Thoracic Spine

 

Thoracic Spine

 

Bones and areas to remember for the Thoracic Spine:

1. 12 Vertebrae in the Thoracic Spine
2. Spinous Process
3. Transverse Process
4. Body of the Vertebrae
5. Superior Costal Facets (for the head of the ribs

Thoracic Vertebrae & Anatomy

Thoracics Vertebrae

This is a posterior view of the Thoracic Spine. Notice the connection of the ribs into the Thoracic Vertebrae.

 

Thoracic Vertebrae & Anatomy

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Knee Patella, Injuries & Pain and  Ligaments

See Quadriceps Exercises

Knee Joint

3 types of knee sprains

Menisci of human knee top view

Meniscus tears and treatment

Illustration of all knee ligaments, meniscus and cartilage

Torn Anterior Cruciate Ligament

Posterior Cruciate Ligament tear: Because this ligament stabilizes the knee with backward forces, the knee will drop back when fully ruptured. This is examined with the “Posterior Draw Test” by evaluating the distance the knee moves backward (posteriorly) compared to the non-effected knee.

Posterior Cruciate Ligament tear

“ACL Posterior Draw Test” is when you pull forward with the leg and hamstrings as lose as the patient can get, and evaluate the distance the tibia bone moves compared to the opposite non-effected knee.

Knee Brace

Once the knee suffers blunt trauma in sports or everyday life, it is important to get ice applied to the knee joint ASAP to stop any swelling and pain. Depending on the level of injury, the tissue around the knee like the quads, hamstrings, gastrocnemius, and the ligaments may have torn and the knee will swell.

This is the knee capsule surrounding the knee joint. It is so thick, when the knee bleeds from a blunt trauma and torn tissue, you will not be able to see black and blue (aka ecchymosis) marking on the skin accept swelling.

Chondromalacia of the patella is when the cartilage behind the patella bone becomes torn and stringy. When the knee is flexed, the patella is pressed into the femoral groove and grinds on the choppy cartilage causing a spaghetti snapping sound. An imbalance and week support of the quadriceps is the cause of this and strength balance with leg exercises is needed.

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Anterior Tibialis Pain

Pain from the Anterior Tibialis is directly on the shaft of the Tibia bone and tender to the touch. Depending on the amount of inflammation, the pain can spill down to the ankle.

RX is always ice 30 minutes 2 – 3 x a day on the painful area. Take anti-inflammatory meds, stretch, and tape the shin and arch before any physical activity.

Stretching the Gastrocnemius on the opposite side helps reduce tension.

Great stretch for the tibialis muscle.

The Anterior Tibialis is where shin splints come from. The Anterior Tibialis job is to lift the front of the foot to clear the ground when running. This action can over work the muscle causing it to inflame. The inflammation compounded by a dropping Talus bone (flat footed), will pull down on the distal end of the Anterior Tibialis tendon pulling the muscle from the Tibia bone causing pain and inflammation. It is important to make sure you have proper arch support in your shoes with professional, doctor grade, shoe orthotics. This will help support the Talus bone and take the stress off the Tibialis muscle.

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Peroneus Longus Brevis and Tertius Pain

Pain is mostly located at the top of the foot.

RX is always ice 30 minutes 2 – 3 x a day on the painful area. Take anti-inflammatory meds, stretch, and tape the shin and arch before any physical activity.

 

Basically, the Peronius Longus muscle starts above from the head and upper two-thirds of the lateral surface of the fibula. It continues down running behind the lateral malleolus and attaches below on the lateral side of the base of the first metatarsal bone. It is part of three muscles known as the Peroneus group, Peroneus Longus Brevis and Tertius, The Peronius Longus plantar flexes and inverts the foot also supporting the arch.

 

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My suggestion with this area is apply Ice. It’s usually injured by over use. So, rest, ice, elevation, compression sock and anti-inflammatory should help this muscle.

RX is always ice 30 minutes 2 – 3 x a day on the painful area. Take anti-inflammatory meds, stretch, and tape the shin and arch before any physical activity.

The Extensor Hallucis Brevis arises from the calcaneus and attaches on the 1st proximal phalanx or the big toe where it help extend the big toe.

The Extensor Hallucis Longus starts at the anterior surface of the Fibula and also attaches below on the 1st Proximal Phalanx or big toe and helps extend it, but also causes dorsiflexion of the foot and ankle.

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(Abdominal Muscles) RECTUS ABDOMINIS

See Exercises

RECTUS ABDOMINIS

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See Wrist Exercises

The extensor digiti minimi originates from the lateral epicondyle of the humerus, or the outer edge of the elbow if the palm is facing up, in the anatomical position. It runs along the back of the back of the arm to the wrist and past the wrist to the proximal phalanx V, or the bone between the genital knuckle and first bend of the finger of the little finger.

RX is always ice 30 minutes 2 – 3 x a day on the painful area. Take anti-inflammatory meds, stretch, and tape the shin and arch before any physical activity.

Becaus these muscles extend the wrist, it becomes painful to extend the wrist and us it in actions that require resistance.

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Extensor Carpi Ulnaris and Radialis

(See Exercises)

(See More Explanation)

The ECR & ECU are involved in tennis elbow injury. It becomes very tender to the touch on the elbow (lateral epicondylitis), which is a condition when the outer portion of the elbow becomes sore and tender. It is commonly caused by over use.

The extensor carpi radialis longus is one of the five main muscles that control movements at the wrist. This muscle, starts on the lateral side of the humerus, and attaches to the base of the second metacarpal bone aka index finger.

The extensor digiti minimi originates from the lateral epicondyle of the humerus, or the outer edge of the elbow if the palm is facing up, in the anatomical position. It runs along the back of the back of the arm to the wrist and past the wrist to the proximal phalanx V, or the bone between the genital knuckle and first bend of the finger of the little finger.

RX is always ice 30 minutes 2 – 3 x a day on the painful area. Take anti-inflammatory meds, stretch, and tape the shin and arch before any physical activity.

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Teres Major and Minor (Also See Rotator Cuff S.I.T.S)

All Rotator-Cuff-pain patterns.

Infraspinatus stretch it also get the Teres major and Minor

Teres Minor of the Rotator Cuff

Subscapularis of the Rotator Cuff

Infraspinatus of the rotator cuff

Supraspinatus of the Rotator Cuff

Because the Teres Major is more visible then the Teres Minor, it shows up on the anatomy chart. The Teres minor is covered by the Deltoid and Trapezius. Most of the time the injury is more of the Teres Minor and the rotator cuff Infraspinatus.

RX is always ice 30 minutes 2 – 3 x a day on the painful area. Take anti-inflammatory meds, stretch, and tape the shin and arch before any physical activity.

Apply ice ASAP. If severely injured or you have suffered a dislocation see a doctor right away. If the area is painful with the arm is in the down position, use a sling to support it. Perform the rotator cuff exercises shown in this post.

Rotator Cuff rehab instructions

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Gluteus Maximus Pain- Also Sciatic Nerve and Piriformis

Most of the time the Gluteus Maximus is not the problem area. It usually is the Piriformis muscle located just under the GM.

When the Piriformis and the sciatic nerve are inflamed you can take on a posture like this when standing or walking.

This is the Piriformis and the sciatic 4 pathways. #1 is the normal way behind the Piriformis. #2 Is when the sciatic splits and forms around the Piriformis exposing the nerve to more pressure from sitting or falling. #3 & 4 are cutting through the Piriformis causing much more pain because of irritation when the Piriformis muscle swells.

This illustration is showing all the attachments of the muscles near the hip joint and under the GM. Notice the Piriformis is webbed in with other muscles that look almost the same. These other muscles are part of the 6 lateral rotators of the hip.

RX is always Ice 30 minutes 2x day on the painful area (Sit on Ice on soft seat). Take anti-inflammatory, and stretch doing the Piriformis Stretch

When stretching try to hold on to the shin if you can and pull gradually towards your body. This is the most effective way to stretch the Glutes and Piriformis.

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