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PhysioFit365 - Physiotherapy


The lack of stability or “instability” of the lumbar spine must be differentiated from hypermobility. In both the range of motion is greater than normal. However, instability is present when excessive movement is accompanied by a lack of “protective” muscle control (Maitly 1986). The two situations are often the cause of many lumbar pains.

Spine stability is determined by three different systems: the passive, relating to noncontractile tissue; the active, to contractile tissue (muscles); and the neural control system related to the nervous system.

One of our goals in the rehabilitation process is to acheive the restoration of active lumbar stabilization, so that the final stage is to convert the conscious control of movements (cortical pathway) to an unconscious level (subcortical pathway).

This can be achieved by an increase in sensorial stimulation, improving the activation of the subcortical systems and thus the muscle reaction speed.

Yet in many back pain prevention or treatment programs, the norm are still abdominal exercises in which torso flexion (“sit-ups”) with or without rotation, or leg elevation, mainly using the mobilizing abdominal muscles, predominate. However, one of the important functions of the abdominals is spine stabilization.

We may classify the muscles of the torso in the following way:

  • Mobilizing: the rectus abdominis, the lateral fibers of the external oblique and erector spinae
  • Primary stabilizers:transversus abdominis and multifidus
  • Secondary stabilizers(can also move joints):internal oblique, medial fibers of the external oblique and the quadratum lumborum.
PhysioFit365 - Physiotherapy



Carpal Tunnel Syndrome is the name given to the compression of the median nerve in its passage through the carpal tunnel. The latter may be compared to an oval osteofibrous slide that has a dorsolateral wall made of the carpal bones and an anterior wall formed by the strong anterior annular ligament of the carpus. The flexor muscles of the fingers and median nerve pass through there. Due to the inextensibility of the tunnel the median nerve is easily compressed by anything that might alter the content-contingent relationship; for example, fractures or luxations of the carpus, Colles fractures, hematomas, rheumatoid arthritis, synovitis, tenosynovitis, tumors or cysts, endocrine disorders (menopause), pregnancy and collagenopathies.

In many cases no precise cause is found: only hypertrophy of the anterior annular ligament of the carpus (loss of the normal content-contingent relationship). En muchos casos no se encuentra ninguna causa precisa: solo hipertrofia del ligamento anular anterior del carpo (pérdida en la relación normal contenido-contingente). This neuropathy can be cause by the repeated movement of the wrist joint or overuse associated with specific occupational tasks, occupations and sporting activities that put a lot of strain on the wrist joint. With repetitive movements, the carpal tunnel can become inflamed and irritated, and compress the median nerve.

Among the most prominent clinical manifestations figure, initially, a sense of numbness, tingling or burning in the first three fingers if the hand, and pain. These symptoms get worse during the night, waking the patient, or at first light. Later on, if the compression continues, it evokes clumsiness in the manual activity, weakness when pinching and grasping objects and thumb movements, inflammation in the hand and forearm, and thenar muscle atrophy