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Load question from case study

Exit forum ID Forum Discussion Load question from case study

This topic contains 3 replies, has 4 voices, and was last updated by   William Brady, DC September 13, 2016 at 9:54 am.

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  • #3553

    Andrew Wengert
    Participant

      In the chronic neck and back pain case study at 11:20 into the history, Dr Brady asks if driving is worse than sitting at a desk. I have always treated load from sitting the same as load from driving. Are different structures loaded with each of these activities?

      #3555

      Adam Holen D.C.

        I’ve been wondering this as well especially after this weekend. Is it that people tend to drive more inclined/seat back rather than an upright posture? Loading their discs more posteriorly? Or were you referring to something like constantly rotating their cervical spine to be aware of other traffic? Personally I can’t do longer than a couple hours in a car before I start to ache. What’s loaded differently or improperly with driving vs. how someone might sit at a desk?

        #3557

        Scott King, DC
        Participant

          Dr. Brady may have just been drilling down the specifics to the patient’s provocative activity and the load that it takes to produce a symptom in the initial exam? For ex – continuing to ask the patient throughout care if it is painful when they bend over to tie their shoes isn’t specific to their problem if it only hurts when they load it while bending over to deadlift.

          Aside from the occasional cervical rotation I don’t know if the neck is loaded much differently than sitting at a desk – although poor posture will wreak havoc in either of these settings. There is also the possibility of the contraction of the shoulder muscles (many attach to the cervical spine) while keeping your hands at 10-2, but speaking from personal experience I will often shift from a variety of 1-2 handed driving.

          As for not being able to do more than a couple hours in the car without pain this is the stress fatigue curve in play – sitting for a little while (~20-30 minutes) is okay, but after that point the damage being done is exponentially increased on those discs. Most people don’t sit-side-and lean into their car chair, or desk chair for that matter, and typically lean forward or lean over to the right with one hand on the wheel, so I don’t think that the problem is just that the discs are loaded too posteriorly – it is an array of possibilities in which the disc is loaded improperly and/or for too long.

          #3559

          William Brady, DC
          Participant

            For the cervical spine, disc load with driving is less than with sitting at a desk. Driving requires you to be looking forward while most people at a desk are looking down.

            Not a huge deal though. He mentioned both hurt so I was curious which was worse. Partly (as Scott said above) for pre/post determining progress data points.

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