Williams Williams Exercises (WFE) - also called Williams lumbar curvature or just Williams exercises - is a set or related physical exercise system intended to improve lumbar flexion, avoiding lumbar extension, and strengthening abdominal and gluteal muscles in an attempt to treat low back pain without surgery. This system was first created in 1937 by Dr. Paul C. Williams (1900-1978), then a Dallas orthopedic surgeon.
WFE has been the cornerstone in the management of low back pain for years to treat a variety of back problems, regardless of diagnosis or major complaints. In many cases they are used when the cause of the disorder or characteristics is not fully understood by the doctor, Athletic trainer or physical therapist. In addition, physical therapists and athletic trainers often teach these exercises with their own modifications.
Video Williams Flexion Exercises
History
The WFEs were developed from Regen practice (also called "squat exercise"), recommended in 1930 by Eugene M. Regen (1900-1983), a Tennessee orthopedic surgeon, and who consisted of squatting and emphasizing the lumbar convexity of the area. (The Regen Training was initially published in a film by the Veterans Administration.) Williams first published his own modified training program in 1937 for patients with chronic back pain in response to his clinical observation that the majority of patients with low back pain had degenerative secondary vertebrae against the disease degenerative discs. This exercise was originally developed for men under 50 and women under 40 who had excessive lumbar lordosis, whose x-ray films showed a decrease in disk space between lumbar spine segments (L1-S1), and those with chronic, but low-grade.
Maps Williams Flexion Exercises
Theory
Williams suggests that humans, in evolving to stand upright, severely damage vertebral columns, distribute body weight to the posterior aspect of intervertebral discs in the lumbar spine. At the 4th and 5th lumbar levels, great stress is said to be applied to the posterior aspect of each vertebra and transferred from the vertebra to the disk. Williams states that in most cases, the 5th lumbar disk bursts and nuclear material from the disc moves into the spinal canal causing pressure on the spinal cord. In addition to broken discs, nerve irritation in the intervertebral foramen where nerves exit the spinal canal may occur. He believed that this was rare except at the 5th lumbar level, and that the likelihood of the nerve that befell greatly increased by extending the lumbar spine. Williams emphasizes the universality of this problem: "The fifth lumbar disk has broken out in most everyone at the age of twenty...." He went on to explain that although most people at this age have not experienced severe lower back pain. , they will, most likely, be exposed to a mild backache attack that can be attributed to a broken disk. The solution, Williams explains, is for patients to practice and adhere to postural principles that serve to reduce lumbar lordosis to a minimum, thereby reducing the pressure on the posterior element of the lumbar spine.
Procedures and mechanisms
The WFEs for many years are standard for the treatment of non-surgical lower back pain. These exercises are performed in a supine position on the floor or other flat surface. There are variations, but the main maneuver is to take the foot and pull the knee to the chest and hold it there for a few seconds. Patient then relax, lower leg down and repeat the exercise again. The main benefits should be the opening of intervertebral foramen, stretching of ligmentous structures, and apophyseal joint disorders. The goal of doing this exercise is to reduce pain and provide lower stability stem by actively developing "stomach, gluteus maximus, and hamstring muscles as well..." passive stretching of the hip flexor muscles and the lower back (sacrospinalis). Williams said: "The outlined exercise will achieve the right balance between the flexor and the extensor group of the postural muscles...". Williams suggests that posterior tilted pelvic positions are needed to get the best results.
Both flexion and extension exercises have been shown to help reduce back pain and have been shown to achieve the following: a) significantly increase the canal area, b) increase the midsagittal diameter, c) increase the subarticular sagittal diameter, and d) increase all foraminal dimensions significantly
Seven WFE variations are described below (Ref):
- Pelvic tilt. Lie on your back with your knees bent, feet flat on the floor. Flatten the small part of your back to the floor, without pressing with your feet. Hold for 5 to 10 seconds.
- Knee Single to chest. Lie on your back with your knees bent and feet on the floor. Gently pull the right knee to the shoulder and hold for 5 to 10 seconds. Lower the knee and repeat with the other knee.
- Knee double to chest. Start as in the previous exercise. After pulling the right knee to the chest, pull the left knee to the chest and hold both knees for 5 to 10 seconds. Slowly lower one leg at a time.
- Partial sit-ups. Perform a pelvic tilt (exercise 1) and, while holding this position, gently bend your head and shoulders off the floor. Hold on for a moment. Return slowly to the starting position.
- Stretching hamstring. Begin with a long sitting with your toes pointing to the ceiling and your knees fully stretched out. Slowly, lower the body forward over your legs, allow your knees to stretch out, arms outstretched over your legs, and focus your eyes forward.
- Flexor Hip Bending. Put one foot in front of the other with the left knee (front) flexed and the right knee (back) perpendicular. Progress forward through the trunk until the left knee is in contact with the armpit region. Repeat with your right foot forward and left leg back.
- Squat. Stand with both legs aligned, about shoulder width. Trying to keep the stems perpendicular to the floor, eyes focused forward, and feet flat on the floor, the subject slowly lowered his body by stretching his knee.
McKenzie extension exercise
The WFEs stand in some resistance to other types of back exercises, designed by Robin McKenzie (born 1931) and known as the "McKenzie extension exercise", which involves the opposite movement of extending the spine to the back. (One review stated that "There may not be two methods of physical therapy therapy for back pain that are very contradictory in both theory and practice"). Unlike Williams, McKenzie suggests that all spine pain may be associated with changes in the position of the nucleus pulposus disk, in conjunction with adjacent annulus; mechanical deformation of the soft tissue of the spine that has experienced an adaptive shortening; or soft-tissue mechanical deformation caused by postural pressure. McKenzie concluded that a continuously bending lifestyle may cause the nucleus to migrate more backward, resulting in lower back pain. In addition, this lumbar spine anomaly is largely due to our modern lifestyle and "an almost universal loss of extension". As a treatment, McKenzie recommends postural exercises and instructions that restore or maintain lumbar lordosis. Although exercises involving lumbar spine extensions are emphasized in this treatment protocol, especially in the early stages, lumbar flexion exercises are usually added at a later time in order for patients to have full range of flexion and spinal extension. Although the treatment protocols of Williams and McKenzie differ greatly, both continue to be widely prescribed despite the lack of clinical evidence that measures their efficacy (at least in 1984, at the time of publication cited).
References
Quote
Other sources
- Williams, Paul C. (1974), Back and Neck Pain: Causes and Conservative Treatment , Ed 3; Springfield: Charles C Thomas; 78 pages.
- Williams P, (1955), "Conservative examination and treatment for spinal disc lesions", Clinical Orthopedics and Related Research 528-40.
See also
- List of eponymous medical treatments
Source of the article : Wikipedia
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