Treating Disc Injuries With Manual Therapy and Exercise – Part 2

Manual Therapy

Removing any type of mechanical restriction that causes stress on the disc will be of great benefit. The specific physical restrictions that need to be addressed with manual procedures (ART, Graston, Massage, Manipulation) in a disc injury will vary depending on the individual.

Determining which areas need to be addressed will depend on biomechanical analysis and palpation of the affected areas. A key point to remember is that there is no one group of structures that is the key to addressing all disc issues. Any injured muscle, joint capsule, ligament, tendon, or connective tissue restriction can cause changes in motor patterns (neuromuscular imbalances) that directly affect spinal stability.

Imbalances increase stress on the discs of your back which perpetuate or cause further injury. Fortunately, those spinal imbalances can be addressed with manuel procedures. When these procedures are combined with dynamic exercises to re-estabilsh normal motor control good results are often seen.

The following muscles are example of structures that can affect disc function. These are examples of structures that manual procedures can address can to manage or resolve a disc problem. Just remember these are only two examples in a very large list of structures.

Structure

• Multifidus Muscle (deep back extensors)

Relationship to disc injuries

• Research shows that during a disc injury neurological input to the multifidus muscle can be reduced. This leads to muscle wasting (type I and type II fibres). This deep spinal muscle functions as a spinal stabilizer. ART procedures can help in re-establishing normal multifidus function. Yoshihara at el. (2001). Spine, 26(6), 622-626

Structure

• Abdominal muscles and back extensor muscles

Relationship to disc injuries

• A balance between the abdominal muscle and back extensors affects muscle strength and lumbar lordosis (lumbar curve), sacral angle and spinal stability. Any imbalance in these antagonistic muscles can cause increased spinal tension, spinal instability, and stress on the disc. Manuel procedures are very effective at addressing this type of imbalance.

Bottom line when it comes to therapy, the successful resolution of a disc problem involves a complex understanding of kinetic chain relationships, and a functional understanding of how each body action is related to specific anatomical structures.

In part three of “Treating Disc injuries with Manual Therapy and Exercise” will cover Exercise for disc injuries.

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