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Spine

The spine is the central structural pillar of the human body, composed of 33 vertebrae organized into five regions. It provides stability, enables movement, protects the spinal cord, and serves as the foundation for posture and load transfer throughout the body.

Quick Reference​

The spine consists of three primary mobile regions, each with distinct characteristics and functions:

RegionVertebraeCountPrimary MotionsKey Characteristics
CervicalC1-C77Flexion, extension, rotation, lateral flexionMost mobile region; supports head; natural lordotic curve
ThoracicT1-T1212Rotation, limited flexion/extensionAttached to ribs; provides stability; natural kyphotic curve
LumbarL1-L55Flexion, extension, limited rotationLoad-bearing region; largest vertebrae; natural lordotic curve

Additional regions include the sacrum (5 fused vertebrae) and coccyx (4 fused vertebrae), which form the posterior pelvis.

Anatomy​

The spine is a sophisticated articulated column that balances mobility with stability through its structural design. Each vertebra consists of a vertebral body (the weight-bearing anterior portion), a vertebral arch enclosing the spinal canal, and various processes for muscle and ligament attachment.

Structural Components​

Intervertebral Discs: Fibrocartilaginous cushions between vertebral bodies that absorb shock and allow movement. Each disc contains a gel-like nucleus pulposus surrounded by a tough annulus fibrosus. Discs comprise approximately 25% of total spinal height.

Facet Joints: Paired synovial joints between the articular processes of adjacent vertebrae. Their orientation varies by region and determines the primary directions of movement available at each spinal level.

Spinal Curves: The spine exhibits four natural curves that enhance its load-bearing capacity and shock absorption:

  • Cervical lordosis: Anterior convex curve in the neck
  • Thoracic kyphosis: Posterior convex curve in the upper/mid back
  • Lumbar lordosis: Anterior convex curve in the lower back
  • Sacral kyphosis: Posterior convex curve at the base

Ligamentous System: Multiple ligaments provide stability while allowing controlled movement, including the anterior and posterior longitudinal ligaments (running the length of the spine), ligamentum flavum (connecting adjacent laminae), and interspinous/supraspinous ligaments (connecting spinous processes).

Spinal Column Structure​

Regional Specialization​

Cervical Region: C1 (atlas) and C2 (axis) are specialized for head support and rotation. C3-C7 have smaller bodies, bifid spinous processes, and transverse foramina for vertebral arteries. Facets oriented at 45° allow multidirectional movement.

Thoracic Region: Features costal facets for rib articulation, providing thoracic cage stability. Vertically oriented facet joints favor rotation while limiting flexion/extension. Intermediate-sized vertebral bodies transfer loads from upper to lower body.

Lumbar Region: Characterized by massive vertebral bodies designed for load bearing, thick intervertebral discs (providing motion), and sagittally oriented facet joints that permit flexion/extension while restricting rotation.

Range of Motion​

Spinal mobility varies significantly by region, reflecting the balance between stability requirements and functional movement demands:

RegionFlexionExtensionLateral FlexionRotationLimiting Factors
Cervical50-60°60-75°40-45° each side70-80° each sideLigaments, disc compressibility, uncinate processes
Thoracic20-45°20-35°20-40° each side30-40° each sideRib cage, facet orientation, thin discs
Lumbar50-60°15-25°15-20° each side5-10° each sideFacet orientation, large discs, ligaments
Total Spine110-140°80-115°75-85° each side90-120° each sideCombined regional constraints

Movement Characteristics​

Cervical Mobility: The most mobile spinal region, with C1-C2 providing 50% of cervical rotation and C4-C5 typically showing the greatest flexion/extension. The cervical spine supports the head (10-12 lbs) while maintaining extreme mobility.

Thoracic Stability: Rib cage attachments create inherent stability, with the best rotation capacity of any spinal region despite limited sagittal plane motion. T5-T8 typically show the least motion, while upper and lower thoracic segments are more mobile.

Lumbar Load Bearing: Maximum flexion/extension occurs at L4-L5 and L5-S1, the segments bearing the greatest loads. Rotation is severely limited by sagittal facet orientation, protecting against injury during lifting.

Coupling Patterns: Spinal movements rarely occur in isolation. Lateral flexion typically couples with rotation (C-shaped curve), and proper movement quality requires coordination across multiple segments rather than hypermobility at a single level.

Joint Actions​

The spine produces movement through coordinated segmental motion across multiple vertebral levels. Each region contributes differently based on its structural design and functional role.

Cervical Movements​

Flexion (Chin to Chest)

  • Primary Muscles: Sternocleidomastoid, longus colli, longus capitis, rectus capitis anterior
  • Range: 50-60°
  • Function: Bringing chin toward chest, reading, looking down
  • Key Segments: C4-C5 and C5-C6 contribute most

Extension (Looking Up)

  • Primary Muscles: Semispinalis capitis, splenius capitis, upper trapezius, suboccipital muscles
  • Range: 60-75°
  • Function: Looking upward, stargazing, painting ceilings
  • Key Segments: C0-C1 (atlanto-occipital joint) crucial

Lateral Flexion (Ear to Shoulder)

  • Primary Muscles: Scalenes, levator scapulae, sternocleidomastoid (unilateral), splenius cervicis
  • Range: 40-45° each side
  • Function: Tilting head sideways, answering phone with shoulder
  • Note: Often couples with slight rotation

Rotation (Turning Head)

  • Primary Muscles: Sternocleidomastoid (contralateral), rotators, obliquus capitis inferior, splenius capitis
  • Range: 70-80° each side
  • Function: Checking blind spot, looking over shoulder
  • Key Segments: C1-C2 provides 50% of total cervical rotation

Muscles Acting On It​

The spine is controlled by a complex layered muscular system ranging from superficial global movers to deep local stabilizers. These muscles work synergistically to produce movement, maintain posture, and protect spinal structures.

Deep Spinal Stabilizers​

Multifidus

  • Location: Deep layer spanning 2-4 vertebral segments throughout entire spine
  • Primary Function: Segmental stabilization, fine motor control of individual vertebrae
  • Actions: Extension, rotation (small range), proprioceptive feedback
  • Clinical Significance: Often atrophies with low back pain; critical for spinal health

Rotatores

  • Location: Deepest spinal layer, spanning one vertebral segment
  • Primary Function: Proprioception and segmental rotation
  • Actions: Minimal force production; primarily sensory role
  • Distribution: Most developed in thoracic region

Intertransversarii & Interspinales

  • Location: Between transverse processes and spinous processes respectively
  • Primary Function: Proprioceptive monitoring of spinal position
  • Actions: Segmental stabilization, minimal motion production

Intermediate Spinal Muscles​

Erector Spinae Group

  • Components: Iliocostalis (lateral), longissimus (intermediate), spinalis (medial)
  • Location: Superficial to multifidus, running entire spine length
  • Primary Function: Spinal extension, lateral flexion, maintaining upright posture
  • Actions:
    • Bilateral: Extension and hyperextension
    • Unilateral: Lateral flexion, assists rotation
  • Role: Primary "anti-gravity" muscles maintaining erect posture

Quadratus Lumborum

  • Location: Posterior abdominal wall between 12th rib and iliac crest
  • Primary Function: Lateral flexion, spinal stabilization, assists breathing
  • Actions:
    • Unilateral: Lateral flexion of lumbar spine, hip hiking
    • Bilateral: Extension, stabilizes lumbar spine and pelvis
  • Clinical Note: Often overactive in low back pain; key for frontal plane control

Anterior Core Stabilizers​

Rectus Abdominis

  • Location: Vertical anterior abdominal wall (six-pack muscle)
  • Primary Function: Trunk flexion, prevents anterior pelvic tilt
  • Actions: Spinal flexion, posterior pelvic tilt, increases intra-abdominal pressure
  • Role: Opposes erector spinae to control spinal extension

External & Internal Obliques

  • Location: Lateral and anterior abdominal wall in oblique fiber directions
  • Primary Function: Rotation, lateral flexion, core stabilization
  • Actions:
    • External oblique: Contralateral rotation, ipsilateral lateral flexion
    • Internal oblique: Ipsilateral rotation, ipsilateral lateral flexion
    • Together: Trunk flexion, forced expiration
  • Integration: Create rotational force couples with opposite-side partners

Transversus Abdominis

  • Location: Deepest abdominal layer with horizontal fibers
  • Primary Function: Core stabilization, increases intra-abdominal pressure
  • Actions: Compresses abdominal contents, stabilizes lumbar spine and pelvis
  • Timing: Activates before limb movement to pre-stabilize spine
  • Clinical Significance: Critical for spinal protection during functional activities

Cervical Specific Muscles​

Deep Neck Flexors (Longus Colli, Longus Capitis)

  • Location: Anterior cervical spine
  • Primary Function: Cervical flexion, maintains proper cervical curve
  • Clinical Note: Often weak with forward head posture

Suboccipital Muscles

  • Location: Between C1, C2, and occiput
  • Primary Function: Fine head positioning, proprioception
  • Clinical Note: Dense with mechanoreceptors; involved in balance and coordination

Sternocleidomastoid

  • Location: Superficial neck from sternum/clavicle to mastoid process
  • Primary Function:
    • Unilateral: Ipsilateral lateral flexion, contralateral rotation
    • Bilateral: Neck flexion, assists inspiration
  • Visibility: Prominent during forced neck rotation

Scalenes (Anterior, Middle, Posterior)

  • Location: Lateral neck from cervical transverse processes to first two ribs
  • Primary Function: Cervical lateral flexion, assists neck flexion, accessory breathing muscles
  • Clinical Note: Can compress neurovascular structures causing thoracic outlet syndrome

Hip-Spine Connection​

Psoas Major

  • Location: Originates from lumbar vertebrae and discs, inserts on lesser trochanter
  • Dual Role: Hip flexor and spinal stabilizer
  • Spinal Function: Lumbar stabilization, slight flexion with bilateral activation
  • Clinical Note: Links hip and spine function; tightness affects lumbar lordosis

Mobility Work​

Spinal Mobility Exercises

Cat-Cow (Marjaryasana-Bitilasana)​

Purpose: Mobilizes entire spine through flexion and extension, promotes segmental motion

Execution:

  1. Start on hands and knees (quadruped position)
  2. Cow Phase: Inhale, drop belly toward floor, lift chest and tailbone (extension)
  3. Cat Phase: Exhale, round spine toward ceiling, tuck tailbone, drop head (flexion)
  4. Flow slowly between positions, emphasizing smooth segmental motion
  5. Perform 10-15 repetitions

Focus Points: Move slowly to feel each vertebral segment; avoid jamming into end ranges; coordinate breath with movement

Variations:

  • Cervical emphasis: Minimize lumbar motion, focus on neck movement
  • Thoracic emphasis: Keep lumbar spine neutral, mobilize mid-back
  • Segmental: Pause and "wave" motion through each spinal region

Thoracic Rotation (Open Book Stretch)​

Purpose: Increases thoracic rotational mobility, counters desk posture

Execution:

  1. Lie on side with knees bent to 90°, arms extended forward
  2. Keep bottom arm on ground, top hand on top
  3. Slowly rotate top arm and upper body backward, following hand with eyes
  4. Keep knees stacked and grounded (isolates thoracic rotation)
  5. Hold end position 5 seconds, return slowly
  6. Perform 8-10 repetitions per side

Focus Points: Breathe into expanding rib cage; avoid lumbar compensation; lead with eyes to maximize rotation

Chin Tucks (Cervical Retraction)​

Purpose: Restores proper cervical alignment, strengthens deep neck flexors

Execution:

  1. Sit or stand with neutral spine
  2. Draw chin straight back (like creating double chin) without tilting head
  3. Feel gentle lengthening at base of skull
  4. Hold 5 seconds, release
  5. Perform 10-15 repetitions, 2-3 times daily

Focus Points: Movement is small (1-2 inches); maintain eye level; avoid jaw clenching

Progressions:

  • Add gentle overpressure with fingertips
  • Perform lying supine with head on ground
  • Add rotation or lateral flexion after retraction

Quadruped Thoracic Rotation​

Purpose: Isolates thoracic rotation, promotes shoulder mobility

Execution:

  1. Start on hands and knees
  2. Place one hand behind head
  3. Rotate elbow down toward opposite hand (flexion/rotation)
  4. Rotate elbow up toward ceiling (extension/rotation)
  5. Follow elbow with eyes throughout movement
  6. Perform 8-10 repetitions per side

Focus Points: Keep hips stable; initiate from thoracic spine; breathe into rotation

Foam Rolling Thoracic Extension​

Purpose: Mobilizes thoracic extension, releases paraspinal tension

Execution:

  1. Lie supine with foam roller perpendicular under mid-back
  2. Support head with hands (avoid pulling on neck)
  3. Extend back over roller, keeping core engaged
  4. Hold 5-10 seconds
  5. Roll incrementally up/down thoracic spine
  6. Spend 2-3 minutes on region

Focus Points: Avoid lumbar spine; control extension with core; breathe deeply into tight areas

Safety: Skip if severe osteoporosis; use softer roller for beginners

Child's Pose with Lateral Reach​

Purpose: Lengthens spine, gentle traction, lateral flexion stretch

Execution:

  1. Kneel with knees wide, sit hips back toward heels
  2. Walk hands forward into child's pose
  3. Walk both hands to one side for lateral stretch
  4. Hold 30-60 seconds each side
  5. Return to center, rest

Focus Points: Breathe into rib cage expansion; relax shoulders; allow gentle traction

Spinal Segmentation (Rolling Bridge)​

Purpose: Develops segmental control, strengthens posterior chain

Execution:

  1. Lie supine, knees bent, feet flat
  2. Slowly lift pelvis, articulating one vertebra at a time
  3. Achieve straight line from knees to shoulders
  4. Lower slowly, placing one vertebra down at a time
  5. Perform 6-8 repetitions

Focus Points: Move slowly to achieve segmental control; avoid "plunking" down; engage glutes and core

Common Issues​

Spinal Pathologies and Dysfunctions

Disc Herniation​

Description: Nucleus pulposus protrudes through torn annulus fibrosus, potentially compressing nerve roots

Common Locations: L4-L5 and L5-S1 (90% of cases); C5-C6 and C6-C7 in cervical spine

Symptoms:

  • Radiating pain into extremity (sciatica in lumbar, radiculopathy in cervical)
  • Numbness, tingling, weakness in specific dermatomal/myotomal pattern
  • Pain worsened by flexion, sitting, Valsalva maneuver

Contributing Factors: Repetitive flexion with rotation, poor lifting mechanics, age-related disc degeneration, genetic predisposition

Management Considerations: McKenzie extension-based approach often beneficial; avoid provocative flexion; core stabilization; surgical consultation for severe neurological compromise

Spinal Stenosis​

Description: Narrowing of spinal canal or intervertebral foramina compressing spinal cord or nerve roots

Types:

  • Central stenosis: Canal narrowing affecting spinal cord
  • Foraminal stenosis: Narrowing where nerves exit spine

Symptoms:

  • Neurogenic claudication (leg pain with walking, relieved by sitting/flexion)
  • Bilateral or unilateral radicular symptoms
  • Better with flexion (opens canal), worse with extension

Contributing Factors: Age-related degenerative changes, facet joint hypertrophy, ligamentum flavum thickening, disc bulging

Management Considerations: Flexion-based exercises often helpful; avoid prolonged extension; maintain neutral spine; surgical decompression if conservative treatment fails

Spondylolisthesis​

Description: Forward slippage of one vertebra relative to the one below

Common Location: L5 on S1 (70% of cases), L4 on L5

Types:

  • Isthmic: Fracture/stress fracture of pars interarticularis (common in athletes)
  • Degenerative: Facet joint arthritis allowing slippage (common in older adults)

Symptoms:

  • Lower back pain, buttock pain
  • Radicular symptoms if nerve root compressed
  • Palpable "step off" at affected level

Contributing Factors: Repetitive hyperextension (gymnastics, football linemen), genetic factors, degenerative changes

Management Considerations: Core stabilization critical; limit extension activities; monitor for progression; surgical fusion for severe or progressive cases

Hyperlordosis (Excessive Lumbar Curve)​

Description: Exaggerated anterior curve of lumbar spine ("swayback")

Symptoms:

  • Lower back pain, especially with prolonged standing
  • Anterior pelvic tilt
  • Compensatory thoracic kyphosis possible

Contributing Factors:

  • Weak core musculature (especially rectus abdominis and transversus abdominis)
  • Tight hip flexors (psoas, rectus femoris)
  • Weak gluteal muscles
  • Pregnancy, obesity, poor postural habits

Management Considerations: Strengthen anterior core and glutes; stretch hip flexors and erector spinae; posterior pelvic tilt training; address breathing patterns

Hyperkyphosis (Excessive Thoracic Curve)​

Description: Exaggerated posterior curve of thoracic spine ("hunchback" or "dowager's hump")

Types:

  • Postural: Reversible with conscious correction
  • Scheuermann's: Structural changes to vertebral bodies during growth
  • Degenerative: Age-related vertebral compression fractures

Symptoms:

  • Rounded upper back appearance
  • Reduced thoracic extension and rotation
  • Neck pain from compensatory cervical hyperextension
  • Reduced respiratory capacity

Contributing Factors: Prolonged sitting/slouching, weak thoracic extensors and scapular retractors, tight pectorals, osteoporotic compression fractures

Management Considerations: Thoracic extension exercises; strengthen middle/lower trapezius and rhomboids; stretch pectorals; address forward head posture; screen for osteoporosis in older adults

Scoliosis​

Description: Lateral curvature of spine with rotational component (three-dimensional deformity)

Types:

  • Idiopathic: Unknown cause (80% of cases), typically develops during growth
  • Congenital: Vertebral malformations present at birth
  • Neuromuscular: Secondary to muscular dystrophy, cerebral palsy, etc.
  • Degenerative: Adult-onset due to disc and facet degeneration

Classification: Measured by Cobb angle

  • Mild: Under 20°
  • Moderate: 20-40°
  • Severe: Over 40°

Symptoms:

  • Asymmetric shoulder/hip height
  • Rib prominence with forward bending (rib hump)
  • Visible spinal curve
  • Back pain (more common in adults)

Contributing Factors: Genetic predisposition (idiopathic), growth spurts, neuromuscular conditions, unilateral weakness/tightness

Management Considerations:

  • Mild (under 20°): Observation, general exercise
  • Moderate (20-40°): Bracing for skeletally immature individuals
  • Severe (over 40°): Surgical consideration (spinal fusion)
  • Exercise focuses on symmetry, core strength, breathing mechanics

Facet Joint Syndrome​

Description: Inflammation or arthritis of facet joints causing localized back pain

Symptoms:

  • Localized paraspinal pain
  • Worse with extension and rotation toward affected side
  • Morning stiffness
  • Minimal or no radicular symptoms

Contributing Factors: Repetitive extension/rotation, age-related degeneration, previous injury, excessive lumbar lordosis

Management Considerations: Avoid excessive extension; mobilize into flexion; strengthen core; address movement patterns; facet injections for diagnostic/therapeutic purposes

Spinal Joint Relationships

Hip Joint​

Relationship: The lumbar spine and hip function as an integrated system for bending and lifting movements

Lumbopelvic Rhythm: During forward bending, initial motion comes from lumbar flexion (0-45°), followed by anterior pelvic rotation via hip flexion. Return movement reverses this sequence.

Clinical Significance:

  • Hip flexor tightness (psoas, rectus femoris) can increase lumbar lordosis
  • Limited hip mobility forces compensatory lumbar motion, increasing injury risk
  • "Hip hinge" pattern protects spine during lifting by emphasizing hip flexion over lumbar flexion
  • Gluteal weakness can lead to excessive lumbar extension during standing and gait

Movement Integration: Deadlifts, squats, and picking objects from ground require coordinated hip-spine control. Loss of this coordination is a primary mechanism for lower back injury.

Shoulder Complex​

Relationship: Thoracic spine mobility directly impacts shoulder range of motion and scapular positioning

Scapulothoracic Interface: Scapula glides on thoracic rib cage; thoracic kyphosis affects scapular position and movement quality

Clinical Significance:

  • Excessive thoracic kyphosis limits shoulder flexion/abduction by anteriorly tilting scapula
  • Reduced thoracic extension restricts overhead reaching
  • Thoracic rotation enables optimal scapular rotation during shoulder elevation
  • Poor thoracic posture contributes to shoulder impingement syndromes

Movement Integration: Overhead pressing, throwing, and swimming require integrated thoracic-scapular-shoulder motion. Thoracic stiffness forces compensatory shoulder stress.

Rib Cage​

Relationship: Ribs articulate with thoracic vertebrae at costovertebral and costotransverse joints

Biomechanical Impact:

  • Rib attachments limit thoracic flexion/extension but facilitate rotation
  • Ribs 1-7 (true ribs) attach directly to sternum, providing maximum stability
  • Ribs 8-10 (false ribs) have indirect sternal attachment via costal cartilage
  • Ribs 11-12 (floating ribs) have no anterior attachment, allowing more motion at T11-T12

Clinical Significance:

  • Thoracic spine mobility exercises affect breathing mechanics
  • Rib dysfunctions can refer pain mimicking visceral or cardiac pathology
  • Deep breathing exercises mobilize costovertebral joints
  • Optimal breathing requires coordinated thoracic and rib cage motion

Cranium and Temporomandibular Joint​

Relationship: Upper cervical spine (C0-C2) directly interfaces with skull; cervical posture affects jaw position

Clinical Significance:

  • Forward head posture alters atlanto-occipital joint mechanics
  • Cervical dysfunction can contribute to TMJ disorders
  • Suboccipital muscle tension affects headache patterns
  • Head position influences vestibular system and balance

Pelvis and Sacroiliac Joint​

Relationship: L5-S1 junction is the critical transition between mobile lumbar spine and relatively fixed sacrum

Clinical Significance:

  • Sacral position influences lumbar curve magnitude
  • SI joint dysfunction can refer pain mimicking lumbar disc pathology
  • Pelvic asymmetry creates compensatory lumbar scoliosis
  • Force transfer from legs to spine occurs through pelvis

Movement Integration: Walking, running, and single-leg activities require coordinated lumbopelvic stability. Dysfunction in pelvis or SI joint forces lumbar compensation.

Sources​

References and Further Reading

Textbooks and Academic Resources​

  1. Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed. Elsevier; 2017.

    • Comprehensive coverage of spinal biomechanics and regional functional anatomy

  2. Oatis CA. Kinesiology: The Mechanics and Pathomechanics of Human Movement. 3rd ed. Wolters Kluwer; 2017.

    • Detailed analysis of spinal movement patterns and pathomechanics

  3. McGill SM. Low Back Disorders: Evidence-Based Prevention and Rehabilitation. 3rd ed. Human Kinetics; 2015.

    • Research-based approach to spinal stabilization and injury prevention

  4. Bogduk N. Clinical and Radiological Anatomy of the Lumbar Spine. 6th ed. Elsevier; 2019.

    • Authoritative reference on lumbar spine anatomy and biomechanics

  5. Kapandji IA. The Physiology of the Joints, Volume 3: The Spinal Column, Pelvic Girdle and Head. 7th ed. Handspring Publishing; 2019.

    • Classic text with detailed illustrations of spinal mechanics

Research Articles​

  1. White AA, Panjabi MM. Clinical Biomechanics of the Spine. 2nd ed. Lippincott Williams & Wilkins; 1990.

    • Foundational work on spinal stability and biomechanical principles

  2. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. Part II. Neutral zone and instability hypothesis. J Spinal Disord. 1992;5(4):383-397.

    • Landmark papers on spinal stability concepts

  3. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. Spine. 1996;21(22):2640-2650.

    • Important research on core stabilization and timing in low back pain

  4. Adams MA, Hutton WC. The effect of posture on the role of the apophysial joints in resisting intervertebral compressive forces. J Bone Joint Surg Br. 1980;62(3):358-362.

    • Classic biomechanical study on facet joint function

  5. Solomonow M, Zhou BH, Baratta RV, et al. Biomechanics of increased exposure to lumbar injury caused by cyclic loading: Part 1. Loss of reflexive muscular stabilization. Spine. 1999;24(23):2426-2434.

    • Research on mechanisms of repetitive loading injury

Clinical Guidelines and Reviews​

  1. Nordin M, Carragee EJ, Hogg-Johnson S, et al. Assessment of neck pain and its associated disorders: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine. 2008;33(4 Suppl):S101-S122.
  • Evidence-based assessment framework for cervical spine disorders
  1. Hoy D, March L, Brooks P, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968-974.
  • Epidemiological data on low back pain prevalence and impact
  1. McGill SM, Childs A, Liebenson C. Endurance times for low back stabilization exercises: clinical targets for testing and training from a normal database. Arch Phys Med Rehabil. 1999;80(8):941-944.
  • Normative data for core endurance testing

Online Resources​

  1. Physiopedia - Spine Anatomy

  2. Teach Me Anatomy - Vertebral Column

  3. Visible Body - Spine and Back