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::
Low back pain:
The onset of pain appears to have a permanent effect on the
pattern of muscle activation around the lumbar spine. The
normal back brace (transversus abdominis) that protects the
spine "switches off" simply due to the onset of
pain. Our bodies are generally designed very well to handle
any acute situation (the flight and fight response), but unfortunately
these responses are not good for the back in the chronic situation.
We need to relearn how to contract our stabilisers after an
acute attack of back pain.
:: Unstable pelvis:
Some people are just born a little more 'floppy' than the
rest of us. Usually these people have poor muscle tone in
their stabilising muscles. The transversus abdominis is the
muscle that holds the two halves of the pelvis together. Learning
to contract it is an important preparatory step prior to advanced
stabilising exercises such as Swiss ball or Clinical
Pilates.
:: 'Pot belly':
Some (mainly) women have a 'pot belly' - that lower abdominal
bulge that no matter how hard you pull in your tummy, the
lower part just doesn't seem to pull in. The problem is that
the transversus muscle for some reason has stopped working
and the upper abdominal muscles take over. Hence as you pull
in you just get tighter and tighter above the belly button
but nothing happens below it. With Ultrasound Retraining you
can learn to contract the lower part also.
:: Post
abdominal pelvic surgery:
Abdominal and pelvic surgery involves
either cutting or piercing the abdominal layers. This alters
the ability of the transversus to contract and slide normally
under the other abdominal muscles. Like other muscle cuts,
the muscle need to be strengthened afterwards otherwise it
remains permanently weak. The nerve supply to the lower part
of the transversus muscle are cut through in many abdominal/pelvic
incisions (such as in appendix and caesarean scars), hence
the patient needs to retrain the muscle to learn how to correctly
use it again.
:: Pre or post
partum (pregnancy), low back pain (LBP) or Sacroiliac joint
(SIJ) pain:
Carrying a child is a physically wearing
occupation! The weight of the baby puts continual pressure
on the pelvic floor muscles and stretches the lower abdominal
muscles. The trauma of birth involves further stretching of
the pelvic floor muscles and sometimes tearing. Hence, the
pelvic floor muscles and the transversus become weak, stretched
and inhibited. Coupled with this, the circulating hormone
"relaxin", makes the pelvic ligaments lax and hence
the transversus muscles have to work even harder to stabilise
the pelvis and lumbar spine i.e. hold them together.
:: SIJ dysfunction:
The Sacroiliac joint (SIJ) should be
a fairly stiff or rigid link between the pelvic bones. In
some people due to trauma or just excess mobility, the SIJ
has too much motion and this allows it to adopt an unusual
position which may result in pain. The transversus through
its attachments to the iliac bones, facilitates closure of
the pelvis and assists symmetry of the sacroiliac joints.
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