was outlined by Jenny on the first day. Active stabilisation of the spine is maintained by three interdependent subsystems – active (muscles & tendons), passive (vertebrae, discs, etc.) and control (neural) subsystems. Injury, degenerative disease or muscle weakness may decrease the ability of these systems to stabilise the spine. The loss of control of a spinal segment in the neutral zone is thought to be the cause of related pain and disability. It is suggested that the incidence of LSI in the chronic low back pain population may range from 6-30%. Therefore, it is important for osteopaths and chiropractors to be aware of the signs and symptoms of LSI for those patients with chronic and recurring low back pain.

Specific and controlled exercises can be used to train the local lumbar muscle system to improve intersegmental support. Use of a Fitball for these exercises further encourages spinal stability. Lisa Westlake B.App.Sc.(Physio), M.A.P.A., RFL introduced us to the ball exercises that promote the use of the lumbar stabilising muscles. Lisa was a wonderful instructor who made control of the Fitball appear effortless. The rest of us struggled valiantly to gain control of our oversized ‘beachballs’. Practice is certainly needed before attempting to demonstrate these exercises to patients, as I discovered the following Monday.

Assessing and teaching patients about LSI and the relevant exercise program is time consuming and challenging, although hopefully rewarding for both chronic back pain patients and their practitioners. Congratulations to COCA on another successful seminar.

Kylie Phillips, Osteopath