A to Z Entries
Clare E. Milner in Functional Anatomy for Sport and Exercise, 2019
The lumbar spine and pelvis support and transmit the weight of the upper body to the lower extremities. The pelvis has a limited amount of movement between its bones and is supported by strong ligaments. The sacroiliac joint has a very limited amount of movement and is supported by the strong posterior and interosseous sacroiliac ligaments, plus the thinner anterior sacroiliac ligament. The interosseous ligaments are the primary structures involved in the transfer of upper body weight to the pelvis and then to the lower extremities. Movement at the sacroiliac joint is further held in check by the strong sacrotuberous ligaments. These ligaments run from the sacrum to the ischial tuberosity of the pelvis and prevent superior rotation of the inferior end of the sacrum. The lumbosacral joint is supported by the iliolumbar ligaments which run from the transverse processes of the L5 vertebra to the iliac bones of the pelvis. There is also a joint between the sacrum and coccyx, although it does not contribute to weight transfer to the lower extremities. The sacrococcygeal joint is supported by anterior and posterior sacrococcygeal ligaments, which run longitudinally from the sacrum to the coccyx.
Seating and Mobility for The Severely Disabled
Raymond V. Smith, John H. Leslie in Rehabilitation Engineering, 2018
The articulation between the spine and the pelvis is termed the lumbosacral joint. The position of the pelvis is traditionally defined by the lumbosacral angle (Figure 13). The lumbosacral angle is defined as the angle between a line drawn through the superior plateau of the first sacral vertebrae and the horizontal. In the ASRP, this angle is approximately 15 to 20 degrees as measured in the midsagittal plane. Motion of the pelvis can be described in terms of pelvic tilt, pelvic obliquity, and pelvic rotation. Pelvic tilt — Movement in the sagittal plane from the neutral position is described as a forward or backward pelvic tilt (see Figure 13).Pelvic obliquity — Rotational movement from neutral in the frontal plane about a horizontal axis passing through the lumbosacral joint measures the lateral obliquity of the pelvis. Obliquity is named in terms of the side which moves downward. A right pelvic obliquity means that the right side of the pelvis is lowered and the left side is raised (Figure 14, front view).Pelvic rotation — Rotation of the pelvis in the transverse (horizontal plane) is measured about a vertical axis passing through the lumbosacral joint. The movement is defined in terms of the direction toward which the front of the pelvis turns (Figure 14, lower diagram).
Low Back Pain
Benjamin Apichai in Chinese Medicine for Lower Body Pain, 2021
Acute spraining of the waist may affect many anatomic structures in the lumbar region. The sacroiliac joint, commonly called the SI joint, is the joint between the lateral articulating surfaces of the sacrum and the articulating surfaces of the ilium bones of the pelvis. There are two joints, one on each side of the sacrum. The joint is a synovial articulation between the articular surface of the sacrum and ilium on either side. In humans, when standing (Hayat 2020),10 the sacrum and the ilium support the spine, and the sacroiliac joint serves to transfer weight from the upper body to the lower limbs. This acts as a shock absorber and reduces the pressure on the spine.11 The joint is stabilized by strong ligaments and muscles. Even though they are joints, the movement of the joints is minimal; it is limited to only 2 to 4 mm in any direction (Raj 2019). When either of the joints comes out of alignment, it can be painful.12Sacrospinalis muscles13 are also known as erector spinae muscles. These muscles run essentially vertically on either side of the vertebral column spinous processes and extend throughout the lumbar, thoracic, and cervical regions. They are large, roughly one hand’s width from the spinous processes. They stabilize the entire vertebral column.The lumbosacral joint is a joint between the last lumbar vertebra (L5) and the first of the auricular surfaces of the sacrum (S1).14 This joint has an intervertebral disc.The ligaments connecting the L5 and the S1 are the continuation downward of the anterior and posterior longitudinal ligaments, the ligamenta flava, and the intervertebral fibrocartilage.
A comparative analysis of lumbar spine mechanics during barbell- and crate-lifting: implications for occupational lifting task assessments
Published in International Journal of Occupational Safety and Ergonomics, 2020
Jackie D. Zehr, Danielle R. Carnegie, Timothy N. Welsh, Tyson A. C. Beach
A statistically significant object × grip interaction effect was found for lumbosacral joint compression (F(1,15) = 7.2, p = 0.017) (Figure 2). The compression force magnitude was approximately 238 N and 264 N greater when the crate was lifted with a neutral and a pronated grip, respectively, than when lifting the barbell with a neutral grip (p < 0.001; d > 0.78). Compared to when the barbell was lifted with a pronated grip, lumbosacral joint compression magnitudes were 440 N and 416 N greater when the crate was lifted with a pronated and a neutral grip, respectively (p < 0.001; d > 1.30). Lumbosacral joint compression was not different between the crate-lifting conditions (i.e., neutral grip = pronated grip) (p = 0.646), but did differ between the barbell-lifting conditions (i.e., neutral grip > pronated grip) (p = 0.005; d = 0.68). In sum, the lumbosacral joint compression was greater when lifting the crate than when lifting the barbell, and the type of grip did not influence the compression during crate-lifts but did influence compression in the barbell-lifts.
Improving balance and walking ability in community-dwelling people with lower limb loss: a narrative review with clinical suggestions
Published in Physical Therapy Reviews, 2018
Christopher Kevin Wong, Jeremy Sheppard, Katherine Williams
Hypomobile passive structures including joints and connective tissues can limit hip extension range-of-motion and lead to functional muscle weakness and imbalance, seen commonly especially after transfemoral amputation.37 One study sought to minimize the common underlying hip, sacroiliac, and lumbosacral joint hypomobility in people with lower limb loss through manual therapy, followed by a stretching program to maintain and optimize hip range-of-motion and muscle function.24 Joint mobilizations performed in prone with residual limb supported, included anterior directed grade III-IV hip mobilizations, sacroiliac mobilizations with movement, and sacral muscle energy mobilizations.24 Balance and walking ability improved in this small study without adverse event, suggesting joint mobilization can be used safely to help optimize prosthetic gait.24
A preliminary study in classification of the severity of spine deformation in adolescents with lumbar/thoracolumbar idiopathic scoliosis using machine learning algorithms based on lumbosacral joint efforts during gait
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Bahare Samadi, Maxime Raison, Philippe Mahaudens, Christine Detrembleur, Sofiane Achiche
Gait pattern provides useful information to assess and follow-up musculoskeletal disorders. AIS affects trunk symmetry and anatomy of spine that can modify human locomotion. Significant differences have been reported in kinematics (Schmid et al. 2015) and ground reaction forces during gait in AIS with different levels of severity (Chockalingam et al. 2004). Therefore, the intervertebral efforts as variables, which are computed by using kinematics and ground reaction forces, can provide valuable information to assess and follow-up scoliosis. Raison et al. reported that the magnitude, maxima and minima of intervertebral efforts normalized to the body mass are being influenced by the severity of spinal deformity (Raison et al. 2010; Raison and Ballaz 2018). Guilbert et al. and Samadi et al. reported (Guilbert et al. 2019; Samadi et al. 2020) that the intervertebral efforts have significant differences between the scoliotic patients and typically developed individuals. We considered these findings from the literature for feature selection process to train the classification algorithms. Consequently, in the current study, we developed a machine learning algorithm based on the lumbosacral (L5-S1) joint efforts during gait as an aid for clinicians to follow-up and assess the progression of scoliosis. The proposed method classified the severity of scoliosis (Cobb angle) in 30 patients without any spinal fusion surgery within the Lenke 5-6 (left lumbar/thoracolumbar scoliosis). Three different classes based on the treatments strategies and clinical classification, were considered: AIS individuals with mild, moderate and severe scoliosis. The lumbosacral joint is known as the most mobile part of the spine in lumbar/thoracolumbar scoliosis. Additionally, mediolateral force and torque as well as anteroposterior torque, in this part of the spine, have shown differences between healthy individuals and the individuals with different severity as shown in Figure 2 and studies presented in Mahaudens et al. (2009), Raison and Ballaz (2018) and Samadi et al. (2020). Therefore, these mentioned efforts in the lumbosacral joint are promising parameters to be chosen as features for the classifier algorithm. It can be explained by the fact that spinal deformity causes the AIS to compensate on the opposite limb to that of the curve. Furthermore, it has been reported that lumbar curve causes asymmetrical trunk movement in the coronal plane (Nishida et al. 2017). Therefore the efforts related to the lateral direction, i.e. ML force and torque and AP torque are influenced the most by the spinal deformity during gait, compared to the other components of the intervertebral efforts (Chockalingam et al. 2004).