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Lumbago

localisation The term lumbago simply defines a pain in the lumbar region, meaning the lower spine.

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Jocelyn-William LOUBRIAT
 

Definition

The term lumbago simply defines a pain in the lumbar region, meaning the lower spine.

localisation

localisation de la région lombaire

Lumbagos of climbers vary in either the type of pain or in their causes.
The different structures which may generate lumbagos are:


· the muscles of the lumbar region that are tense or cramped because of strain or to protect the underlying structure,
· the intervertebral ligaments that have been exposed to prolonged stretching,
· worn-out joints, i.e. arthrosis.
· the intervertebral discs that may be worn-out, crushed or herniated.
· the meninges, the envelope of the spinal cord that may be negatively affected e.g. by tension or pressure.

Mechanism of the lesion

Except for isolated accidents du to “twist” movements or serious falls with vertebral fracture, several mechanisms may be at the origin of lumbagos:

- the prolonged position of the pelvis in retroversion, which places the posterior structures in stretch and therefore deprives them of a good blood flow. This is the position we adopt often in the harness or on a sofa.


retroversion

Position in retroversion

- an imbalance between the anterior musculature (mainly the abdominal muscles) and the posterior musculature (the paraspinal muscles) with a predominance of the first one which favours the trunk winding forward, with a locking of the pelvis in retroversion (through the couple hamstring and rectus abdominis muscles)

- contrary to the locking of the lumbar region in hyperlordosis through the contraction of certain muscles due to a too strong solicitation (broadest muscles, psoas muscles, quadriceps), which places the posterior spinal joints in support.


anteversion

Position in anteversion: 
tilting the pelvis forward leads to the increase of the lumbar lordosis

- the combination of anterior and posterior tension which causes a phenomenon of compression of the lumbar region.

compression-lombaire

Compression of the lumbar region through anterior and posterior tension

All these factors associated with the shocks occurring at falls (either in bouldering or in rock climbing) can lead to painful symptoms.

Repetitive falls in bouldering from variable heights are far from harmless. With the impact of each fall, the trunk bends forward suddenly and sometimes pulls violently on the whole structure and in particular on the meninges or even the nerve roots. Over time, these shocks can provoke a very painful and lasting phenomenon, known as the "whiplash syndrom".


Prevention

Material correction:
Choose a comfortable harness with a large belt.
The use of crash pads is essential in bouldering. Crash pads are designed to cushion falls and absorb shocks. Traditional foams have quite a good absorption quality; however they have a bounce reaction that is transmitted in part during the impact. During the fall, usually the feet hit the pad which reacts to this first impact, then the buttocks land more or less delicately on the pad at the moment it reacts to the impact caused by the feet. The buttocks may also be subjected to the bouncing of the foam.
Viscoelastic foams offer a better shock absorption and the bouncing is markedly diminished. During the fall, using an air pad (Andréa Boldrini) made of viscoelastic foam reduces the impact on all joints and in particular in the lumbar region.

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Technique correction:
In bouldering, climb down rather than jump.

Correction of the physical preparation:
Core muscle strengthening work should not be done to the detriment of the range / freedom of movement of the joint and above all it should not lead to an increase of the compression of the lumbar region or to an anterior-posterior imbalance.
Train your abdominals in their whole range (indoor and outdoor run) and in all modes (concentric training, isometrics, eccentrics, if necessary plyometrics). Do not forget to train the opposing muscles (paravertebrals).
After each strengthening training session, you should do the following stretching exercises.

Maintaining the optimum mobility of the whole musculature will avoid overworking the lumbar region.
Therefore, regularly stretch the following muscles:


· {avrpopup type="lightbox" id="lecteur_09"}Abdominals{/avrpopup}

· {avrpopup type="lightbox" id="lecteur_11"}Latissimus dorsi muscles{/avrpopup}

· {avrpopup type="lightbox" id="lecteur_21"}Psoas iliac muscles{/avrpopup}

· {avrpopup type="lightbox" id="lecteur_22"}Buttocks{/avrpopup}

· {avrpopup type="lightbox" id="lecteur_23"}Quadriceps{/avrpopup}

· {avrpopup type="lightbox" id="lecteur_24"}Hamstrings{/avrpopup}


Treatment

A few physiotherapy sessions may help you relieve your pain, teach you how to improve your stretching and your understanding of how your “back” works and therefore allow you to better manage your lumbago.

Ostheopathy can help to free you of some persistent pain. One type of therapy does not exclude the other, on the contrary, they are complementary.

In the case of Whiplash syndrome, following a complete treatment like Mezieres/Muscular chains should be considered seriously. This would be a long term treatment.

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