Spinal Traction

Following completion of this chapter, the

student will be able to:
• Analyze the physical effects and therapeutic value of traction on
bone, muscle, ligaments, joint structures, nerve, blood vessels, and
intervertebral disks.
• Evaluate the clinical advantages of using positional lumbar traction
and inversion traction
• Describe the clinical applications for using manual lumbar traction
techniques including level-specific manual traction and unilateral leg
pull manual traction
• Explain the setup procedures and treatment parameter
considerations for using mechanical lumbar traction.
• Articulate the advantages of using a manual traction technique of the
cervical spine.
• Demonstrate the setup procedure for mechanical traction techniques
for the cervical spine.
Background
• The word traction is a derivative of the Latin word "tractico",
which means "a process of drawing or pulling
• since the time of Hippocrates, for the relief of pain.
• James Cyriax popularized lumbar traction during the 1950s and
1960s as a treatment for disc protrusions, and until today, it is
still a common modality for treating patients with back pain and
leg pain
• James Cyriax describes three benefits of lumbar traction:
1. distraction to increase the intervertebral space,
2. tensing of the posterior longitudinal vertebral ligament to exert
centripetal force at the back of the joint and suction to draw the disc
protrusion towards the center of the join
3. Some other effects attributed to traction include widening of
the intervertebral foramen and distraction of the apophyseal
joints
THE PHYSICAL EFFECTS OF TRACTION
• Effects on Spinal Movement
• Effects on Ligaments
• Effects on Bone
• Effects on the Disk
• Effects on Articular Facet Joints
• Effects on the Muscular System
• Effects on the Nerves
• Effects on the Entire Body Part
Mechanism of Action
TRACTION TREATMENT TECHNIQUES
• LUMBAR POSITIONAL TRACTION
• INVERSION TRACTION
• MANUAL LUMBAR TRACTION
• MECHANICAL LUMBAR TRACTION
• MANUAL CERVICAL TRACTION
• MECHANICAL CERVICAL TRACTION
MECHANICAL LUMBAR TRACTION

• Patient Setup and Equipment

• Body Position
• Traction Force
• Intermittent versus Sustained Traction
• Duration of Treatment
• Progressive and Regressive Steps
How much Percent of body weight must be
used?
• In deciding what traction weight to apply, one must consider 2
aspects :
1.What weight will overcome friction between the body and the
bed
2.What amount of force is required to exert an effect on the
lumbar spine
INDICATIONS AND CONTRAINDICATIONS
Evidence
• Lumbar disc herniation:
summary : A meta-analysis of 32 randomized trials
showed no significant benefit of lumbar traction
Autotraction does not change the location and size of an herniation but
there is a marked clinical improvement in the patients
• Low back pain:
summary : Either alone or in combination with other
treatments, traction has little or no impact on pain intensity, functional
status, global improvement and return to work among people with low
back pain
• Lumbago - sciatica:
summary : In the treatment of lumbago – sciatica lumbar
autotraction is a better method than the use of a corset and rest
Learning task
• What is traction and how may it be performed by the athletic trainer?
• What are the physical effects and therapeutic value of spinal traction on
bone, muscle, ligaments, facet joints, nerves, blood vessels, and
intervertebral disks?
• What are the clinical advantages of using positional lumbar traction and
inversion traction?
• What are the clinical applications for using manual lumbar traction
techniques, including level specific manual traction, and unilateral leg pull
manual traction?
• What are the setup procedures and treatment parameter considerations
for using mechanical lumbar traction?
• What are the advantages of using a manual traction technique of the
cervical spine?
• What is the setup procedure for mechanical and wall-mounted traction
techniques for the cervical spine?
Thanks….