Assessment of the effect of stretching the muscles posterior thigh and shin onthe intensity of cervicalgia and patient′s posture

Abstract

Introduction. The human body is a single system of interconnected organs that are connected not only anatomically, but also functionally. The most extensive fascial-muscular associations are called «anatomical trains» (the concept of Thomas Myers), the impact on which can cause changes at a significant distance from the point of application of force. The available literature describes the effect of stretching hamstrings (an important component of the «surface posterior muscle band») on changes in the function of the temporomandibular joint, lumbodynia, mobility of the lumbosacral spine and hip joints. However, the values of stretching hamstings on human posture and reducing cervicalgia were not evaluated.The goal of research — investigate the effect of active isolated stretching of the muscles posterior thigh and shin on the intensity of cervicalgia and patient posture.Materials and methods. The material for this work is the results of observation of 17 patients aged 15–17 years with cervicalgia of various genesis, who are under inpatient treatment for spinal deformities with a distinct increase in the severity of thoracic physiological kyphosis (juvenile osteochondrosis, dysplastic kyphoscoliosis, cervical spine dysplasia, etc.). Patients performed daily physical exercises for 12 days with active isolated stretching of the muscles of the posterior surface of the thigh and lower leg (according to the concept of Thomas Myers — «surface posterior muscle band»). The orthopedic status and clinical condition of patients were evaluated. Instrumental diagnostics was performed by the method of topography of optical deformities of the spine (TODS) (Novosibirsk, «Medical topographic systems» — LLC «METOS»), as well as using a standard tablet computer with a software application (patent RU 2638644) «Smart-Ortho 2D» for Android. The intensity of pain in the cervical spine was assessed by the doctor using a dynamometer-algometer, as well as by the patients themselves on the VAS scale.Results. During the initial clinical examination, 14 out of 17 (or 82 % of cases) observed patients with complaints of cervicalgia registered femoral-lumbar rigidity. It was most pronounced in the limitations of the Tomayer test (the forward tilt of the torso). In 15 patients (88 %), the value of thoracic physiological kyphosis exceeded the norm (20–23 mm according to TODS data) by 6–43 mm. Active isolated stretching of the posterior thigh and lower leg muscles resulted in complete elimination of pain syndrome in all patients in the study group. With regard to kyphotic posture, we note that these therapeutic measures did not cause significant changes in the parameters of the sagittal profile of the vertebral column, but there was a clear trend to reduce the severity of thoracic kyphosis with simultaneous deepening of lumbar lordosis. The angle of the anterior pelvic tilt changed (increased) according to the TODS data. The Tomayer test began to approach the norm in 12 people (70,5 %).Conclusion. The use of active isolated exercises aimed at stretching the «surface posterior muscle band» in the observed group of patients contributed to the complete relief of pain in 100 % of cases. At the same time, these therapeutic measures did not have a significant effect on the severity of physiological sagittal bends and pelvic tilt. The results of clinical observation of patients with cervicalgia of various genesis, being treated and using a set of exercises with active isolated stretching of muscles posterior thigh and shin, make it possible to recommend this complex for using. The simplicity of the exercises does not cause any difficulties in performing, which makes it understandable and accessible for general prophylaxis.