By Dilen Samarakoon, Physiotherapist at getback
getback™ devices were developed by Biomechanists and Exercise Scientists to enable targeted and safe exercise for the deep spinal muscles (multifidus) associated with back or neck pain.
These deep spinal muscles play a critical role in stabilising the spine, supporting the individual vertebra as they move during everyday activities such as bending forwards, sideways, backwards and rotating our body.
In a series of articles, we will look at the specific function of each of the getback devices.
#2 The Cervical Rotation Device
Another common presentation at getback is patients with neck pain, made worse by head turns or activities such as checking blind spots while driving, which are pain-free for most people. The action of turning your head is essential in daily life – allowing us to look at things without turning our whole torso – hence, stiffness and pain in this movement can be very debilitating.
The cervical rotation device, in conjunction with the cervical extension/lateral flexion device, are the most important getback devices for people with neck pain.
The rotation device isolates and assesses the strength of muscles involved in rotational movement – including the deeper multifidus muscles between each vertebra – and gradually strengthens them by reproducing the movement in a safe, pain-free range.
When a person begins to turn their head, the deep multifidus muscle on one side activates and adapts its length to stabilise the vertebrae. These short, triangular muscles initiate the movement and ensure it is well controlled.
As we turn our head further, the intermediate and superficial muscles play an increasing role in controlling the neck, contracting to enable our heads to turn as far as we need to.
A lack of strength in the deeper muscles is commonly associated with pain, stiffness and spasm in the neck. An assessment conducted by your therapist will determine whether there is a deficit in your strength and range of motion for rotational movement.
The results are compared with averages for people of your age, weight, height and gender. Your getback treatment programme will target this normal strength range to promote ongoing spinal health and long term pain reduction.
How does the rotation device strengthen the multifidus?
Weakness in the deep neck multifidus muscles has been shown to cause overactivity and increased fatigability of the more superficial neck muscles. This weakness and resulting pain also causes reduced movement in the neck and increased activity in the torso so we can rotate to see things.
This is common in people working from home who spend a lot of time at their computer with little rotational movement throughout the day, leading to stiffness and weakness of the deep muscles of the neck.
To isolate and strengthen the multifidus in the neck, the cervical/rotation device disengages our torso to ensure the movement is coming only from the neck. The device’s unique design includes chest pads which ensure your upper body is straight throughout the whole movement.
Setting your individual programme on the device
In your Initial Consultation, your therapist will identify the pattern of your pain by collecting a subjective history of your individual pain. You will be asked questions such as: Where is your pain worse? Is your pain constant or intermittent? It is worse when you bend your head forward to look down, or extend your neck backwards to look up?
The therapist will then use the devices to complete an assessment of your deep spinal muscles, collecting data on your strength, range of movement, endurance, control and coordination.
Your responses to the questionnaire and data collected from the assessment allow us to collaboratively make goals – it might be working on your endurance, pain levels, strength, range of motion or a combination of these goals.
The therapist will then create an individual treatment programme for your specific needs – range of motion (how far you turn your head from side to side), load and speed of movement will be tailored to ensure you’re working in a safe and pain-free range on the device.
Initially, the exercise will be gentle – focusing on activating and targeting the multifidus to produce smooth, coordinated movement before gradually increasing the resistance.
Isolating the neck and taking away any contribution from the torso encourages segmental movement of the spine – ensuring that this small, deep muscle located between the vertebrae in your spine is specifically targeted.
The device also collects data regarding your feedback. You will be asked to rate the intensity of the exercise after each set. This feedback allows us to ensure you are working in a safe range before we gradually increase the amount of resistance.
The device also provides feedback to you about how well you performed the exercise within the set parameters.