The Dynamic Lumbar Stabilization (DLS) approach progresses the patient through three phases of strengthening activities, each of which builds upon control of lumbopelvic position during activity. This treatment approach works particularly well with mechanical back pain, sacroiliac instability and disk pathology. Research has indicated that improvements in dynamic spinal stability may result in the reduction of forces on the intervertebral disk – an important aspect of reducing the chances for further injury.
At Concorde Therapy group, we are uniquely prepared to implement a progressive dynamic lumbar stabilization program. For patients in significant discomfort, the therapeutic pool is an excellent medium for the initiation of low level exercise. The 92o water offers un-weighting as well as the opportunity for light resistance. From that point, we are able to progress to mat exercises, progressive resistance training with controlled exercise equipment, and unique strengthening approaches involving the physioball and other exercise tools.
Most importantly, successful long-term management must begin and end at home. Regardless of the tools available in the clinic, each patient is in need of self-management strategies that they can control and progress. Each level of the patient’s progression through the dynamic lumbar stabilization program is accompanied by clearly outlined home exercises – not traditional simple stretches and range of motion routines. The therapist works with the patient to select and implement the appropriate exercises based on the physician’s input.
The Dynamic Lumbar Stabilization Program is a systematic progression of strengthening activities which begins with efforts aimed at providing the patient with a sense of lumbopelvic position and the ability to maintain a neutral position with simple body movements.
Phase I focuses on the motor planning components of this awareness. Patients perform low level mat exercises or aquatic movements and learn a sensitivity for appropriate positioning during activity.
In Phase II, progressive resistance exercises are incorporated to challenge trunk muscles during increasing exercise loads. Patients use free weights, cables, elastic resistance and specialized machines to provide resistance. In addition, progressive cardiovascular exercise challenges postural control during progressively longer activities.
Patients progressing to Phase III can expect significant challenges to develop enhanced core strength, a concept which is also increasingly popular in training and conditioning for athletes. This is the level at which significant strength gains can be added to the motor control gains of Phase I & II.
These increased dynamic stabilization capabilities are a significant factor in normalizing forces on the spine during both routine functional activities and aggressive recreational and work activities.
Patients are frequently surprised at the challenges they experience in their back from upper extremity and lower extremity activities like those illustrated here, but can invariably notice the change in their functional capabilities when they are stronger.
For referral information or further details on spine rehabilitation services at Concorde, call the location closest to you.