Prevention & Treatment of Cervical & Lumbar Injury for the Oculofacial Surgeon<br />Renée Ostertag, DPT, MPT, COMT<br />De...
Objectives<br />Increased awareness to aid in prevention of injury<br />
Anatomy Review<br />
Physiology of a Disc<br />
Cervical Physiology<br />Cervical Protrusion and Retraction<br />Cervical Flexion and Extension<br />
Lumbar Disc Physiology<br />Lumbar Flexion<br />Lumbar Extension<br />
Load to Lumbar Disc<br />
Load to Lower Cervical Disc<br />Neutral Head Position is 12 lbs.<br />Forward Head Position is 36 lbs.<br />
Pathophysiology Stage #1<br />Microscopic tears<br />Weakens annulus<br />
Pathophysiology Stage #2<br />Disruption of inner layers of annulus<br />No innervation of inner 1/3 of disc<br />
Pathophysiology Stage #3<br />Tissue Damage has reached innervated tissue<br />
Pathophysiology Stage #4<br />Marked displacement of nerve root<br />Symptoms:<br />Severe neck/UE pain<br />UE weakness a...
Operating Room Suggestions<br />Avoid sustained end range loading<br />Practice “Neutral Spine” posture<br />
Take a knee<br />
Position Change<br />Standing<br />Sitting<br />
Take breaks!<br />
More Practical Suggestions<br />Set your ideal posture first<br />Adapt the patient and environment to you<br />Avoid sust...
Exercises 1. Head Retraction<br />Common Errors<br />Tipping head back<br />Tensing up neck/shoulders<br />Thoraco-lumbar ...
Exercises 2. Posture Correction<br />Slouched Overcorrected	Less 10%= IDEAL<br /> “Neutral Spine”<br />
Exercises 3. Back Extension in Standing<br />Variations<br />Bend back over counter/chair<br />
Exercises 2. Back Extension in Prone<br />Common Errors<br />Tensing back/buttocks<br />Letting hips come off<br />Variati...
Guidelines for Self-Care<br />GREEN LIGHT<br />No current symptoms<br />Neck and Back exercises 5-10 reps, ≥5x/day<br />Cu...
Guidelines for Self-Care<br />YELLOW LIGHT<br />I/M neck/back symptoms that respond to position change or movement<br />Sy...
Guidelines for Self-Care<br />RED LIGHT – seek medical attention!<br />Constant neck/back symptoms<br />I/M or Constant ra...
Further Reading<br />Robin McKenzie<br />“Treat Your Own Back”<br />“Treat Your Own Neck”<br />
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Prevention & Treatment Of Cervical & Lumbar Injury

A presentation from Florida to a group of Opthalmic Surgeons on how to prevent/manage neck and back pain
Published on: Mar 4, 2016
Published in: Health & Medicine      Entertainment & Humor      
Source: www.slideshare.net


Transcripts - Prevention & Treatment Of Cervical & Lumbar Injury

  • 1. Prevention & Treatment of Cervical & Lumbar Injury for the Oculofacial Surgeon<br />Renée Ostertag, DPT, MPT, COMT<br />Denver, Colorado<br />ASOPRS Spring Meeting, 2011- Amelia Island<br />
  • 2. Objectives<br />Increased awareness to aid in prevention of injury<br />
  • 3. Anatomy Review<br />
  • 4. Physiology of a Disc<br />
  • 5. Cervical Physiology<br />Cervical Protrusion and Retraction<br />Cervical Flexion and Extension<br />
  • 6. Lumbar Disc Physiology<br />Lumbar Flexion<br />Lumbar Extension<br />
  • 7. Load to Lumbar Disc<br />
  • 8. Load to Lower Cervical Disc<br />Neutral Head Position is 12 lbs.<br />Forward Head Position is 36 lbs.<br />
  • 9. Pathophysiology Stage #1<br />Microscopic tears<br />Weakens annulus<br />
  • 10. Pathophysiology Stage #2<br />Disruption of inner layers of annulus<br />No innervation of inner 1/3 of disc<br />
  • 11. Pathophysiology Stage #3<br />Tissue Damage has reached innervated tissue<br />
  • 12. Pathophysiology Stage #4<br />Marked displacement of nerve root<br />Symptoms:<br />Severe neck/UE pain<br />UE weakness and/or incoordination<br />Loss of sensation and reflexes<br />+/- surgery<br />
  • 13. Operating Room Suggestions<br />Avoid sustained end range loading<br />Practice “Neutral Spine” posture<br />
  • 14. Take a knee<br />
  • 15. Position Change<br />Standing<br />Sitting<br />
  • 16. Take breaks!<br />
  • 17. More Practical Suggestions<br />Set your ideal posture first<br />Adapt the patient and environment to you<br />Avoid sustained end range positions<br />Take breaks from positions every 15-20 min.<br />Avoid loupes/head lamps as able<br />High Powered Reading Glasses as alternative?<br />Dictation <br />Headpiece vs. holding phone to ear<br />
  • 18. Exercises 1. Head Retraction<br />Common Errors<br />Tipping head back<br />Tensing up neck/shoulders<br />Thoraco-lumbar compensation<br />Variations<br />Add “overpressure”<br />Stand at a wall <br />Repeated or sustained<br />
  • 19. Exercises 2. Posture Correction<br />Slouched Overcorrected Less 10%= IDEAL<br /> “Neutral Spine”<br />
  • 20. Exercises 3. Back Extension in Standing<br />Variations<br />Bend back over counter/chair<br />
  • 21. Exercises 2. Back Extension in Prone<br />Common Errors<br />Tensing back/buttocks<br />Letting hips come off<br />Variations<br />Repeated or sustained<br />Sustain position by propping on elbows<br />Rest on pillows<br />
  • 22. Guidelines for Self-Care<br />GREEN LIGHT<br />No current symptoms<br />Neck and Back exercises 5-10 reps, ≥5x/day<br />Current symptoms: local neck, scapular or shoulder pain/stiffness<br />Neck and Back exercises<br /> 5-10 reps, 10x/day<br />Symptoms reduce/eliminated <br /> during and/or immediately <br /> after exercise<br />
  • 23. Guidelines for Self-Care<br />YELLOW LIGHT<br />I/M neck/back symptoms that respond to position change or movement<br />Symptoms produced or increased during exercise<br />no worse or better immediately after<br />Neck and/or Back exercises <br /> 5-10 reps, 10x/day<br />
  • 24. Guidelines for Self-Care<br />RED LIGHT – seek medical attention!<br />Constant neck/back symptoms<br />I/M or Constant radicular pain<br />Loss of/change in extremity power, sensation, coordination <br />Symptoms that are worse or <br /> peripheralized after exercise<br />
  • 25. Further Reading<br />Robin McKenzie<br />“Treat Your Own Back”<br />“Treat Your Own Neck”<br />

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