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11102013
1
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Need technical support for this live event
Please call 1800 006 293 then press 1
NOTE You will be initially asked for the email address associated with this webinar account ndash ldquoSay Irsquom a webinar attendee ndash I donrsquot have an accountrdquo
This webinar will begin in the next few minutes
Be sure to convert to your own time zone at wwwworldhealthwebinarscomau
A New Perspective on NSLBP
and its Management
Presented by Sarah Key
Will commence LIVE from Sydney AUS at 7pm AEDT
Andrew Ellis BSc (Ex Sci) M Phty
World Health Webinars CEO
World Health Webinars Host
Musculoskeletal Physiotherapist Sydney CBD
Need technical support
Please call 1800 006 293 then press 1
You will need to tell them that you are a webinar attendee and do not have an email account with Citrix
Click red button to minimise
You will be muted
during every webinar
Make as much noise as
you like )
Dodgy computer
speakers Select
Telephone and call in
toll - FREE to hear the
presentation
Questions Wersquoll
answer them all at
the end
Sarah Key
bull Best known for treating the Royal family and was made a Member of the Victorian Order by Her Majesty the Queen in 2003
bull Author of best selling back pain books including Back in Action Back Sufferers Bible Body in Action and The Back Sufferers Pocket Guide These books have sold over 100000
bull Recently published two papers on disc degeneration
bull Educates aspiring physiotherapists and holds Back-in-a-Week intensive 5 day spinal therapy programs in Australia and the UK
Physiotherapist
11102013
2
A New Perspective on
NSLBP
and its Management
SARAH KEY
Part 1 The Basics of
How a Healthy Spine Works
wwwsarahkeycom
A normal spine and lumbar spinal segment
Front
compartment
Back
compartment
Front
compartment
Back
compartment
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The intervertebral disc is like a water-filled
pillow between the bony spinal segments
bull
Adams et al Biomechanics of Back Pain
wwwsarahkeycom
Component parts of the intervertebral disc
Prithvi Raj Pain Pract 2008 Vol 8 (1) 18ndash44
wwwsarahkeycom
The disc wall [anulus fibrosus]
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
3
Only the outer few layers of the disc wall has
a nerve and blood supply
Bogduk Clinical Anatomy of the Lumbar Spine
wwwsarahkeycom
Each 24 hours the lumbar discs exchange about
20 of their discal fluid
Wersquore all 2cm shorter when we go to bed
wwwsarahkeycom
Discs have 3 lsquonutritional enginesrsquo
bull Diffusion molecules spread from high to low density areas like a sugar cube in tea [small solute molecules]
bull Osmosis created by the complex proteoglycans molecules [small solutes]
bull Convection physical squash-and-suck effect of pressure changes [large molecules] physical=physiotherapy
Ishihara H Urban JP
Effects of low oxygen concentrations and metabolic inhibitors on
proteoglycans and protein synthesis rates in the IVDrsquo
J of Ortho research 1999 17 829-835
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Discs are huge torpid structures They need
help to transport nutrients and waste products
bull By day spinal movement helps suckampsquirt a fluid exchange through
bull By night the discs get most of their nutrition by osmosisdiffusion
wwwsarahkeycom
The paired facet joints flanking the disc
have a rich blood supply amp are lsquowired for painrsquo
wwwsarahkeycom
The spinal nerve roots exit bilaterally between
the disc and facet joints at each spinal level
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
4
Part 2 Why a Spinal Segment
Starts Causing Pain
wwwsarahkeycom
Lumbar discs break down in life earlier
than any other human tissue
Adams TBOBP
wwwsarahkeycom
The lower back sacrifices mobility for
stability
wwwsarahkeycom
We are a culture of mod con users
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Our activity mode is mostly bent forward
wwwsarahkeycom
Even moderate flexion increases disc loading
wwwsarahkeycom
11102013
5
Sedentary postures smother the metabolic
activity of discs and force too much fluid out
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The lumbar discsrsquo metabolic rate slows and
load is transferred to the disc walls
wwwsarahkeycom
It becomes easier and easier to injure a
non-compliant outer disc wall
wwwsarahkeycom
The ligamentous outer annulus can sense injury
wwwsarahkeycom
The muscles lock up to protect the stiffer link
BUT BEWARE
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Muscular compression can escalate breakdown
wwwsarahkeycom
11102013
6
Part 3 What Can We
Therapists Do About It
wwwsarahkeycom
Mobilising first But only short term
Beattie Joint mobilisation can increase water content in a degenerated L5 disc by 22
Beattie P F Donley J W Arnot C F Miller R The change of diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization
compared to prone lying Jan 09 Vol 39 Number 1 Journal of Orthopaedic and Sports Physical Therapy
wwwsarahkeycom
I say the heel is the most effective - and gentle - spinal
mobilising tool
lsquorestoring compliance of the outer annulusrsquo
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Part 4 The Patientsrsquo Daily Decompression
wwwsarahkeycom
Does prophylactic BackBlock Stretching the
annulus lsquoarm itrsquo against future compression
Lotz lsquoMaintaining tension in the annulus protects it from degeneration initiated by compressionrsquo
Lotz J C Hadi T Bratton C Reiser K Hsieh K Anulus fibrosis tension inhibits degenerative structural changes in the lamellar collagen Eur Spine J (2008) 171149-1159
wwwsarahkeycom
Because of the proteoglycans factor itrsquos easier
separating than squashing segments
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
2
A New Perspective on
NSLBP
and its Management
SARAH KEY
Part 1 The Basics of
How a Healthy Spine Works
wwwsarahkeycom
A normal spine and lumbar spinal segment
Front
compartment
Back
compartment
Front
compartment
Back
compartment
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The intervertebral disc is like a water-filled
pillow between the bony spinal segments
bull
Adams et al Biomechanics of Back Pain
wwwsarahkeycom
Component parts of the intervertebral disc
Prithvi Raj Pain Pract 2008 Vol 8 (1) 18ndash44
wwwsarahkeycom
The disc wall [anulus fibrosus]
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
3
Only the outer few layers of the disc wall has
a nerve and blood supply
Bogduk Clinical Anatomy of the Lumbar Spine
wwwsarahkeycom
Each 24 hours the lumbar discs exchange about
20 of their discal fluid
Wersquore all 2cm shorter when we go to bed
wwwsarahkeycom
Discs have 3 lsquonutritional enginesrsquo
bull Diffusion molecules spread from high to low density areas like a sugar cube in tea [small solute molecules]
bull Osmosis created by the complex proteoglycans molecules [small solutes]
bull Convection physical squash-and-suck effect of pressure changes [large molecules] physical=physiotherapy
Ishihara H Urban JP
Effects of low oxygen concentrations and metabolic inhibitors on
proteoglycans and protein synthesis rates in the IVDrsquo
J of Ortho research 1999 17 829-835
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Discs are huge torpid structures They need
help to transport nutrients and waste products
bull By day spinal movement helps suckampsquirt a fluid exchange through
bull By night the discs get most of their nutrition by osmosisdiffusion
wwwsarahkeycom
The paired facet joints flanking the disc
have a rich blood supply amp are lsquowired for painrsquo
wwwsarahkeycom
The spinal nerve roots exit bilaterally between
the disc and facet joints at each spinal level
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
4
Part 2 Why a Spinal Segment
Starts Causing Pain
wwwsarahkeycom
Lumbar discs break down in life earlier
than any other human tissue
Adams TBOBP
wwwsarahkeycom
The lower back sacrifices mobility for
stability
wwwsarahkeycom
We are a culture of mod con users
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Our activity mode is mostly bent forward
wwwsarahkeycom
Even moderate flexion increases disc loading
wwwsarahkeycom
11102013
5
Sedentary postures smother the metabolic
activity of discs and force too much fluid out
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The lumbar discsrsquo metabolic rate slows and
load is transferred to the disc walls
wwwsarahkeycom
It becomes easier and easier to injure a
non-compliant outer disc wall
wwwsarahkeycom
The ligamentous outer annulus can sense injury
wwwsarahkeycom
The muscles lock up to protect the stiffer link
BUT BEWARE
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Muscular compression can escalate breakdown
wwwsarahkeycom
11102013
6
Part 3 What Can We
Therapists Do About It
wwwsarahkeycom
Mobilising first But only short term
Beattie Joint mobilisation can increase water content in a degenerated L5 disc by 22
Beattie P F Donley J W Arnot C F Miller R The change of diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization
compared to prone lying Jan 09 Vol 39 Number 1 Journal of Orthopaedic and Sports Physical Therapy
wwwsarahkeycom
I say the heel is the most effective - and gentle - spinal
mobilising tool
lsquorestoring compliance of the outer annulusrsquo
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Part 4 The Patientsrsquo Daily Decompression
wwwsarahkeycom
Does prophylactic BackBlock Stretching the
annulus lsquoarm itrsquo against future compression
Lotz lsquoMaintaining tension in the annulus protects it from degeneration initiated by compressionrsquo
Lotz J C Hadi T Bratton C Reiser K Hsieh K Anulus fibrosis tension inhibits degenerative structural changes in the lamellar collagen Eur Spine J (2008) 171149-1159
wwwsarahkeycom
Because of the proteoglycans factor itrsquos easier
separating than squashing segments
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
3
Only the outer few layers of the disc wall has
a nerve and blood supply
Bogduk Clinical Anatomy of the Lumbar Spine
wwwsarahkeycom
Each 24 hours the lumbar discs exchange about
20 of their discal fluid
Wersquore all 2cm shorter when we go to bed
wwwsarahkeycom
Discs have 3 lsquonutritional enginesrsquo
bull Diffusion molecules spread from high to low density areas like a sugar cube in tea [small solute molecules]
bull Osmosis created by the complex proteoglycans molecules [small solutes]
bull Convection physical squash-and-suck effect of pressure changes [large molecules] physical=physiotherapy
Ishihara H Urban JP
Effects of low oxygen concentrations and metabolic inhibitors on
proteoglycans and protein synthesis rates in the IVDrsquo
J of Ortho research 1999 17 829-835
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Discs are huge torpid structures They need
help to transport nutrients and waste products
bull By day spinal movement helps suckampsquirt a fluid exchange through
bull By night the discs get most of their nutrition by osmosisdiffusion
wwwsarahkeycom
The paired facet joints flanking the disc
have a rich blood supply amp are lsquowired for painrsquo
wwwsarahkeycom
The spinal nerve roots exit bilaterally between
the disc and facet joints at each spinal level
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
4
Part 2 Why a Spinal Segment
Starts Causing Pain
wwwsarahkeycom
Lumbar discs break down in life earlier
than any other human tissue
Adams TBOBP
wwwsarahkeycom
The lower back sacrifices mobility for
stability
wwwsarahkeycom
We are a culture of mod con users
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Our activity mode is mostly bent forward
wwwsarahkeycom
Even moderate flexion increases disc loading
wwwsarahkeycom
11102013
5
Sedentary postures smother the metabolic
activity of discs and force too much fluid out
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The lumbar discsrsquo metabolic rate slows and
load is transferred to the disc walls
wwwsarahkeycom
It becomes easier and easier to injure a
non-compliant outer disc wall
wwwsarahkeycom
The ligamentous outer annulus can sense injury
wwwsarahkeycom
The muscles lock up to protect the stiffer link
BUT BEWARE
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Muscular compression can escalate breakdown
wwwsarahkeycom
11102013
6
Part 3 What Can We
Therapists Do About It
wwwsarahkeycom
Mobilising first But only short term
Beattie Joint mobilisation can increase water content in a degenerated L5 disc by 22
Beattie P F Donley J W Arnot C F Miller R The change of diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization
compared to prone lying Jan 09 Vol 39 Number 1 Journal of Orthopaedic and Sports Physical Therapy
wwwsarahkeycom
I say the heel is the most effective - and gentle - spinal
mobilising tool
lsquorestoring compliance of the outer annulusrsquo
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Part 4 The Patientsrsquo Daily Decompression
wwwsarahkeycom
Does prophylactic BackBlock Stretching the
annulus lsquoarm itrsquo against future compression
Lotz lsquoMaintaining tension in the annulus protects it from degeneration initiated by compressionrsquo
Lotz J C Hadi T Bratton C Reiser K Hsieh K Anulus fibrosis tension inhibits degenerative structural changes in the lamellar collagen Eur Spine J (2008) 171149-1159
wwwsarahkeycom
Because of the proteoglycans factor itrsquos easier
separating than squashing segments
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
4
Part 2 Why a Spinal Segment
Starts Causing Pain
wwwsarahkeycom
Lumbar discs break down in life earlier
than any other human tissue
Adams TBOBP
wwwsarahkeycom
The lower back sacrifices mobility for
stability
wwwsarahkeycom
We are a culture of mod con users
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Our activity mode is mostly bent forward
wwwsarahkeycom
Even moderate flexion increases disc loading
wwwsarahkeycom
11102013
5
Sedentary postures smother the metabolic
activity of discs and force too much fluid out
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The lumbar discsrsquo metabolic rate slows and
load is transferred to the disc walls
wwwsarahkeycom
It becomes easier and easier to injure a
non-compliant outer disc wall
wwwsarahkeycom
The ligamentous outer annulus can sense injury
wwwsarahkeycom
The muscles lock up to protect the stiffer link
BUT BEWARE
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Muscular compression can escalate breakdown
wwwsarahkeycom
11102013
6
Part 3 What Can We
Therapists Do About It
wwwsarahkeycom
Mobilising first But only short term
Beattie Joint mobilisation can increase water content in a degenerated L5 disc by 22
Beattie P F Donley J W Arnot C F Miller R The change of diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization
compared to prone lying Jan 09 Vol 39 Number 1 Journal of Orthopaedic and Sports Physical Therapy
wwwsarahkeycom
I say the heel is the most effective - and gentle - spinal
mobilising tool
lsquorestoring compliance of the outer annulusrsquo
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Part 4 The Patientsrsquo Daily Decompression
wwwsarahkeycom
Does prophylactic BackBlock Stretching the
annulus lsquoarm itrsquo against future compression
Lotz lsquoMaintaining tension in the annulus protects it from degeneration initiated by compressionrsquo
Lotz J C Hadi T Bratton C Reiser K Hsieh K Anulus fibrosis tension inhibits degenerative structural changes in the lamellar collagen Eur Spine J (2008) 171149-1159
wwwsarahkeycom
Because of the proteoglycans factor itrsquos easier
separating than squashing segments
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
5
Sedentary postures smother the metabolic
activity of discs and force too much fluid out
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
The lumbar discsrsquo metabolic rate slows and
load is transferred to the disc walls
wwwsarahkeycom
It becomes easier and easier to injure a
non-compliant outer disc wall
wwwsarahkeycom
The ligamentous outer annulus can sense injury
wwwsarahkeycom
The muscles lock up to protect the stiffer link
BUT BEWARE
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Muscular compression can escalate breakdown
wwwsarahkeycom
11102013
6
Part 3 What Can We
Therapists Do About It
wwwsarahkeycom
Mobilising first But only short term
Beattie Joint mobilisation can increase water content in a degenerated L5 disc by 22
Beattie P F Donley J W Arnot C F Miller R The change of diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization
compared to prone lying Jan 09 Vol 39 Number 1 Journal of Orthopaedic and Sports Physical Therapy
wwwsarahkeycom
I say the heel is the most effective - and gentle - spinal
mobilising tool
lsquorestoring compliance of the outer annulusrsquo
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Part 4 The Patientsrsquo Daily Decompression
wwwsarahkeycom
Does prophylactic BackBlock Stretching the
annulus lsquoarm itrsquo against future compression
Lotz lsquoMaintaining tension in the annulus protects it from degeneration initiated by compressionrsquo
Lotz J C Hadi T Bratton C Reiser K Hsieh K Anulus fibrosis tension inhibits degenerative structural changes in the lamellar collagen Eur Spine J (2008) 171149-1159
wwwsarahkeycom
Because of the proteoglycans factor itrsquos easier
separating than squashing segments
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
6
Part 3 What Can We
Therapists Do About It
wwwsarahkeycom
Mobilising first But only short term
Beattie Joint mobilisation can increase water content in a degenerated L5 disc by 22
Beattie P F Donley J W Arnot C F Miller R The change of diffusion of water in normal and degenerative lumbar intervertebral discs following joint mobilization
compared to prone lying Jan 09 Vol 39 Number 1 Journal of Orthopaedic and Sports Physical Therapy
wwwsarahkeycom
I say the heel is the most effective - and gentle - spinal
mobilising tool
lsquorestoring compliance of the outer annulusrsquo
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Part 4 The Patientsrsquo Daily Decompression
wwwsarahkeycom
Does prophylactic BackBlock Stretching the
annulus lsquoarm itrsquo against future compression
Lotz lsquoMaintaining tension in the annulus protects it from degeneration initiated by compressionrsquo
Lotz J C Hadi T Bratton C Reiser K Hsieh K Anulus fibrosis tension inhibits degenerative structural changes in the lamellar collagen Eur Spine J (2008) 171149-1159
wwwsarahkeycom
Because of the proteoglycans factor itrsquos easier
separating than squashing segments
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
7
There are many different ways to achieve
lumbar tractiondecompression
wwwsarahkeycom
The easiest The cheapest The best
wwwsarahkeycom
Then my patients do BackBlock [PCT] self-help
-- once per day 3 steps 3 times
bull Passive traction over BackBlock (60 secs)
bull Active assisted flexion (15 secs)
bull Reverse curl ups (15 times)
bull Each evening (for life)
wwwsarahkeycom
From our recent BackCare research grant at
Bristol University
We believe that treatment should aim to promote healing of the peripheral anulus
Adams M Key S Tarlton J Sharif M Dolan P Harding I
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Mike Adams in recent lsquoClinical Biomechanicsrsquo paper
bull lsquoPhysical therapies should aim to promote healing in the disc
periphery by stimulating cells boosting metabolite transport and
preventing adhesions and re-injury Such an approach has the
potential to accelerate pain reliefrsquo
Adams MA et al Healing of a painful intervertebral disc should not be confused with reversing disc degeneration Implications for physical therapies for discogenic back pain
Clin Biomech(2010) doi101016jclinbiomech201007016 [not in print until late 2010]
wwwsarahkeycom
The very strong anterior spinal ligament and the
hip flexors are stretched by passive extension
wwwsarahkeycom
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
8
Greatest velocities of discal fluid shift happens
after loading and unloading the spine
wwwsarahkeycom
The BackBlock is traction
helps restore fluid content of discs
bullGuehring lsquoDistraction results in disc rehydration and increased numbers of protein-expressing cellsrsquo
Guehring T Omlor GW Lorenz H Engelleiter K Richter W Carstens C Kroeber M Disc distraction shows evidence of regenerative potential in degenerated intervertebral
discs as evaluated by protein expression magnetic resonance imaging and messenger ribonucleic acid expression analysis Spine 2006 Jul 1 31(15)1658-65
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Cyclic stretching alone restores healthy discal
lsquobiosynthetic activityrsquo
Hee lsquoDynamic stretch at a rate of 1 Hz with 10 tensile strain is capable of increasing collagen synthesis in a previously compressed annulusrsquo
Hee H T Zhang J Wong H K Effects of cyclic dynamic tensile strain on previously compressed inner annulus fibrosus and nucleus pulposus cells of human IVD -an in vitro study J Orthop Res 2010 Apr28(4)503-9
wwwsarahkeycom
Neuro-vascular net is stretched lsquoknees rockingrsquo
wwwsarahkeycom
The lower abdominal muscles get weaker
with prolonged sitting
wwwsarahkeycom
Reverse curl-ups strengthen the lower
abdominals amp pelvic floor
bull Mainly internal oblique transversus abdominus
bull The below navel lower basket of the belly lsquoreefed inrsquo
bull No aggressive end-scoring to cause incidental shear
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
9
Sarah Keyrsquos Masterclasses (SKMC)
are held 2xyear in Sydney
bull SKMC
bull SKMC L1 (8 hour online theory component + 1 day practical)
bull SKMC L2 (8 hour online theory component + 2 days practical)
bull SKMC L3 (8 hour online theory component + 2 days practical)
bull SKMC L4 (8 hour online theory component + 2 days practical)
bull Upcoming Course Dates
bull SKMC L1 14 Feb 2014 (Sydney)
bull SKMC L2 15-16 Feb 2014 (Sydney)
bull wwwsarahkeycommasterclasses
wwwsarahkeycom
wwwsarahkeycom
wwwsarahkeycom
PREVIEW ONLY
These notes are a preview
Slides are limited
Full notes available after purchase from
wwwworldhealthwebinarscomau
Live Q amp A With Sarah Key
Coming up next
Facebook Twitter LinkedIn Google +
Live Q amp A With Sarah Key
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau
11102013
10
Thank you
From Sarah Key
amp
World Health Webinars Australia
httpworldhealthwebinarscomau