Lumbar Flexion Syndrome

Lumbar Flexion Syndrome

Medical Diagnoses:

  • Acutely herniated disk
  • Lumbosacral strain
  • lumbago
  • degenerative disk disease

Description:

Your pain is worse in sitting or when you bend forward.  Your pain may be localized to your back, or it may travel down 1 leg (probably not both legs).  This is a result of excessive motion into flexion (bending), possibly as a result of decreased motion elsewhere in the body (hips, thoracic spine).

Demographics:

Men are more likely than women

Younger people are more likely than older people

Diagnostic Tests:

  • Forward Bend: increased lumbar flexion and possibly pain
    • Secondary Test: decreased pain with hip hinge
  • Supine bilateral and unilateral hip and knee flexion: increased lumbar flexion and possibly pain
    • Secondary Test: reduced pain when stopping motion when lumbar flexion begins
  • Prone position reduces pain
  • Sitting posture reveals decreased lumbar lordosis and possibly pain
    • Secondary Test: reduced pain with upright posture
  • Quadruped Rocking: painful and increased lumbar flexion
    • Secondary Test: reduced pain with neutral spine
  • Seated Knee Extension causes posterior pelvic tilt and possibly pain
    • Secondary Test: reduction in pain, posterior pelvic tilt with decreased ROM

Comerford Tests:

  • Standing: Trunk Lean
  • 4 Point: Backward Push
  • Crook Lying: Double Bent Leg Lift
  • Sitting: Forward Lean
  • Sitting: Chest Drop
  • Sitting: Double Knee Extension
  • Stand to Sit: Ischial Weight Bearing

SFMA: Multi-Segmental Flexion + Breakouts

Treatment:

  • Decrease / eliminate spinal flexion in daily activities, especially sitting.
  • Improve mobility of hips and hamstrings to allow more motion in the lower extremities versus the spine.
    • single knee to chest for hip stretch
    • rectus abdominis stretch – supine shoulder flexion
    • unilateral prone shoulder flexion or unilateral prone hip extension
    • quadruped rocking in extension
    • seated knee extension
    • waiter’s bow / hip hinge > deadlift and squat
    • standing shoulder flexion
    • single leg deadlift
    • lunge
    • birddog

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