The Cervical Spine - Understanding The Science Behind Both Movement and Dysfunction

The Cervical Spine Understanding The Science
Behind Both Movement And Dysfunction

By Chris Gellert
The spine is a complex

structure, comprised of
nerves, connective
tissue, bones, discs,
muscles and other
essential integrative
components.
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By Chris Gellert
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.

By Chris Gellert
Basic anatomy
When we look at the
neck, there are seven
bones(vertebrae) that
are part of the
supportive column of
the spine.

By Chris Gellert
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.

By Chris Gellert
There are over 700

muscles in the
human body. Each
with a specific
function and task.

By Chris Gellert
Common injuries and

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

By Chris Gellert
a. Cervical whiplash
Mechanism 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.

By Chris Gellert
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.

By Chris Gellert
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).

By Chris Gellert
d. Cervical disc injury

Mechanism 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).

By Chris Gellert
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.

By Chris Gellert
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.

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

By Chris Gellert
Training strategies and

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

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

By Chris Gellert
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.

By Chris Gellert
c. Cervical Radiculopathy due to

pinched nerve
Recommendations 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.

By Chris Gellert
d. Cervical Radiculopathy due

to disc injury
Recommendations 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.

By Chris Gellert
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

The spine is a complex