Flexionsprotokoll

Spinalkanalstenose der LWS

Verengung des Wirbelkanals, die bei LWS-Streckung Schmerzen provoziert.

KLINISCHES BILD

Typische Symptome

Beinschwere beim Gehen
Besserung beim Vornüberbeugen ("Einkaufswagen-Phänomen")

DRINGENDE WARNUNG

Zu vermeidende Bewegungen

✗ Starke Hohlkreuz- und Überstreckbewegungen

💡 PHYSIOTHERAPEUTISCHER PRAXISTIPP

Flexionsübungen wie Knie-zur-Brust erweitern den Spinalkanal spürbar.

STUFENWEISE ABFOLGE

Verschriebenes Übungsprotokoll

6 EXERCISES

Clinical back pain images demonstration - LUMBAR ELONGATION

LUMBAR ELONGATION

🎯 Lower Spine & Lats

Dekompression 2-3 mins • 30s

Kindeshaltung zur LWS-Entlastung

Gentle spine elongation that decompresses lumbar vertebrae and releases tight latissimus dorsi.

T8-T9 T9-T10 Erector Spinae Latissimus Dorsi +1

Clinical back pain images demonstration - SPINAL MOBILIZATION

SPINAL MOBILIZATION

🎯 Facet Joints & Discs

Mobilisation 2 mins • 5s

Katze-Kuh Wirbelsäulen-Mobilisation

Synchronized flexion and extension to lubricate intervertebral discs and restore spine mobility.

C2-C3 C3-C4 Erector Spinae Rectus Abdominis +1

Clinical back pain images demonstration - ANTI-EXTENSION CORE

ANTI-EXTENSION CORE

🎯 Deep Transverse Core

Kräftigung 3 mins • 3s

Deadbug (Anti-Extensions-Coretraining)

Re-trains the deep transverse abdominis to protect the lumbar spine during extremity movement.

L1-L2 L2-L3 Transverse Abdominis Internal Obliques +1

Clinical back pain images demonstration - LUMBAR FACET OPENING

LUMBAR FACET OPENING

🎯 Spinal Canal Foramina

Dekompression 2 mins • 30s

Knie-zur-Brust in Rückenlage

Relieves facet joint irritation and gently stretches the lower back and gluteus maximus in bed or on floor.

L2-L3 L3-L4 Gluteus Maximus Erector Spinae +1

Clinical back pain images demonstration - POSTERIOR PELVIC TILT

POSTERIOR PELVIC TILT

🎯 Core Dissociation

Mobilisation 2 mins • 5s

Beckenkippung in Rückenlage (Pelvic Tilt)

Gentle rocking of the pelvis that frees tight lower lumbar segments and activates the deep transverse core.

L3-L4 L4-L5 Transverse Abdominis Internal Obliques +1

Clinical back pain images demonstration - BILATERAL CANAL WIDENING

BILATERAL CANAL WIDENING

🎯 Stenosis Decompression

Dekompression 2 mins • 30s

Doppeltes Knie-zur-Brust (LWS-Flexion)

Maximum posterior pelvic decompression that widens the spinal canal and relieves lumbar stenosis and facet irritation.

L1-L2 L2-L3 Erector Spinae Gluteus Maximus +1

CLINICAL QUESTIONS & ANSWERS

Häufig gestellte Fragen: Spinalkanalstenose

Q Why does leaning forward on a shopping cart relieve stenosis pain?

Flexing the lumbar spine anteriorly widens the neuroforaminal canals by up to 24%, relieving mechanical compression on passing spinal nerve roots and alleviating leg claudication.

Q Which exercises are dangerous for lumbar spinal stenosis?

Backward bending (extension), prone press-ups, and prone cobras narrow the spinal canal and should be avoided in favor of flexion-biased decompression routines.

WISSENSCHAFTLICHE LITERATUR

Peer-Review Evidenz & Leitlinien

•
"Comparison of Flexion-Biased Physical Therapy vs. Standard Care in Lumbar Spinal Stenosis" — JOSPT (2023).