In this video, we will show you direction-specific exercises in case of directional preference and/or centralization. Enroll in our online course now. Link is in the video description. Hi and welcome back to Physioutors. Directional preference and centralization are two phenomena described in the derangement classification of the McKenzie concept.
Directional preference means that repeated movements into one direction, so either flexion, extension, or lateral flexion of the lumbar or cervical spine are able to progressively abolish symptoms and/or increase lumbar range of motion. A systematic review of May et al. in the year 2012 found that 70% of patients did exhibit such a directional preference. The McKenzie concept also talks about the phenomenon of centralization. Centralization is a symptom response to repeated movements, which is characterized by the abolition of spinal pain and referred spinal pain symptoms in a distal to proximal direction.
According to the review of May, 44% of patients presented with centralization. The prevalence was higher among younger patients and in acute low back pain with 74% in comparison with patients above 65, or if back pain was persistent, with 42%.
The presence of centralization was also a useful treatment effect modifier in seven out of eight included studies. In case of directional preference and or centralization, a patient’s symptoms can often be modified by performing repeated movements into the preferred direction. In the following, we will show you a couple of examples for the lumbar spine that we find useful in practice for patients with acute low back pain, with or without radiculopathy.
Be aware that this is absolutely no strict application of the McKenzie concept whatsoever. Alright, this was our video on direction-specific exercises for low back pain with or without radicular symptoms. Some patients present with fear avoidance behavior. In this case, exercises that challenge the patient’s fear in a graded exposure manner can be helpful. Click on the video right next to me to get a couple of ideas on how to do that.
A lot of this information and much more can be found in our soon to be released online course for physiotherapy of the spine (released in 2020).
Thanks a lot for watching and I’ll see you in another video. Bye..
Hey everybody it’s Doctor Jo, and today I’m going to show you some stretches and exercises to relieve back pain. Let’s get started. So these stretches and exercises are just for general back pain. If you’ve got some soreness in your back or it’s aching a little bit, maybe you pulled a muscle, but not a specific diagnosis. This is just the the common aches and pains that you might have.
So let’s start off on your back. Prop up your knees and you’re going to start off with a pelvic tilt. So a pelvic tilt is just kind of how it sounds, you’re taking your pelvis and tilting it back or rotating it back. So you’re flattening out your back. Imagine that your hands are in that curve, or you can actually put them there, and then you’re pushing down into your hands trying to push them into the floor.
So it’s just that rotation or that tilt of your pelvis. So when you tilt back, you’re going to hold it about three to five seconds and then relax.
To start off with, doing about 10 of those or just holding it keeping those muscles those core muscles nice and tight and relaxing. After you do those, then you’re going to go into a bridge, just to really get that back loosened up, get those tight muscles out of there. So with the bridge, you’re just going to lift your hips up until about a straight line and then slowly come back down one segment at a time.
So you’re not just popping back down, you’re going nice and controlled. So slow controlled movement, again just start off with about 10 of these and then you can work your way up to more. But this is really just get everything loosened up, getting that tightness and soreness out of there, just helping the healing process to relieve the pain. Now you’re going to do a knee to chest stretch. So just take one knee, I like going underneath because if you happen to have any problems going on top that’s a lot of pressure on there, so just grab underneath and pull your knee up towards your chest as far as you comfortably can and hold that for about 30 seconds.
So you’re pulling it, you’re not actually actively moving it up, so just hold that stretch 30 seconds then come back down. Alternate the other side, hold that for 30 seconds as well, and then you’re going to do three on each side total. After you do those, then you’re going to do a double knee to chest. So now you’re just taking both and pulling up at the same time. Again some people like to go up on top kind of grab around like this, if you have any problems you might not want to do that, and you might just want to grab underneath, so whichever way is more comfortable, but again holding that for 30 seconds and doing three of those, nice and relaxed, feel that stretch.
A lot of times you should feel that stretch kind of underneath that low back area right there. After you do three of those, now you’re going to a trunk rotation. Again just to kind of loosen that spine a little bit and help everything relax and get that soreness out of there.
So just both legs together trying to keep the top part of your body on the ground, and just rotate over as far as you comfortably can, hold that for about three to five seconds, and then rotate back the other way. So again to comfort not to pain, and then do five on each side just kind of rotating back and forth.
After you get those done, then you’re going to turn over and kind of get back on your feet here, or however far back you comfortably can, and then you’re going to put your arms out in front of you going into a prayer stretch as far as you comfortably can, and then bring your head down and just trying to stretch everything as far forward as you can, and again holding that stretch for about 30 seconds, feeling a nice stretch in that back, coming up, and then stretching all the way back down.
And then the last stretch exercise you’re going to do is kind of a yoga vinyasa move. So you’re going to come into the plank position here. You’re going to go down and then come up into your upward dog, hold that stretch for about three to five seconds, and then push back up pushing your heels down coming into the downward dog, and then holding that for about three to five seconds. You can go through that same motion about three to five times.
So there you have it, those are stretches and exercises to help relieve just general back pain. No specific diagnosis. Just if you have a tweaking in your back, or you picked up your dog trying to put it in the bathtub to wash them, and you got some soreness back there, hopefully that’ll help relieve everything. If you have any questions, leave them in the comments section. If you’d like to check out some other videos go to askdoctorjo.
com And remember, be safe, have fun, and I hope you feel better soon. fulfilled.