Spinal compression fracture

[physiobob]

Hi Ray, sounds like your on the right track. I suppose you need to look at the mechanism of the injury to see which movements are likely to be more affected. It might have been an impact e.g. landing off a ladder, a whiplash type fracture, a landing on the head issue etc. You initial thoughts are sound. I would say gently...gently... in the beginning to restore flexion/ext and rotation. Back extensions over a large ball for example to support the extension position might be nicer for the patient that McKenzie Extension in lying to begin with.

Note also that this is a joint that is problematic anyway because you have a relatively rigid ribcage area moving on the lumbar spine. So one should look very much to the mobilisation of the thoracic spine above the issue to lessen the pressure on that pivot point. Also remember they would have been holding a rigid posture for 7 weeks+ and that side bending is a coupled movement of extension/rotation or flexion/rotation. This means simple rotation exercises, e.g. on the floor or in sitting will assist to reintegrate a more normal movement pattern.

Let us know how you get on and the mechanism of injury once you see the client

[SA Physio]

Thanks for the help physiobob, I appreciate it. I found a document that mentions limiting flexion initially, which makes sense depending on the severity of the fracture.
I'll keep you posted.

[zisuer]

hehe, I just treating a traumatic compression fracture patient. He is young and jus took off the binder. He almost loss all range of motion in lumbar area. complain low back pain. The treatment I gave him are pelvic tilt, core mucsle training. Active ROM within pain free range. Extension is his most painful position. I am thinking I may let him do some gentle stretching like what you said cat stretch or others. I also think about increase his cardiac endurance after 2 months less active life, they may need this, but I got to improve his stability first or use the binder when he exe. I would like to hear any comments.