Published Tuesday, February 6th, 2018 at 00:26 am
Mater Private Cork Physio Team Helps Patients Reach Potential
Hugh Tobin, Specialist Physiotherapist at Mater Private Cork, looks at the evolution of the pelvis and spine and their importance in our daily lives.
The aim of the Mater Private Cork Physiotherapy Team is to help patients reach their maximum potential for their physical needs and abilities.
Evolution led us down a complicated road as our distant ancestors travelled on all fours for millions of years, then abruptly (in evolutionary terms) stood up on their back legs and adopted an upright posture. Taking a spine designed to function in a horizontal posture and flipping it into a vertical one created problems.
The pelvis is essentially the centrepiece of the body. It connects the spine to the lower limbs. For about two-thirds of our lives, our bodies are upright, for the remaining third we are lying asleep. As our lifestyles have become increasingly sedentary, the effect on our pelvic area, and consequently our hips and lower back which connect to it, impacts our daily lives.
Much of our time is spent sitting — in the car, at a desk, and at home on the couch. This can lead to tightening of muscles at the front of the hips known as the hip flexors. These muscles originate at the pelvis and lower back and insert into the thigh bone. Prolonged sitting results in the shortening of these muscles, which tends to pull the pelvis forward and down. Shifting the pelvis like this affects the spine, which balances on top of the pelvis, causing the lumbar curve to increase.
Physiotherapy can help people to strengthen the muscles which need to become stronger and lengthen the muscles which have become too tight. Good muscular balance can help improve performance and help reduce the incidences of injury. The altered position of the pelvis also affects the stabilising muscles at the bottom of the spine, which can cause lower back pain of muscular origin. Correcting posture can have marked improvements on lower back pain. Where pain around the pelvic region is due to osteoarthritic problems at the hip, exercise can help to reduce pain and improve function, helping to delay the need for hip replacements or better prepare for the operation.
People will limp on an arthritic leg, spending less time weight-bearing through the sore leg. This leads to atrophy or weakening of the stabilising muscles of the hip. Pre-operative physiotherapy can help people return to normal function faster and correct bad habits which may have developed.
At the NEW Mater Private Cork Orthopaedic and Spine Centre, we have excellent joint replacement surgeons, including Mr Maha Lingham, whose pioneering hip replacement surgery avoids cutting any of the stabilising muscles, thus reducing pain and further accelerating rehabilitation. The spine is made of bones called vertebrae with discs in between each bone. These discs are essentially cartilage doughnuts filled with a jelly-like protein centre. They help with shock absorption. As we age, from our late-teens/early 20s onwards, these discs slowly dry out and wear down. In addition to the ageing process, mechanical stresses like heavy lifting and repeated bending cause further degradation of the discs. The majority of incidences of lower back pain are of muscular origin. But for those for whom it is not, it is worth seeing a specialist in the area.
At Mater Private Cork, consultant spinal surgeon Mr Paul Kiely can guide the patient towards the correct path to treat the condition. As always if you suffer hip spine and back pain, visit your family doctor in the first instance. Your GP can help with treatment and prevention, including diet, exercise and referrals. A little increase in exercise, getting up from the desk and walking around the office wearing the right footwear can make all the difference in the long run.