Mary the “Riveter” is the person chosen for this movement case study project. She is called Mary the “Riveter” because of her former profession as one of the original Rosie the Riveter shipyard welders [for the Richmond California shipyards]. She welded portholes in to the battle ships during the World War II. Mary is eighty-seven years old and a participant of the Eden Medical Center aquatic exercise pool program. She was referred to Eden Medical Center [Outpatient Rehab Facility] two years ago because of a lumbar spine injury. Mary came to the facility unable to stand erect in the frontal-plane postural position. She stated that her injury occurred after picking up and moving a fifty-pound bag of cement.
The paper will discuss Mary’s inability to stand-up straight due to a neurological sciatic nerve root back injury. The paper will briefly convey the mechanism of the injury and how the movement caused the injury. The paper will then talk about; how through an aquatic exercise program, Mary was able to regain her normal erect body alignment [displaying her normal lumbar-curve postural position]. In conclusion, Mary’s case study will convey the outcome of her lumbar spine injury and follow up with recommendation to facilitate improved stability in the injured area.
Mary came to the aquatic exercise program after her prescribed six land physical therapy treatment sessions. She had a noticeable thirty-five degree flexed bend at the hip, when she came to inquire about the aquatic exercise pool program. Now after asking about her noticeable postural position. Mary explained that the injury happen when she bent down to pick-up the bag of cement and moved it. The mechanics of the movement was: narrow base of support, hip flexed [passed 90 degrees], knees fully extended, shoulders reaching downward, elbow extended, and hands grasping the front end of the bag. Mary stated she picked up the bag; in which, she lifted her torso using her lumbar extensor muscles. Mary extended her hips and rotated slightly toward the left; thereby, causing her to pull and strain the musculature tissue surrounding the lumbar vertebra [L4-L5]. Mary immediately felt the spasms of the lumbar musculature begin. The next day; Mary could not fully extend her hips to normalize her lumbar postural curve. Her pelvis was posteriorally tilted and she was visibly flexed at the hips. She also explained the neurological burning pain sensation, which was occurring in her left hamstring musculature.
Mary began participating in the aquatic exercise pool program. She joined the P.A.C.E pool class that was offered at the facility. The acronym letters for P.A.C.E represent-people with arthritis can exercise. A low-level exercise pool program that is designed to improve: balance, stability, flexibility and core strength. After a solid two months in this particular aquatic program class, she displayed tremendous improvement in her lumbar posture. Aquatic therapy is proven to be an excellent low impact activity for individuals of all abilities. The buoyancy of the water acts as support for the spine that may be weakened due to injury or immobilization. The buoyancy of water can also make it possible for people to achieve a position of comfort for exercise not tolerable on land. In Mary’s case, the water reduced the gravitational force to her lumbar spine. The reduction in that force helped Mary perform the exercise activities pain free.
After eight months of participating in the aquatic program, Mary’s lumbar spasticity was eliminated and she no longer displayed any neurological systems that occurred after the injury. Mary was able to regain her flexibility in her hip flexors and lumbar extensor muscles. Last week, Mary was asked to demonstrate a forty five-degree hip flexion movement [starting from a erect standing position]. The movement was performed with: Mary standing with a shoulder width base of support, her arms extended along the side of her body [palms of her hands on her thighs in a neutral position], her head facing forward, her shoulder relaxed in a downward position, her knees were fully extended, and her feet was slightly externally rotated. Mary then performed the movement, in which she: flexed at the hip, her torso breaking the anterior frontal plane, her knee slightly hyper-extending, her head remain in neutral position [looking in the direction of the movement], and with the activation of her lumbar extensor muscles [including her gluteus]. Mary was able to flex forward and fully erect her self with minimal breaks in her form. She also displayed no signs of pain or instability in performing the movement.
In conclusion, Mary came to Eden Medical Center [Outpatient Rehab Facility] with a visible lumbar spine injury. The mechanism of injury proved to have affective her ability to stand in a normal up-right postural position. After joining the aquatic pool program, Mary regained her capability to fully stand erect with her normal lumbar spine in its correct postural position. Now through research and personal experience in the field of rehabilitation for over fifteen years. It is known that, aquatic therapy will: improve muscle tone, strength, balance, endurance, and overall a person quality life. Mary can maintain and increase her chance of living her life actively and independently for the years to come.