KINE/AT 213
Chapter 10 Outline - Injuries to the Thoracic Through Coccygeal Spine

Thoracic Cage
12 pairs of ribs
12 thoracic vertebrae and verterbral disks
        Protect the heart, both lungs and aorta/vena cava

COMMON SPORTS INJURIES TO THE THORACIC SPINE
1)Vertebral Fractures
    -MOI - trauma to the area
    -S/S - pain and numbness to abdomen and legs

2)Spine Curvatures
    -Kyphosis - round back, convexity of thoracic spine
    -Scoliosis - "S" or "C" curvature, lateral curvature or shift of the spine
    -Lordosis - "swayback", concavity of lumbar spine

3)Scheuremann Disease
    -growth plate deformity to throacic spine

4)Rib fracture
    -MOI - direct blow to area
    -S&S - painful breathing (dyspnea), painful movement

5)Pneumothorax - air gets into pleural cavity (collapsed lung)
    -MOI - fractured rib, illness, trauma or spontaneous
    -S&S - labored breathing and shock

6)Hemopneumothorax - blood and air gets into pleural cavity
    -MOI - fractured rib or gunshot (open) wound

7)Sprains & Strains
    -S&S - painful breathing, painful movement, pain location is different:
     sprain on spine & strain off spine-in muscle

LOW BACK ANATOMY
LUMBAR
-5 vertebrae, L1 - L5
-5 intervertebral disks
-Anterior and Posterior longitudinal ligaments
-Interspinous ligaments

SACRUM
-5 fused vertebrae
-2 sacroiliac joints and strong ligaments

COCCYX
-4 small fused vertebrae (tail bone)


LOW BACK SPORTS INJURIES
More commonly injured than the thoracic spine

-Spondylolysis - a defect in the vertebrae bone - neural arch ring (pars interarticularis area)
    -MOI - stress fracture (fx) or congenital fx from birth defect
    -S&S - low back pain and spasm, hyperextension of back aggravates condition

-Spondylolisthesis - anterior displacement of L5 vertebrae on S1 vertebrae
    -MOI - both sides of neural arch are fractured
    -S&S - pain and spasm with pain radiating down into buttock(s)

-Traumatic Fractures - uncommon in sports setting
    -MOI - severe blow to the spine
    -S&S - pain on spine, radiating pain, shock, muscle spasms

-Sprains & Strains -
    -MOI - tension or shearing force, i.e. quick twisting movement, bending over to pick something up
    -S&S - localized muscle spasm, increase pain on trunk movement, pain will not radiate into buttock(s)

-Lumbar Disk Injuries -
    -MOI - twisting while lifting an object
    -S&S - sharp pain especially when sitting, pain usually radiates into buttocks or even legs, burning or numbness        
      sensation in legs, muscle spasms, loss of strength in leg muscles
    -Parts of Intervertebral disks:
        1)annulus fibrosis - outer ring (doughnut)
        2)nucleus pulposis - fluid center (jelly)
    -Treatment - REST, REST, heat, stretching and strengthening exercises with surgery being a last resort!