The cervical spine – understanding the science behind both movement and dysfunction

The Cervical Spine – Understanding The Science
Behind Both Movement And Dysfunction
By Chris Gellert
www.fitnessprofessionalonline.com
The spine is a complex
structure, comprised of
nerves, connective
tissue, bones, discs,
muscles and other
essential integrative
components.

Specifically, the cervical
spine is a vulnerable area
that is commonly injured
due to fall, trauma, motor
vehicle accident, stress, as
well as poor ergonomic
setups, which all lead to
pain.
By Chris Gellert

Basic anatomy
When we look at the
neck, there are seven
bones(vertebrae) that
are part of the
supportive column of
the spine.
By Chris Gellert

Within the cervical region,
there are several key
anatomical structures that
include; spinous process,
transverse process, and
facets, which are an
articular surface within the
bone that allows gliding of
bones to occur.
By Chris Gellert

There are over 700
muscles in the
human body. Each
with a specific
function and task.
By Chris Gellert

Common injuries and
causes of cervical spine
The most common are
cervical whiplash,
osteoarthritis, disc injury
including pinched
nerve(radiculopathy).
By Chris Gellert

a. Cervical whiplash
Mechanism of
injury/pathophysiology:
The term “whiplash”
commonly refers to
symptoms and signs
associated with a
mechanical event such as a
sudden acceleration and
deceleration of the neck.
By Chris Gellert

b. Cervical
osteoarthritis(degenerative disc
disease)
Mechanism of
injury/pathophysiology:
Is termed the wear and tear arthritis
because it is thought that the
articular cartilage breaks down
because of an imbalance
between mechanical stress and the
ability of the joint to handle the
given loads.
By Chris Gellert

c. Cervical
Radiculopathy(due to a
pinched nerve)
Mechanism of
injury/pathophysiology: This
is where the cervical nerve
root is being compressed,
resulting in inflammation,
creating local to peripheral
pain(arm).
By Chris Gellert

d. Cervical disc injury
Mechanism of
injury/pathophysiology: A
single incident, or motion that
involves a combined
movement of cervical flexion,
rotation with side bending
repeated over and over may
be the direct cause for a
cervical disc injury(Starkey, C.,
& Johnson, G., 2006).
By Chris Gellert

Types of disc injuries:
1. In Protrusion or bulge, there is
change in the shape of the
annulus that it causes to bulge
beyond its normal perimeter.
2. In Prolapse disc(herniation), the
ligamentous fibers give way,
allowing the nucleus to bulge into
the neural canal. The disc is still
contained by the outer layers of
the annulus and supporting
ligamentous structures.
By Chris Gellert

3. Extrusion is where the disc
protrudes through the annulus
but is contained by the posterior
longitudinal ligament(PLL).
4. Sequestration is where the
nuclear material/free floating
piece of the nucleus
has partially separated from the
remaining nucleus, allowing it to
be free in the neural canal and
moves into the epidural space.
By Chris Gellert

Common Assessments
For safety and based
on the clients past
medical history, length
of time from injury and
general health, I would
recommend the
following assessments.
By Chris Gellert

Training strategies and
programming for neck
injuries
With any injury, the most
important thing to
remember is the type of
injury, healing time and
prior level of function of
the client.
By Chris Gellert

a. Whiplash injuries
Whiplash injuries can
take a long to heal
ranging form 3
months up to one
year in duration.
By Chris Gellert

b. Cervical degenerative
disc disease(DDD)
Recommendations for
training: I would teach
them self-stretching of
the upper trapezius and
pectorals, which are
commonly tight.
By Chris Gellert

c. Cervical Radiculopathy due to
pinched nerve
Recommendations for training:
Most clients will have completed
physical therapy before meeting
them and it would be an
excellent segway from
rehabilitation to the gym, to
contact the clients physical
therapist with their permission.
By Chris Gellert

d. Cervical Radiculopathy due
to disc injury
Recommendations for
training: Most clients will have
completed physical therapy
before meeting them and
it would be an excellent segway
from rehabilitation to the gym,
to contact the clients physical
therapist with their permission.
By Chris Gellert

The neck is a complex unit
that is comprised of a
multitude of ligaments,
tendons, connective tissue,
muscles that synergistically
initiate and correct
movement, and stabilize
when an unstable
environment.
By Chris Gellert

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