Brooke Johnson
Motion: Lumbar Rotation
Lumbar rotation can be preformed in a supine position (lying on your back) keeping your upper extremity fixed and rotating your lower extremity. It is a twisting motion of your lower trunk area.
30-35 degrees of axial rotation occurs to each side of the thoracic spine.1 The orientation of the lumbar facet joint allows for more sagittal plane motion opposed to rotational horizontal plane motion.1 5-7 degrees of horizontal rotation occurs in the lumbar region. If looking at L1 and L2 during right rotation the left inferior articular facet of L1 approximates against the left superior articular facet of L2.1 The right inferior articular facet of L1 distracts from the right superior articular facet of L2. Lumbar rotation consists of the superior vertebra rotating on the inferior vertebra.1 Many nerves innervate the muscles for spinal rotation, there is not one clear myotomal test for lumber rotation.
Primary muscles: Internal and external obliques. Erector spinae, Semispinalis2
Secondary muscles: Multifidus, Psoas major, Quadratus lumborum, Rotatores 2
Stretches
* For all stretches please refer to the video above *
Lumbar rotation stretch (erector spinae, multifidus)3
• Lie flat on your back with legs straight
• Bend one leg and rotate this leg over the straight leg.
• Shoulders should stay on floor one arm out and other arm supporting bent leg
• Three sets of 45 second holds and switch to opposite side
- You should feel this stretch in your buttocks and sides.
Lumbar rotation seated stretch (erector spinae, multifidus)4
• Sit on floor
• One leg straight opposite leg bent crossed over
• Use arm for support behind trunk (same side as bent leg)
• Rotate trunk and use opposite arm to apply pressure.
• Three sets of 45 second holds and switch to opposite side
- You should feel this stretch in your buttocks and sides.
Childs pose with side bend stretch (Quadratus Lumborum)5
• Begin in childs pose position kneeled down and arms extended above head.
• Walk arms to one side and hold for 45 seconds.
• Repeat 3 times on each side.
Strengthening Exercises
Lumbar Rotation Exercise6
1. Lie on your back with your hips and knees bent, feet flat on the floor.
2. Keep your arms out at your sides and your shoulders flat on floor.
3. Rotate hips and knees to one side as far as you can while keeping arms and shoulders flat on floor. Hold this position for 10 seconds.
4. Reverse position and rotate your hips and knees to the opposite side. Hold this position for 10 seconds.
5. Repeat exercise 15 times, 3 times per day.
Progression: Advanced Lumbar Rotation exercise
1. Lie on your back with your hips bent to 90 degrees and knees bent to 90 degrees
2. Keep your arms out at your sides and your shoulders flat on floor.
3. Rotate hips and knees to one side as far as you can while keeping arms and shoulders flat on floor. Hold this position for 10 seconds.
4. Reverse position and rotate your hips and knees to the opposite side. Hold this position for 10 seconds.
5. Repeat exercise 15 times, 3 times per day.
Abdominal crunch with rotation (Rectus abd., obliques)7
1. Lie on back and bend your knees, place feet flat on floor in line with your hips.
2. Put hands behind head
3. Crunch up and across trying to touch opposite elbow to opposite knee.
4. Slowly return to starting position and repeat on other side
5. 3 sets of 10 repetitions
Side Plank (obliques, QL)4
1. Use your elbow to prop up your body. Your elbow should be directly underneath your shoulder.
2. Opposite arm should be resting on your side bent with your hand at your hip.
3. Tighten your core and lift your hip up. Hold position for 15 seconds.
4. 3 sets of 15 second holds on each side.
- You should feel this exercise in the lower back, waist, and abdominals.
Potential Clinical Syndromes or Etiologies:
Degenerative disc disease, stenosis, scoliosis and sciatica 8
Additional Web Based Resources:
http://www.neurospineinstitute.org/procedures/spine-anatomy-physiology/
http://www.chiro.org/ACAPress/Lumbar_Spine.html
http://www.inovaspine.org/spine-conditions/types-of-conditions
http://www.chiro.org/ACAPress/Lumbar_and_Sacral_Areas.html
http://www.unm.edu/~lkravitz/Article%20folder/abdominal.html
References:
1. Neumann DA. Kinesiology of the Musculoskeletal System, Foundations for Rehabilitation. Mosby; 2010. Accessed November 27, 2014.
2. Iowa Governor’s Council on Physical Fitness & Nutrition. Exercise #2 Spinal rotation. http://www.healthyiowa.gov/common/pdf/exercise_2.pdf. Accessed November 23, 2014.
3.Lumbar Rotation Stabilization. Richmond Bone & Joint Clinic, P.A. http://www.rbjc.com/Includes/Documents/lumbar_stabilization_program.pdf. 2008-2010. Accessed November 23, 2014.
4.AAOS. Spine Conditioning Program. Ortho Info by American Academy of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00666. October, 2012. Accessed November 26th, 2014.
5. King, C. How to Stretch the Quadratus Lumborum. Livestrong. .http://www.livestrong.com/video/1007920-stretch-quadratus-lumborum/. 2014. Accessed November 23, 2014.
6. Princeton University. Lumbar/Core Strength and Stability Exercises. Princeton University Athletic Medicine. https://www.princeton.edu/uhs/pdfs/Lumbar.pdf. Accessed November 23, 2014.
7. Moffat M, Vickery S. Chapter eighteen: Strength and Endurance Exercises. In: The American Physical Therapy Association Book of Body Repair & Maintenance, Hundreds of Stretches & Exercises for Every Part of the Human Body. Macmillan; 1999.
8. Schafer RC, Tran TA. Chapter 12: The Lumbar and Sacral Areas. In: Symptomatology and Differential Diagnosis, A Conspectus of Clinical Semeiographies. Arlington, Va. :; Produced by the Associated Chiropractic Academic Press for ACA, the American Chiropractic Association; 1986.
